Essential for Living: A Journey to Life Skills PDF

Essential for Living: A Journey to Life Skills Patrick McGreevy and Troy Fry Essential for Living was born from a desire to provide children and adults with moderate-to-severe disabilities, including but not limited to autism, a comprehensive lif...

Essential for Living: A Journey to Life Skills Patrick McGreevy and Troy Fry Essential for Living was born from a desire to provide children and adults with moderate-to-severe disabilities, including but not limited to autism, a comprehensive life skills curriculum with social validity, along with evidence-based teaching and measurement strategies and procedures, that result in the dignity and quality of life these children and adults deserve The idea for a new curriculum and teaching handbook for children and adults with moderate-to-severe disabilities first emerged in 2004 from conversations between Patrick McGreevy and Troy Fry, the authors of this paper and the eventual authors of Essential for Living. We had spent many years working with these children and adults, especially those with limited skill repertoires and severe problem behavior. Some of these conversations recounted our earlier experiences with non-verbal learners, who, when we first encountered them, did not have an effective alternative method of speaking and, as a result, could not ‘get their wants and needs met’. We recounted our experiences with functional assessment and functional communication training [FCT] (Carr & Durand, 1985). Along with many of our colleagues, we provided some of these learners with a functional assessment and a replacement behavior, permitting them to request one of the following: ‘attention’ by tapping someone’s arm, ‘a break from demands’ by making a gesture or presenting a card, or ‘something to eat’, ‘something to drink', or ‘something with which to play’ by making a gesture or a generalized sign like ‘more’. Even when one of these behaviors replaced the problem behaviors, additional speaking and listening skills often became more difficult to teach, and a ‘speaking repertoire’ of ‘requests for specific wants and needs’ was seldom encouraged and seldom emerged. With other children and adults we provided only procedures designed to reduce the occurrence of problem behavior or protect them from the outcomes of the same. Many of these same conversations recounted our later experiences applying B. F. Skinner’s analysis of language, known as ‘verbal behavior’ (Sundberg & Partington, 1998; Carbone, 2000-2019; Sundberg & Michael, 2001) with minimally-verbal and non-verbal children and adults, but especially those without an effective method of speaking. Along with some of our colleagues, we provided an effective method of speaking for each of these learners and began to build ‘speaking repertoires’ for them which included ‘requests for specific wants and needs’. Some of these learners with echoic responses were taught to use spoken words, while others were taught to ‘speak’ by forming standard, adapted, tactile, or idiosyncratic signs, exchanging or pointing to pictures or digital images, or selecting objects or words spoken by others. Thanks to B. F. Skinner’s analysis, along with that of Barry Lowenkron (1991, 2006), we were also able to efficiently teach some of these learners forms of listener responding not previously available to them. In 1999 and 2000, many behavior analysts and therapists were beginning to apply ‘verbal behavior’, but almost exclusively with children with autism. They were teaching developmentally-sequenced skills, at first from The Assessment of Basic Language and Learning Skills [the ABLLS] (Partington & Sundberg, 1998), and a few years later from The Verbal Behavior Milestones Assessment and Placement Program [the VB-MAPP] (Sundberg, 2008). These instruments were composed of skills acquired by typically-developing children from 1-4 years of age and were designed to help young children with autism ‘catch up’ to these peers. Many older children with autism were being taught these same skills, but were ‘not catching up’. These children were experiencing barriers to the acquisition of language and pre-academic skills that, even with very high quality instruction, were essentially insurmountable. With no obvious curricular alternative, instruction often continued with these same skills with little of no improvement. Meanwhile, children and adults with other moderate-to-severe disabilities were largely not benefitting from Skinner’s analysis, that is, they were seldom provided with effective methods of speaking and educators and therapists seldom built ‘speaking repertoires’ for them. And so, in 2006 we began a journey that, in 2013, would result in Essential for Living. It was a journey that began tentatively as Language for Living, a curriculum and teaching handbook designed to bring a method of speaking and ‘verbal behavior’ as a speaker and a listener to ‘older minimally verbal and non-verbal children and adults with autism’, along with ‘children and adults with all other moderate-to-severe disabilities’. During this journey, it became increasingly obvious to us that, in many states, the Common Core State Standards, along with full inclusion, were having a direct, negative impact on the education of these children. They were being ‘exposed’ to academic lessons with limited to no pragmatic value, along abstract concepts and conditional discriminations with which they would struggle mightily. As a result, daily living skills, including leisure and vocational skills, along with tolerating skills, became part of our agenda and Language for Living became Essential for Living. We invite you to join us as the Essential for Living journey to life skills continues. Patrick McGreevy and Troy Fry Essential for Living (McGreevy, Fry, & Cornwall, 2012, 2014) is a curriculum-based assessment instrument, EFL is a that is, a criterion-referenced assessment instrument that is also a curriculum. These instruments have an curriculum-based assessment extensive history in special education, early intervention, and transition services for children and young instrument, i.e., adults with learning or developmental disabilities (Gickling & Thompson, 1985; Tucker, 1985; Deno, 1989; an assessment Shinn, 1989; Bagnato, 1997). These instruments are referenced against specific curricula and are used to instrument that is inform and implement IEPs, ISPs, program plans, intervention plans, and behavior improvement plans. also a curriculum Essential for Living (EFL) is a functional, life skills curriculum-based assessment instrument designed for child- EFL is referenced ren and adults with moderate-to-severe disabilities, including but not limited to autism, who exhibit limited against safety and high quality partici- skill repertoires and problem behavior. EFL is referenced against criteria, in the form of specific skills within pation in family, the instrument, that are necessary for safe, effective, and high-quality participation in family, school, and school, & commun- community living, and which are reasonable and appropriate expectations of instruction. ity living Some curriculum-based assessment instruments (CBAs) are also ‘referenced against’ age criteria associ- Some develop- ated with typical child development or typical language development and include language skills, social mental CBAs are referenced skills, and milestones that are acquired by typically-developing children between the ages of one and against typical four. These developmental instruments include The Verbal Behavior Milestones Assessment and Placement child or language Program [VB-MAPP, 2nd. Ed.] (Sundberg, 2008), The Assessment of Basic Language and Learning Skills development and [ABLLS-R] (Partington, 2010), and The Early Start Denver Model [ESDM] (Rogers & Dawson, 2010). These are designed for young children instruments, ‘with these references’, are designed only for young children with autism or language delays with autism who for whom expectations of ‘catching up’ to their typically-developing peers and acquiring pre-academic might catch up to and academic skills are both reasonable and appropriate. their peers The majority of children with autism and many children with language delays, even after intensive inter- Many children vention, continue to have difficulty acquiring abstract concepts, complex [conditional] discriminations, with autism will encounter and meaningful answers to questions [intraverbal responses]. These children seldom experience general- barriers and will ization [stimulus generalization], bursts of language [behavioral cusps], or the ‘emergence’ of new skills not be able to without instruction [response generalization, generative learning, or derived relations]. Even with high- acquire quality instruction, these difficulties will often continue to function as barriers to the acquisition of additional additional language skills language skills, along with pre-academic and academic skills. For these children, expectations that along with pre- include ‘catching up’ to their typically-developing peers will no longer be reasonable. Instead, expec- academic and tations consistent with safe, effective, and high-quality participation in family, school, and community academic skills; living should be considered and ‘life skills’ and Essential for Living should guide further instruction. This EFL, rather than change in expectations will be difficult for the parents of many of these children and will necessitate a developmental instrument, thoughtful discussions over time. But these discussions must occur or ‘ignorance will become our curri- should guide culum’ (D’Amelio, 1971) and what we have not considered, we will be unlikely to change (Sagan, 1980). instruction Many children with named developmental disabilities, like Down syndrome, Tay Sachs syndrome, Angel- Many children man syndrome, or Microcephaly, and unnamed pervasive, intellectual or developmental disabilities also with other named and unnamed experience the difficulties previously described. In recent years, some of these children have also been disabilities will ‘diagnosed’ with [i.e., categorized as having] autism. Regardless of age or history of instruction, neither encounter these curricular references to typical development nor expectations for these children that include ‘catching same barriers; up’ to their typically-developing peers are reasonable or appropriate. Expectations consistent with safe, EFL, rather than a developmental effective, and high-quality participation in family, school, and community living should be embraced, and CBA, should also ‘life skills’ and Essential for Living should guide instruction and habilitation. guide instruction Essential for Living includes over three thousand skills sorted into domains on communication, language, EFL includes over daily living, social, functional academic, and tolerating skills, along with a domain on severe problem 3000 skills sequenced from behavior, which encompass the core components of autism and many other developmental disabilities. must-have to Skills within these domains are sequenced from must-have, to should-have, to good-to-have, to nice-to- should-have to have, ‘referenced against’ safe, effective, and high-quality participation in family, school, and community good-to-have to living. The must-have skills are also called the Essential Eight: nice-to-have; the must-have skills 1- Making requests for access to highly preferred items and activities are also called the and for the removal or reduction in intensity of specific situations, Essential Eight 2- Waiting after making requests, 3- Accepting removals — the removal of preferred items and activities, making transitions, sharing, & taking turns, 4- Completing brief, previously acquired tasks, 5- Accepting ‘No’, 6- Following directions related to health and safety, 7- Completing daily living skills related to health and safety, and 8- Tolerating situations related to health and safety. Skills within Essential for Living do not require response generalization or derived relations for children or EFL skills do not adults to achieve safe, effective, and high-quality participation in family, school, and community living. In require general- ization to be func- addition, skills within Essential for Living often inform the appropriate setting for instruction, by specifying the tional and often context in which these skills will be required in everyday living. suggest the setting for instruction Unlike other life skills curricula (cf. Killion, 2003 [The Functional Independence Skills Handbook — FISH]; EFL emphasizes pragmatic language Partington & Mueller, 2012 [The Assessment of Functional Living Skills — AFLS]), Essential for Living empha- skills and helps users sizes communication and pragmatic language skills and is especially designed for learners with limited or determine when an no spoken-word repertoires. A substantial portion of the instrument is devoted to helping users determine if alternative method of a non-verbal or minimally-verbal child or an adult needs an alternative method of speaking, which meth- speaking is needed and how to select a ods would be consistent with his current sensory, skill, and behavioral repertoires, which methods would be method that meets Continuously Available to him, which methods would permit him to Frequently and Effortlessly ‘say’ what the CAFE criteria & is he wants and needs to say (CAFE), and which methods would be more likely than others to last a lifetime. likely to last a lifetime Essential for Living emphasizes interactions and discriminations that tend to occur in concrete situations. EFL emphasizes con- crete situations in Many children and adults with moderate-to-severe disabilities can learn to perform specific skills in these which learners can situations fluently, even beyond performance levels typically exhibited by persons without disabilities perform skills fluently, (Lindsley, 1964; Sacks, 1970, 1985; Gold, 1978; Barrett, 1979). often beyond typical performance levels IDEA [the Individuals with Disabilities Education Act] requires that students with disabilities who have reach- EFL can be used to ed the age of 16 are required to have a formal transition plan. For students with moderate-to-severe develop effective transition plans that disabilities whose previous IEPs have been largely guided by the Common Core State Standards, Essential include functional, for Living can easily be used to develop functional, life skills transition plans. life skills Essential for Living is the only life skills curriculum that is based on B. F. Skinner’s analysis of the function of EFL is the only life language as a speaker and a listener [verbal behavior] (Skinner, 1957; Catania, 1998; Michael, 2004; skills curriculum based on B. F. Sundberg, 2007; Greer & Ross, 2007), along with the pragmatic implications of this analysis for language Skinner’s analysis intervention with children and adults with limited repertoires (Sundberg & Partington, 1998; Sundberg & of language as a Michael, 2001; Greer & Ross, 2007; McGreevy, 2009). In the context of this analysis, Essential for Living is also speaker and a the only life skills curriculum based on the radical behaviorism of Skinner (Skinner, 1974), specifically listener and his formulation of radical addressing private events, that is, thoughts, feelings, and sensations, and how you might teach functional behaviorism, which verbal responses when these events occur or compensate for the lack thereof. An understanding and includes private implementation of Essential for Living, however, requires neither prior knowledge of these elements, nor events (sensations, previous experience with their application. thoughts, & feelings) Essential for Living is also the only life skills curriculum that suggests the virtually effortless collection of first- EFL is the only curri- opportunity, test-trial, probe data that are not averaged across subsequent teaching trials and permit the culum that measures small increments of recording of small increments of learner progress over time from problem behavior in the context of skill progress, each indi- acquisition — to prompts and prompt-fading — to fluency — to generalization across settings and people cating a quality of life —to maintenance over time. Each of the boxes used to record learner progress represents a noticeable improvement improvement in their quality of life. And, Essential for Living is the only life skills curriculum that includes a range of skills and skill repertoires EFL is the only specifically for children and adults with severe, multiple disabilities, medically fragile or terminal conditions, curriculum with skills for children & or severe aggressive and self-injurious behavior. And, with these skills or skill repertoires, the function (what adults with severe it accomplishes for the learner) always outweighs the form. Always. Essential for Living is also the only life disabilities & severe skills curriculum that encourages users to fade prompts, unnecessary supports, and continuous forms of problem behavior reinforcement that do not typically occur in everyday interactions and do not result in skills that are performed as independently as possible. Many skills within Essential for Living are required in frequently-occurring, everyday situations. Hence, with The skills in EFL have respect to their importance as instructional goals, these skills have social validity (Wolf, 1976; Kazdin, 1977; social validity, the teaching procedures Wolf, 1978). Empirically-validated teaching procedures that are part of Essential for Living, along with the are evidence- based, measurement of fluency and generalization across people and settings as outcomes of instruction, also & measurement address this important issue and continue to ‘help behavior analysis and special education find their includes fluency & heart’ (Wolf, 1978). generalization Essential for Living encourages users, who record the occurrence of problem behavior, to display these EFL encourages data on an adaptation (McGreevy, 2012, in press) of the Standard Celeration Chart (Haughton & Lindsley, standard behavior measurement & the 1968), which insures an interpretation that is not influenced by the dimensions of the display itself. Essential Adapted Standard for Living also permits, in tabular format, the measurement of problem behavior and the supports these Celeration Chart behaviors require over months and years. Essential for Living is used in public school classrooms. The communication, language, and functional aca- EFL is used in public demic skills of Essential for Living are linked to the Common Core State Standards, permitting the develop- school classrooms, private centers, ment of IEP objectives that are functional and individualized, and yet, to some degree, related to these along with day standards. Essential for Living is also used in private schools, centers for children with autism, day activity activity, vocational, and vocational setting, residential settings, and hospital settings for those children and adults with medi- residential, and cally fragile conditions or severe aggressive or self-injurious behavior. hospital settings.  References Bagnato, S. J., Neisworth, J. T., & Munson, S. M. 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