Author: haringcomms

“Imagine you’re a parent, and you receive a diagnosis that your child has an intellectual or developmental disability,” says Haring Center researcher and Behavior Analyst Katy Bateman (PhD ‘17). “But, due to a variety of factors, you are unable to access services and support.”

Applied Behavior Analysis (ABA) therapy, a component of early intervention for autism, aims to improve quality of life by focusing on changing human behavior in socially significant ways. With an autism diagnosis, families can access ABA services, but the number of providers in Washington falls far short of the actual need. Ultimately, families find themselves without services despite hearing the importance of these services early in their child’s development.

This need intensifies for children with other intellectual and developmental disabilities. Without an autism diagnosis, insurance providers are not mandated to cover ABA services. “We know from research that the strategies used in ABA are effective for a wide range of children diagnosed with different disabilities and disorders,” explains Bateman. “Families in Washington are currently unable to access meaningful services that will increase quality of life, and that is a huge issue. These families deserve better.”

According to Bateman, the earlier a child begins ABA therapy, the more substantial effects they experience. Through a new research grant, she is seeking to increase access to these services across Washington state.

Starting in May 2020, Bateman will lead a project funded by the Arc of Washington Trust Fund that uses an innovative online service delivery model to provide ABA coaching to parents of children with intellectual and developmental disabilities.

“There are so many barriers to accessing early intervention for children with disabilities,” says Bateman. “Service provider waitlists, transportation, childcare — the list goes on. Parents often serve as the case manager for their child, navigating a world of individual service providers. Our system is complicated, and families should not have to jump through so many hoops to access these beneficial services.”

“It is hard for me to think that we have effective interventions for children with intellectual and developmental disabilities, but not all families who would benefit can access them,” she continues. “So, I decided to find a way to provide these services online.”

Project ECHO (Extension of Community Healthcare Outcomes) is a case-based online service delivery model that builds expertise among participants. For this project, an expert panel will join parents of children with disabilities across 16 weeks to engage in collaborative problem solving and instruction on ABA principles.

“Project ECHO is based on the idea of ensuring the right knowledge is in the right place at the right time,” says Bateman. The model’s founder describes it as a “force multiplier,” as the problem solving and expertise applied to each case presented during an ECHO videoconference can apply to many other cases.

Initially launched in the medical field to increase patient access to healthcare, Project ECHO began connecting expert specialists with primary care clinicians. The model has since expanded: “Today ECHO models are successfully running across the world to serve populations affected by a disability or disorder,” says Bateman.

A defining feature of Project ECHO is the expert panel’s interdisciplinary nature. This project’s panel will consist of Bateman, Haring Center Director Ilene Schwartz and Haring Center Fellow Elizabeth Kelly as behavior analysts, a special education teacher and a parent of a child with Down syndrome.

“Project ECHO is case-based, so parents will present real-life situations they have found challenging at home, and the parents and panel will work together to provide interdisciplinary recommendations and suggestions,” says Bateman. “This design creates learning loops as we problem solve together.”

The intervention will begin in May, and the panel will spend 16 weeks working with the parents around principles of ABA. “We focus on parents, because they are the daily implementers,” explains Bateman. “Parents are key stakeholders in the success of the intervention.”

“Parents will learn basic principles of ABA so they can understand why behavior occurs, strategies to prevent challenging behaviors and how to respond to these behaviors when they do occur,” says Bateman.

Bateman says the desired project outcomes for parents include increased knowledge and implementation of ABA strategies, decreased challenging behaviors at home, and increased parenting confidence and competence.

The community aspect of the Project ECHO model is also central for Bateman.

“The goal of this project is to increase quality of life for families with children with disabilities, and part of that is providing parents with a community of support,” she says. “Through this intervention we are creating a community for parents of children with intellectual and developmental disabilities to know they are not alone.”

Parents of children with disabilities often experience high stress levels, and this project seeks to change that. “These parents are up against many of the same barriers,” says Bateman. “We want to foster relationships so after the 16 weeks, parents will be part of a social network of others and can navigate the future together.”

Bateman explains that families unable to access early intervention often report feelings of isolation. “I was asked recently why I want to carry out this project,” she says. “The answer is that I want families to know it is going to be OK, and that they have a group of people to support them.”

“An international exchange around inclusive education is an opportunity to network with other professionals, listen to stories from parents of children with special needs, learn from struggles and successes and share our passion,” says Pamela Matamoros, a Honduran entrepreneur and founder and director of Centro Psicopedagógico Eduktiva.

In October 2018, Matamoros spent four weeks at the Haring Center as part of the U.S. Department of State’s Young Leaders of the Americas Initiative (YLAI). Matamoros applied for the YLAI Fellowship to expand her knowledge of inclusive education and grow Eduktiva to support more children.

“Pamela taught us what can be done when one person is committed to a vision for improving the lives of others,” says Haring Center Director Ilene Schwartz. “It was a true exchange — Pamela learned from our curriculum, research and training resources; we learned from her experience creating a community, building schools and providing education to children who had previously been excluded from the Honduran education system.”

This year, Matamoros received an additional award through YLAI for a reverse exchange to host a Haring Center staff member in Honduras. Erin Greager, Positive Behavior Interventions and Supports team coordinator and Project DATA coach at the Haring Center, spent a week in San Pedro Sula and Tegucigalpa (Honduras’ largest two cities) in November 2019 fulfilling the exchange.

Over the course of the week, Greager facilitated two days of training in each city and toured Eduktiva, an autism center and three other schools.

“We had to cap attendance at both trainings,” says Greager. “The number of people who showed up was really telling of how excited people are to create more inclusion opportunities for children in Honduras.”

Greager covered topics including Project DATA, positive behavior support, preventing and responding to challenging behavior and inclusive teaching practices. A broad spectrum of audience members turned out for Greager’s training: “We had people working in special education, program directors, school principals, psychologists, general education teachers, a speech-language pathologist, a BCBA and even families.”

At Eduktiva, Greager observed after-school tutoring sessions and she and Matamoros discussed different teaching strategies during a feedback session. “Many of Eduktiva’s clients have an identified disability or delay, and the tutoring program provides the necessary extra support,” explains Greager.

The autism center, Centro Inclusivo LUDCA, serves children in both short-term and long-term capacities. Children attend the center if they exhibit challenging behaviors or require extra academic support that their school cannot provide.

Greager toured three schools during the week: an urban public school serving predominantly children from low-income families, an early childhood center and a smaller private school.

She notes that while the variety of services and specialists available was less than in U.S. schools, she expected there to be more differences between the approach to inclusion in Honduran and U.S. education systems.

“We discussed the need to educate families and worked on that goal,” Greager said. “I had some great conversations with families about how to advocate for their children and how to ensure their children are receiving the services they need.”

Greager found that on the whole, the Honduran education system faces similar challenges to inclusion. “It may be a different scale and a different context, but we see the same barriers — and the same drive,” she says.

“Similar to in the U.S., inclusive practices in Honduran public schools lag behind what the research tells us,” says Greager. “People want to provide inclusive settings at school, but in both countries, we run into a lack of resources in every area: training, staff and money.”

“There is fear that communities will not be open to inclusive education, and educators will get pushback from people,” she explains.

Audiences at Greager’s trainings sought discussion around implementing inclusive practices with limited resources. “People generally had strong knowledge of inclusive practices,” says Greager. “They wanted to do more problem-solving and hear about the Haring Center’s approach.”

“We are doing our best with the resources we have,” says Matamoros. “But regardless of the resources, the passion of educators and community members is the most important component to creating a true inclusive environment.”

“Pamela has been finding different avenues to educate her community around inclusion,” says Greager. “Much of her work involves networking and bringing education to current teachers about inclusion and working with children with special needs.

“It was so helpful to see the strategies and tools we use at the Haring Center applied in different settings. Observing Pamela and others working toward inclusive education in Honduras in a space with different cultural norms and educational politics was invaluable.”

Greager says that she felt connected to people across countries and cultures, meeting her training audiences and touring schools and centers in Honduras. “Children are children. As teachers, we encounter so much of the same.”

“Every person deserves to be valued as a true part of our community,” she continues. “The more we can provide teachers with resources to make that happen, the better.”

Greager and Matamoros intend to continue building their partnership. They are currently planning a web training as a follow-up to the sessions Greager facilitated, in addition to another in-person workshop in Honduras which Matamoros will lead.

“There is a lot we can share with other countries, but also a lot we gain in those conversations,” says Greager of this type of partnership. “We have strategies for inclusion here, but there are more things to try and to discover. Through creating partnerships with people in other countries, we advance the inclusive education field as a whole.”

“Early childhood education is the foundation for future success,” says Haring Center researcher and Associate Professor Angel Fettig. “Early childhood is a critical time, and we need quality people in higher education institutions to advance this field and prepare future educators.”

With a new collaborative grant from the U.S. Department of Education, the Haring Center has a new opportunity to shape the future of the early childhood education field.

The University of Washington will join nine other elite institutions of higher education to form the Early Childhood Doctoral Leadership Consortium (ECLC), which will prepare 28 doctoral students to become leaders in early intervention, early childhood special education and related fields.

“Through the support of this grant, a select number of incoming UW graduate students in special education will receive a fellowship for four years of full-time graduate study beginning in Autumn 2020,” says Kathleen Artman Meeker, the Haring Center’s director of research and associate professor for the College of Education. She joins Fettig and Assistant Professor Maggie Beneke on the consortium’s core faculty recognized as outstanding leaders in the field of early childhood special education.

The consortium’s goal is “to develop leaders who will serve as faculty in early childhood intervention with knowledge and skills about infants and young children with high, intensive, interdisciplinary and individualized learning needs.” The U.S. Department of Education reports on the increasing number of children eligible for early childhood intervention services nationwide, and references both personnel shortages and the need for improved quality and effectiveness of the early childhood intervention workforce, resulting in the need for leadership training programs such as ECLC.

According to Fettig, the early childhood field has a documented shortage of doctoral students pursuing higher education. “It is truly valuable to further develop this field to ensure we highlight the importance of early childhood education,” says Fettig.

“We’re not just talking about children when we’re talking about early childhood,” adds Artman Meeker. “We’re talking about children, families, communities and all of the different places where young children and their families are.”

Students will fulfill all doctoral program requirements from their respective universities, in addition to participating in monthly webinars, summer intensive seminars, advanced methodological training and opportunities to build advocacy, public policy and teaching skills. Through these activities, students will be able to collaborate with faculty and students across the ECLC to develop research projects, learn research approaches and build professional networks.

Faculty will also take part in ECLC’s collaborative component. Fettig says, “Faculty have differing opinions regarding how to best train doctoral students, and this is really a strength of this consortium.” Artman Meeker noted the collaborations that will arise among faculty for future research projects.

In addition to the expanded learning opportunities from other elite universities and expert faculty, Artman Meeker noted the chance to share the Haring Center’s leadership and success: “Twenty-eight doctoral students can learn from the Haring Center about advocacy, policy and adult learning. We can show this model of research and practice partnerships with professional development that touch many different points in the system.”

“There is a lot of overlapping momentum to bring faculty and students across the ten universities together, and any time that happens, really good things come from it,” says Artman Meeker.

The ECLC is by nature interdisciplinary, inviting students with experience as early interventionists, preschool teachers, occupational therapists, speech-language pathologists and more. Artman Meeker identified this as an opportunity for peer learning and networking to expand the status quo.

“This project recognizes different ways of knowing and different experiences with children,” she says. “These are the people who will advance what comes next in the early childhood arena, and it cannot be people all from the same background. This consortium allows us to create a network of different people that can push on the way we do things and expand the field.”

“At the end of the consortium, we want students to feel prepared with their strong training in teaching, their strong training in research and their understanding of our field’s needs,” says Fettig. She explains that the impact will continue as the doctoral students enter higher education, and onto future teachers and teacher educators trained by this consortium’s students. These doctoral students will also be the researchers advancing rigorous, high-quality science and evidence-based practices in early childhood education, says Fettig.

Artman Meeker noted the complexities of the early childhood education field—and how these complexities indicate significant potential. “This consortium gives us the opportunity to recruit the leaders of tomorrow who will advance the Haring Center’s vision of a world where all children learn, play and grow together,” she says. “It recognizes what we already do well and provides opportunities to expand on it.”