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Report of the Indiana Department of Education, Center for by omf20943

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									                          Report of the
 Indiana Department of Education, Center for Exceptional Learner’s
            Task Force on Autism Spectrum Disorders

                              May 2008

                              Authors:

       Louise G. Lord Nelson, Naomi Swiezy and Gary Collings

                          Contributions by:

            Kylee Bassett, Liz Freeman Floyd, Leah Nellis,
Susan Pieples, Cathy Pratt, Lilia Tenity, Ann Schnepf and Sheila Wolfe
                                                                                                                                       2


                                      Report of the
             Indiana Department of Education, Center for Exceptional Learners
                        Task Force on Autism Spectrum Disorders

                                               TABLE OF CONTENTS

Abstract.............................................................................................................................. 3
Executive Summary .......................................................................................................... 9
Introduction ..................................................................................................................... 10
   Impetus ......................................................................................................................... 11
   Overall goal .................................................................................................................. 12
   Strategies ...................................................................................................................... 13
Tasks and Actions ........................................................................................................... 15
   Results........................................................................................................................... 15
       Principle 1: Policy .................................................................................................... 20
       Principle 2: Service Provision ................................................................................. 27
       Principle 3: Training ............................................................................................... 33
       Principle 4: System Collaboration........................................................................... 38
Direct Outcomes and Recommendations ...................................................................... 38
   Direct Outcomes ........................................................................................................... 40
   Recommendations ........................................................................................................ 41
       Policy ........................................................................................................................ 41
       Service provision ...................................................................................................... 42
       Training .................................................................................................................... 44
       Systems collaboration .............................................................................................. 46
Conclusion ....................................................................................................................... 46
References ........................................................................................................................ 47
Appendix I: Charter Document ....................................................................................... 49
Appendix II: Task Force Members ................................................................................. 50
Appendix III: A Summary of State Reports .....................Error! Bookmark not defined.
Appendix IV: Listing of Presenters ................................................................................. 56
                                                                                         3


                                          Abstract

   Indiana’s Task Force on Autism Spectrum Disabilities was convened in January 2006

by the Indiana Department of Education, Center for Exceptional Learners. The task force

was to focus on the creation of minimum guidelines for training individuals in the

educational setting, guidelines for collaboration within the educational settings,

recommendations for bridging services across academic, medical and home

environments, and a collection of information to inform policy making within the

legislature for these and other issues.

   To meet these expectations, the task force investigated services to children on the

spectrum and their families through a review of survey reports, the invitation of speakers

from service agencies and state agencies, and a review of service methods utilized across

the United States. Recommendations to improve services to children (Birth through 22)

and their families were separated into the four categories of: (a) policy, (b) service

provision, (c) training, and (d) system collaboration, bridging and partnership.

                                              .
                                                                                            4


                                  Executive Summary

       In January 2006, the Assistant Superintendent of Exceptional Learners at the

Department of Education, Robert Marra, Ed.D., convened a group of stakeholders from

Indiana to help address four issues related to autism spectrum disorders:

           1. The development of minimum guidelines for training required for

               individuals working in an educational placement with these children.

           2. The recommendation of guidelines for collaboration between disciplines

               working in the educational placement (i.e., inclusive of special educator,

               instructional assistant, general educator, administrator, resource

               therapists).

           3. The provision of recommendations for bridging service to the child across

               caregivers in the academic, medical, and home environments (inclusive of

               primary caregivers and other family members).

           4. The compilation of information to help inform policy making in the

               legislature surrounding these and other issues.

       The task force was comprised of fifteen stakeholders. These individuals

represented parents, self-advocates, psychology, education, pediatrics, Indiana’s

University Center of Excellence, directors of special education, the Autism Society of

Indiana, the Arc of Indiana, and other state agencies. A charter document was utilized to

focus the group’s efforts over the next twenty-four months. A review of task force

recommendations across the county was constructed, informal feedback from consumers

across home community and educational and medical systems was collected, and invited

speakers presented specific topics related to the autism community.
                                                                                           5

       The principles which guided the group’s outcomes and recommendations were

policy, service provision, training and system collaboration. Direct outcomes included:

supporting the development of Indiana’s Comprehensive State Plan to Guide Services to

Individuals with Autism Spectrum Disorders and the coordination of a symposium for

college and university trainers to address the training needs of pre-service and current

educators in the area of ASD. The recommendations the task force offered for the

Department of Education’s review were as follows:

Policy –

       The Center for Exceptional Learners at the Department of Education create and

       oversee the implementation of statewide trainings for educators and parents in the

       spirit of and changes to Article 7, Indiana’s Special Education law.

       The Department of Education join in partnership with The Department of

       Homeland Security on school safety training. It is recommended that this

       collaborative effort utilize Dennis Debbaudt’s expertise in this area. This action is

       supported by Indiana’s Legislative Commission on Autism.

       The competencies developed by The National Council for Accreditation of

       Teacher Education and the Council for Exceptional Learners be infused into the

       teacher standards set by the Division of Educational Licensing and Development.

       The Center for Exceptional Learners become an active participant in the

       interagency council established through Indiana’s Comprehensive State Plan to

       Guide Services to Individuals with Autism Spectrum Disorders.

Service Provision –
                                                                                             6

       Investigate more closely the concept of the Medical Home (creating a centralized,

       web-based location for patient information that is controlled by the family and

       invited members can share information about the client’s services and supports) to

       see if it is applicable to services in Indiana.

       Facilitate the development of standards, guidelines and specific plans that lay out

       proactive services for children and families throughout all service arenas.

       Move beyond the reported barriers to quality service provision in rural areas of

       the state.

Training –

       Pre-service teachers must:

             o   have opportunities to experience working with children who have special

                 needs, specifically ASD.

             o receive guidance and mentoring in how to teach children with ASD.

             o be assessed more effectively in relation to their ability to work with

                 students who have disabilities. Current exam methods (the use of PRAXIS

                 I and PRAXIS II) do not require pre-service teachers to have any

                 demonstrated skills or knowledge on how to best instruct children with

                 disabilities.

       Pre-service teachers, current teachers, administration and others in the educational

       setting must:

             o have consistent training on meeting the needs of children with ASD. The

                 training must include shadowing and mentoring.
                                                                                     7

   o receive training in how to effectively collect and utilize behavioral and

       educational data.

   o receive training in how to create a climate that is collaborative, proactive,

       and supports the specific behavioral and curricular needs demonstrated by

       children with ASD.

   o receive training on social communication skills which are focused on

       enhancing the pragmatic language of children with ASD.

   o receive training which includes information related to Indiana and Federal

       laws and guidelines which define the specific areas of training due to

       accountability and focus related to these defined areas.

   o participate in ongoing evaluation and accountability to demonstrate the

       skills and knowledge discussed above.

The particular training needs of various individuals in these settings should be

developed and outlined based on particular roles and interactions with the

children.

   o Vocational Rehabilitation counselors must have specific training on the

       unique gifts and needs of adolescents and adults with ASD to best

       facilitate the transition and success in VR.

   o School psychologists must receive hands-on training on how to more

       accurately assess children with ASD. The traditional methods utilized

       (I.Q. tests, etc) are not effective our appropriate tools to use.

   o Educational personnel, beyond classroom teachers, need to receive

       practical and hands-on/mentored training on how to effectively work with
                                                                                         8

               students who have ASD. This includes paraprofessionals, support staff,

               bus drivers, lunch room monitors, and others who have meaningful contact

               with the students.

           o Parents can provide a unique insight and should be included in trainings.

           o School Safety Officers must have training specific to the needs of children

               with ASD.

           o Medical professional training must include knowledge of a variety of

               methods inclusive of evidence-based strategies as well as an

               understanding of such issues as sensory processing differences,

               gastrointestinal issues, and immune system deficiencies.

Systems Collaboration –

       Partner with other entities to provide seamless services (education, family and

       social services administration, medical community).

       Develop a systems of care (SOC) concept similar to that in the mental health

       community in the medical and social services areas.

       Create a plan to establish a collaborative system inclluding the Department of

       Education, Vocational Rehabilitation, the Department of Mental Health, Family

       and Social Services Administration, the Department of Corrections and other

       relevant entities.

       Develop a communication system that includes dissemination processes to

       include rural areas, general educators and special services.

       Create a support network for this communication system.

       Utilize teaming to emphasize consistent and proactive practices.
                                                                                     9

Emphasize the consistency of information shared across and within school

districts.

Emphasize the provision of information to a wider network of personnel within

schools, families, practitioners, and others within the child’s system of care.

Continue the expansion of established state and university level partnerships

throughout the state.

Foster professional collaborative relationships that support the crisis and mental

health needs faced by families of children with ASD.

Build these collaborative relationships through ongoing training and professional

development opportunities.

Assure that all training and professional development reflect collaborative efforts

between medical, educational, home and community systems.

Support shared capacity at a local level in recognition of such realities as staff

turnover rates and limited resources.
                                                                                          10


                                       Introduction

        The following report provides an overview of the work completed by the Indiana

Department of Education’s Center for Exceptional Learners (CEL) (formerly the Division

of Exceptional Learners) Task Force on Autism Spectrum Disorders (ASD). This Task

Force was convened by CEL in January 2006 and completed its work in December 2007

based on CEL’s response to the rising number of students diagnosed with ASD and their

specific needs within the educational setting. The Task Force was also designed to be

proactive through relationship development, information sharing, and the establishment

of individual, agency, university and medical partnerships.

        The Task Force played an important role in initiatives and activities of the CEL as

related to individuals with ASD as well as in shaping current and future policies. Its

actions were guided by a defined impetus, an overall goal, and specific strategies which

are listed below. The section that follows is organized by the four guiding principles.

Each incorporates an overview of the topics presented and discussed. Direct outcomes

and recommendations by the Task Force are included at the end of the document.

Impetus

    The Task Force was guided by specific recognition and request from the Director of

the Department of Education’s Center for Exceptional Learners. The DOE determined

that it wanted to:

    1) be proactive (i.e., as opposed to reactive) regarding issues surrounding service to

        children with an Autism Spectrum Disorder and their families through the special

        education system.
                                                                                        11

   2) increase collaboration with appropriate State entities, parents, family groups and

       advocacy groups to increase the awareness as well as effective and efficient

       utilization of community services for children with Autism Spectrum Disorders

       that will improve the overall education, development, and success of these

       children in the community.

   3) provide guidance to the Directors of Special Education regarding the range of

       community service options for children with Autism.

   4) support the need for standards regarding the training to and services from staff in

       the special education setting.

   5) pool knowledge and expertise to make informed policy recommendations and

       platforms based on the increased legislative attention on policy decisions

       influencing the service to children across the Autism Spectrum in the public

       schools.

   6) bridge all areas of services related to the education and development of the

       individual with ASD in an effort to service the whole child.

   7) derive input and recommendations from the Autism community.

Overall goal

       Given the premise statements above, the CEL’s specific goal for the Task Force

on Autism Spectrum Disorders was as follows: to improve the academic and functional

skill development of children with an Autism Spectrum Disorder (ASD) through the

development of regulations, and/or standards of practice. These pertained to the

following guiding principles of the task force.
                                                                                          12

   1. The development of minimum guidelines for training required for individuals

       working in an educational placement with these children.

   2. The recommendation of guidelines for collaboration between disciplines working

       in the educational placement (i.e., inclusive of special educator, instructional

       assistant, general educator, administrator, resource therapists).

   3. The provision of recommendations for bridging service to the child across

       caregivers in the academic, medical, and home environments (inclusive of

       primary caregivers and other family members).

   4. The compilation of information to help inform policy making in the legislature

       surrounding these and other issues.

   While accomplishing these tasks, the Task Force was asked to consider a holistic

approach to the child and the family encouraging coordination, collaboration, and

integration of caregivers/services across settings. In addition, the Task Force was

empowered with the flexibility necessary to pursue outcomes not listed within our

charter.

Strategies

       There were four key strategies utilized in the development and implementation of

the Task Force. These included: a) the identification of co-chairs from the educational

and medical communities which established immediate bridging and collaboration across

multiple core systems, b) the work of the CEL and co-chairs to formulate and identify a

systematic process for building cross-system collaboration, c) the establishment of the

Task Force Charter document to guide the process (Appendix I), and d) the invitation to

potential members to participate in implementation of the Task Force missions. The CEL
                                                                                          13

and co-chairs chose individuals representing larger, and often multiple systems which

were integral to the initial collaboration (see Appendix II).

                                    Tasks and Actions

   The Task Force met nineteen times over the course of twenty-four months with the

goal of developing a fuller and deeper understanding of the community systems

impacting the lives of individuals and families with an autism spectrum disorder (ASD).

By utilizing three strategies to gather information, the Task Force was better able to work

as a collaborative and cohesive team. The first strategy was a comprehensive review of

task forces across the country with regard to their systems of development, identified

missions, and relevant issues specific to autism spectrum disorders (see Appendix III).

Second, the group discussed informal feedback from consumers across home,

community, educational and medical systems. Third, the Task Force invited speakers to

present on specific topics related to the autism community. The methods utilized by the

Task Force for each of these examples are described below.

   The coordinator of the Task Force on ASD performed an on-line search of other

states that had either conducted task forces or committees focused on services to

individuals diagnosed with ASD. States were only selected for review if their task force

or committee was brought together by a state entity (e.g., the Department of Education,

the Office of the Governor, the Mental Health Department, the Department of

Developmental Disabilities, or a legislative ruling), and was conducted from a statewide

perspective. Recommendations from 35 states were reviewed and organized according to

the four principles identified by the conveners of the Indiana Task Force. This
                                                                                           14

information was able to serve as a guide of lessons learned from similar entities across

the United States.

   Information shared by the Task Force members was rich in description and provided

thorough, first-hand accounts of experiences throughout Indiana. Each member of the

Task Force came from areas of support, service, or direct involvement with individuals

diagnosed with ASD. Though the Task Force members all recognized that anecdotal

stories can be limited in scope, all believed it was important to share examples that

helped clarify, support or even dispute generalized information. Conversations containing

such examples took place at each of the 19 meetings.

   Invited speakers to the Task Force were selected based on an initial schedule

developed with input from the Task Force members. This schedule was determined after

choosing entities to present who represented large systems in the state with particular

relevance to at least one of the guiding principles of the Task Force. Other relevant

speakers were subsequently identified as a result of content covered in one of the

meetings. While each speaker discussed a single topic, most topics overlapped several

principles. Speakers were asked to address the mission of their organization/system, how

they address particular issues related to autism spectrum disorders currently as well as in

the past, and any plans for the future.

   The general areas and system practices discussed by the various speakers were

familiar to many Task Force members. These presentations, though, were designed to

allow all Task Force members to hear the same information simultaneously and to fully

process and understand the relevance of these organizations and systems related to autism

spectrum disorders in a collaborative manner. After hearing from each speaker, the Task
                                                                                               15

Force conducted a debriefing session. This activity helped the group process the

relevance of the present topic and identify items within the presentation as they related to

the guiding principles of the Task Force and action items pertaining to the conclusions.

Results

   The following section provides a description of all topics covered. It should be noted

that while Task Force members felt the current lack of services and supports and

subsequent needs identified within the four principles of policy, service provision,

training, and system collaboration could not be ignored, members were also looking for

current, positive efforts that were making a measurable difference. A shared commitment

to focusing energy on improving and bolstering current and positive efforts within the

state was noted.

   The information shared by the presenters is organized below according to the four

principles of (a) policy, (b) service provision, (c) training, and (d) system collaboration,

bridging and partnership. Each of the four sections begins with a description of the

principle and is followed by an overview of how topical information shared by speakers

representing different projects and agencies related to the identified principle. A table

listing all of the speakers and the organizations, entities or projects they represented are

listed in Appendix IV.

Principle 1: Policy

   This principle focused on the provision of guidance and recommendations to inform

policy-making related to autism spectrum disorders. Policy was addressed three ways by

the Task Force: (a) learning what policies are currently in place, (b) considering how

current activities, programs and initiatives impact policy development, and (c) providing
                                                                                         16

suggested language based on both empirical and anecdotal data collection. This section

reviews the below listed topics according to these three viewpoints.

       Lilia Teninty from the Family Social Services Agency’s Division of Disability

Rehabilitative Services offered information about the Autism and Support Services

waivers (further described at http://www.in.gov/fssa/ompp/2632.htm). This included a

presentation on the services available, total expenditures for each waiver and future

trends. In addition, the Task Force members gained information on state-funded services

available through the Division of Disability and Rehabilitative Services (DDRS).

Members were able to ask how current policies are determined, set, and how the Task

Force might have an impact and input on those decisions. Ms. Teninty, who sat on the

Task Force at the time, agreed to take information generated by the Task Force back to

her team at DDRS.

       John Hill from the Department of Education’s Center for Exceptional Learners

provided information on school-based Medicaid. The Task Force members learned about

the statute requiring all school corporations to be enrolled providers in the Indiana

Medicaid program. This statute, however, does not require school systems to participate

or bill Medicaid. The Department of Education representative also overviewed the

process used to reimburse the participating schools. In 1998 there was a policy change

written by the Indiana Office of Medicaid Policy and Planning. The policy exempted

schools from two areas Medicaid previously required: (a) prior authorization and, (b)

managed care provider certification requirement. Under the new policy agreement, these

areas relate to all Medicaid-covered health related services that are authorized in a
                                                                                             17

student’s Individualized Education Program. More information can be found at

http://www.doe.state.in.us/exceptional/speced/medicaid.html.

       Kristen Schunk, another representative from the Center for Exceptional Learners,

spoke about the Children’s Social, Emotional and Behavioral Plan, also known as the

State Enrolled Act 529 (Indiana Code 20-19-5)

(http://www.kpcnews.com/content/current/online_features/sea529/planfinal.pdf). While

this plan does not focus on specific groups of children or specific disabilities, it does

address the need for a comprehensive, coordinated children’s mental health system that is

grounded in prevention, early intervention, and treatment across all state systems. The

five expectations of the plan include: (a) better agency coordination, (b) early

identification and intervention, (c) identification of ways to use resources wisely, (d)

improvement of the process to receive services, and (e) education of stakeholders

regarding mental illness. The Task Force discussed the controversial topic of screening as

it related to this act and how that might impact decisions made by the legislators. Ms.

Schunk pointed out the language within the 529 Plan that specifically addressed this

concern. The Plan read that active consent must be obtained from the child’s parent

before any screening could be done. This meant parent control would still be present and

required. Ms. Schunk suggested that members of the Task Force could act as independent

citizens or through their organizations to help their local legislators understand this

language and how this bill could assist in earlier identification and support for children

with autism spectrum disorders.

       The President of the Indiana Coalition on Autism spoke to the group about the

Statewide Comprehensive Plan. Ms. Freeman-Floyd provided an update to the group
                                                                                            18

about the collection of focus group data from across the state. Stakeholders included

individuals diagnosed with ASD, parents, educators and direct service providers. Policy

issues that have been discussed during the focus group meetings include government

funding, service structures, the lack of flexibility in the use of funds, the accountability of

providers and educators, and the growing need for post-secondary services. This

information and more will be compiled into a final report to the Indiana Commission on

Autism. It is hoped that it will be verbally presented in October of 2007. Interested

parties can read the document at:

http://www.in.gov/fssa/files/TheASDServicesCompPlan20070108.pdf.

       Nina Brahm, legal counsel from the Center for Exceptional Learners and the

Assistant Superintendent of Public Instruction worked closely with the Task Force as the

group wrote language to submit to the State Advisory Council specific to professional

training as written in Article 7. Though this Task Force was focused on the needs of

children diagnosed with autism spectrum disorders, the language needed to include the

training necessary for professionals working with all children who have special needs.

The group’s language was presented to the State Advisory Council, altered by the

Council, and then updated again after the Center for Exceptional Learners held statewide

meetings with parents and community members about the proposed changes to Article 7.

Language specific to this policy is discussed under the third principle of training.

       Michelle Trivedi, a parent of a child with autism and an expert in insurance issues

and Dr. Cathy Pratt, Director of the Indiana Resource Center on Autism at the Indiana

Institute on Disability and Community, Indiana’s University Center on Excellence in

Disability, provided an overview of insurance concerns of families. They explained
                                                                                             19

Indiana’s policy can only provide support to those families who hold insurance with

companies based in Indiana. For many families, this policy provides no support. They

also discussed how regulations were being misinterpreted by local insurance companies,

but that there are individuals watching that and reporting these mis-steps to the regulatory

commission over insurance. To locate and read the mandate, go to:

http://www.iidc.indiana.edu/irca/ServArticles/INhealthInsurance.html.

       The Associate Executive Director of the Arc of Indiana, Kim Dodson, provided

the Task Force with an overview of the bills concerning autism and developmental

disabilities under review by legislators during the 2006 Session. Though none of the areas

of focus directly related to autism, the Task Force benefited from learning about each

area. It was recognized that services to individuals with ASD, however specific and

individualized, fit within the larger scope of services to all children with special needs

and general education. It was with this attentive mindset that the Task Force members

learned from the speakers. Ms. Dodson was able to answer questions about procedures

and processes within our state’s legislature. The Arc regularly posts updates and action

alerts during Indiana’s session meetings at: http://arcind.org/.

       At that same meeting, Senator Marvin Riegseker, chair of the Commission on

Autism, spoke with the group about the work of the Commission (see

http://www.in.gov/legislative/interim/committee/auti.html). He encouraged the Task

Force to provide the commission with information on service updates. The Task Force

also heard from the Department of Education’s Legislative Liaison, Scott Minier, who

spoke about the focus of the Department of Education for that legislative session. All

three speakers provided information about (a) the current climate within the Indiana
                                                                                            20

legislature towards education and services to individuals with developmental disabilities,

and (b) how Task Force members can be effective partners within the process.

       Personnel from the Department of Education’s Division of Professional Standards

(now known as the Division of Educational Licensing and Development), including

Shawn Sriver and Mary Glenn Rinne, Ed.D., spoke with the group about teacher

licensure in Indiana. The Task Force learned what standards influence various licenses

and how those standards have been changed to reflect current classroom needs. Currently,

the state uses dual licensing systems. One was designed in the 1970’s and is being phased

out while a new system was put into place in 2002. Under the new system, there is no set

number of courses that must be taken; rather, specific standards have to be met. The

standards for special education are divided into four different areas: mild intervention,

intense intervention, deaf and hard of hearing, and blind and low vision. Standards that

meet the needs of children diagnosed with autism spectrum disorders are found in the

mild and intense intervention areas. Higher institutions are required to create teacher

training programs that will help students meet these standards. The measurement tools

used are Praxis I and Praxis II. These exams, respectively, focus on the overall areas of

reading, writing and math and specific content areas. There is, however, no exam for

special education. Instead, higher institutions must meet the standards set forth by the

National Council on Accreditation of Teacher Education that relate to special education

(see: http://www.doe.in.gov/media/video/dps-licensing.html).

Principle 2: Service Provision

       This principle was the provision of guidelines and recommendations regarding

effective and appropriate service provision. The Task Force viewed services as the
                                                                                             21

ultimate outcome of the other three principles (policy, training and collaboration). In

addition, services most directly influence the lives of the children and parents. To inform

the members about current services, a variety of speakers from both public and private

entities shared information about services provided to children with autism spectrum

disorders. Task Force members also offered updates on their own work and efforts. The

Task Force found this information useful in helping them determine where service gaps

and seamless services were occurring in Indiana.

       Lilia Teninty from the Family Social Services Agency’s Division of Disability

Rehabilitative Services shared how families can utilize the Autism and Developmental

Disabilities waivers offered through the state. While the Division of Disability

Rehabilitative Services does not provide direct services, it has a relationship with all

providers and must approve the services and the rate paid for those services for all

children and adults utilizing these waivers. She answered questions about Indiana’s

waiting list and the community’s push for the state to recognize emerging therapies as

legitimate and useful.

       John Hill from the Department of Education’s Center for Exceptional Learners

answered service questions related to how schools utilize Indiana’s Medicaid dollars to

cover the cost of some health care services for students with disabilities. As listed by a

document provided by the speaker, Medicaid can cover a wide range of medically

necessary services. These can include: hospitalization, physician laboratory and x-ray

services, prescription drugs, dental services, nursing home and home health care, speech

therapy, physical therapy, occupational therapy, nursing services, some health status

assessments and evaluations, and medical transportation (Department of Education
                                                                                            22

Division of Exceptional Learners, 2005). These services are reimbursed by Medicaid if

they are provided by a Medicaid-qualified individual and the services are specified in the

student’s Individualized Education Program (IEP). To further answer Indiana specific

questions, the speaker gave the following web links to the group:

http://doe.state.in.us/exceptional/speced/pdf/2004-08-08-MedBillGuide.pdf

http://doe.state.in.us/exceptional/speced/pdf/1srEditionToolKit061705.pdf

http://doe.state.in.us/exceptional/speced/pdf/IPINParentBroSchlsBillMdcd061705.pdf

       The Senate Education Act 529, or The 529 Plan, was very important to the Task

Force because it demonstrated policy that would require coordinated efforts around

service provision in relation to mental health. Kristen Schunk explained how the

interagency task force involved in the creation of The 529 Plan “envisioned a

comprehensive, coordinated children’s mental health system comprised of prevention,

early intervention, and treatment across all state systems (mental health, substance use,

child welfare, juvenile justice, schools, Medicaid, and primary healthcare)” (Indiana

Department of Education, 2006). The implications for children with autism spectrum

disorders would be significant in that parents would be provided an option for screening,

services would be coordinated across school, community and state entities, and best

practices were woven into the proposed policy. This was to be handled under the goals

and strategies of The Plan. To obtain services and referral network the following five

strategies were suggested:

       1. Identify gaps in the existing processes for each State agency.

       2. Create a master flow chart for the entry point into the mental health system for

       children and make recommendations for process improvements.
                                                                                            23

       3. Create a process for children who do not need to enter the mental health system

       but do need some services.

       4. Integrate social and emotional development practices into existing services.

       5. Disseminate information and referral procedures of state and local programs

       serving children with social and emotional concerns and their families to

       stakeholders (Indiana Department of Education, 2006, p. 26).

During the course of the Task Force, the Plan was passed as Indiana Code 20-19-5.

       The Task Force received information from Dr. Cathy Pratt about the services

provided by the Indiana Resource Center on Autism (IRCA) at the Indiana Institute on

Disability and Community (IIDC). As a part of the Association of University Centers on

Disabilities, IIDC and IRCA fulfill the role of service provision through resource sharing,

training, research, publishing, and testimony when called for at the state house. IRCA

functions as a statewide entity and personnel at the Center travel extensively to provide

free trainings to both families and professionals and the dissemination of resources. Dr.

Pratt’s focus was to provide information to the Task Force on the statewide assessment of

needs conducted by IRCA every three years. The survey collects information on

demographic, educational placement and services, community services, cost, access to

resources, employment, Medicaid Waiver usage, and insurance coverage. This survey is

requested by the legislature to assess autism services across the state. More information

about IRCA can be found at: http://www.iidc.indiana.edu/irca/fmain1.html.

       The President of the Indiana Coalition on Autism, Liz Freeman-Floyd, informed

the group that the final report of the statewide assessment performed on behalf of FSSA

revealed several gaps in services throughout the state, specifically in the rural areas, and
                                                                                             24

pulled together suggestions for specific actions based on national initiatives, best

practices, and current findings in Indiana. To ensure the completion of these action items,

the report called for the establishment of an Interagency ASD Coordinating Council

which will begin meeting in 2008.

       The information distributed to the Task Force by Michelle Trivedi and Dr. Cathy

Pratt about the Indiana insurance industry and its relationship with the autism community

helped the group understand the barriers families face even when services are available in

their area. Some services are cost prohibitive for families due to the recommended

intensity and time for the service. A health insurance mandate for Indiana was passed in

July of 2001 as Indiana Code 27-8-14.2. This required Indiana insurance plans to cover

the entire family, even the child with autism. At the same time, a separate law was passed

stating autism is a neurological condition. In both cases, the Department of Insurance

interpreted the law and distributed the information to the companies. Unfortunately,

families were left to find the information on their own. The speakers continue to work

strategically to get the information out to families in Indiana. To date, each case and

coverage for therapy is treated on a case by case basis. Also, the interpretation of

therapies became more specific. For example, Applied Behavior Analysis (ABA) is

considered a brain therapy and not physical therapy. Also, if a child participates in ABA

at a center, it is typically covered as a doctor’s visit would be covered. If an insurance

company chooses to challenge whether a therapy is a medical necessity, the burden of

proof is on the insurer. Finally, only Indiana insurance can be covered rather than those

who are self-insured through federally mandated insurance.
                                                                                           25

       The 290 Group speakers, represented by Nancy Zemaitis and Teresa Grossi,

Ph.D., along with Jonathan Kraeszig from Vocational Rehabilitation discussed the

service outcomes related to their work. Specifically, the policy and implementation

change of beginning services the summer after a student’s junior year came into action.

To receive this service, there must be a level of need demonstrated by the student. This

means the student will require intense Vocational Rehabilitation services to participate

successfully post-secondary employment settings. The Task Force had several questions

pertaining to specific service delivery at both the school and post-secondary settings for

individuals with an ASD. In each case, the follow up comments were related to the

principle of training and will be discussed within that section.

       Representatives from the Indiana Autism Academy provided the Task Force with

frontline stories and information on what is going on in schools across Indiana in relation

to the delivery of services to children with autism spectrum disorders. The Autism

Academy members come from schools across Indiana and act as autism consultants

within their school systems. Each member has trained at the Indiana Resource Center on

Autism and they maintain that connection with IRCA through additional trainings and

meetings. These individuals openly discussed both struggles and successes in the services

their school districts are able to provide. These ranged from financial barriers to positive

changes in the attitudes of professionals. At the heart of each conversation about service

was the issue of training. These issues will be addressed within that section below.

       The work the Task Force did with the legal counsel, Nina Brahm, at The

Department of Education’s Center for Exceptional Learners correlated with the principle

of service based on the outcomes teachers, families and students with autism spectrum
                                                                                                26

disorders would experience due to the suggested policy language. The delivery of

services is directly related to the quality of training provided (i.e., style, follow-up, and

appropriateness) and the teacher’s application of the new found information and

techniques. The legal counsel worked with members of the Task Force to help them

understand the role of the policy and how it could most effectively lead to positive

outcomes and services.

        Andrew Ranck and Randy Krieble from the Family and Social Services

Administration (FSSA) provided updates on crisis assistance, Indiana’s Outreach

Services, and direct support staff training initiatives. All of these initiatives stem from an

FSSA vision of “lifespan empowerment” for all consumers of services for individuals

with developmental disabilities in general, not just autism spectrum disorders. Further,

they seek to facilitate “effective partnerships which enhance the quality of life for the

people [they] serve in their communities and pursuits of their choice” (Ranck & Krieble,

2007). Second, the crisis assistance services are put into action when “a behavioral or

psychiatric emergency resulting in the need for immediate and intensive services” occurs.

The components of this service include a 24-hour crisis hotline, in-home assessments and

interventions, out-of-the-home interventions and follow-up services.. The Outreach

Services initiative is intended to create a single, united statewide team that will provide

staff training, technical assistance and consultation. It will have a human rights

committee, oversee risk management and provide time limited backup to providers when

necessary. At this time, parents, caregivers, provider staff, Bureau of Quality

Improvement Services staff, Bureau of Developmental Disabilities services staff and

educators can request training assistance. Information can be found at
                                                                                               27

http://www.in.gov/fssa/disability/services/seoutreach/index/html. Finally, the staff

training initiative through IN-Train was discussed. This committee, which includes a co-

chair of the Task Force, is establishing a plan for statewide training of all direct service

provider workers. To date, there is a certification program through Ivy Tech which will

be discussed in more detail under the training section.

       Dr. Naomi Swiezy, co-chair of the Task Force, though not presenting formally at

the Task Force, presented information informally throughout the course of the Task Force

meetings about services provided at the Christian Sarkine Autism Treatment Center.

Though a diverse number of departments at Riley Hospital service children and families

with the disorder (e.g., Developmental Pediatrics, Child Development, Neurology,

Speech and Language, Occupational Therapy), the Center is the only entity servicing

autism spectrum disorders almost exclusively. The Christian Sarkine Autism Treatment

Center (CSATC) is housed in the Riley Outpatient Center and is affiliated with the

Indiana University School of Medicine, Clarian Health Partners, and the Riley Hospital

for Children. The Center provides a variety of services including psychopharmacological

management, behavioral consultation, counseling, parent training, educational

consultation, social skills training, and diagnostic and psychological assessment. The

CSATC is committed to helping children and adults with autism and related disorders to

achieve their potential and to participate as fully as possible in family, school, and

community life. Interventions are based on the individual goals and objectives of the

family and reflect the most recent and empirically supported approaches to treatment. For

more information, one may consult www.iupui.edu/~psycdept/autism

Principle 3: Training
                                                                                             28

       This principle was the provision of guidelines and recommendations regarding

training. The Department of Education’s Center for Exceptional Learner’s legal counsel

worked closely with the Task Force to write strong language supported by the Individuals

with Disabilities Education Improvement Act (IDEA 04) for the proposed Article 7 in the

area of training for educators. As stated above, the Task Force worked diligently on this

task and hoped to submit language that would help guide schools to provide appropriate

training for all school employees engaged with children who have disabilities. The Task

Force chose to create language which focused the process on the needs of the child (as

demonstrated through the IEP) rather than the training needs of the teachers. This way,

educators can be provided training specific to the needs of their current students and can

seek more specific training.

       Nancy Zemaitis, Teresa Grossi, Ph.D., and Jonathan Kraeszig from The 290

Group and Vocational Rehabilitation discussed the need for training in three specific

areas: (1) Vocational Rehabilitation services to children with more mild disabilities, (2)

making the transition plan within a child’s IEP a working document, and (3) autism

specific training for Vocational Rehabilitation counselors to help these providers

understand how to look for the gifts and talents these students have to offer. Currently,

there are 13 outreach grants funded across the state to address the needs of students who

typically do not receive services from Vocational Rehabilitation due to their placement in

the general education setting. These trainings help Vocational Rehabilitation counselors

think differently about how to provide services to these students. There are continued

efforts to make the IEP transition plan a working document. Improved communication

with Vocational Rehabilitation counselors (who typically have a case load of 150-180
                                                                                            29

individuals) is another reason for stakeholders to see the transition plan as a working

document. Finally, there is specific training for Vocational Rehabilitation counselors in

relation to autism. The challenges include: the eligibility criteria are not always

consistent, counselors have to be versed in all disability areas, and when students turn 18

they are their own advocate. Students who have challenges with pragmatic language, as

many who are diagnosed with autism do, can find their advocacy abilities significantly

affected.

       The representatives from the Autism Academy spent a considerable amount of

time discussing the strategies they use to train educators. Most provide trainings during

the school day either before school or after school. Some have “brown bag” trainings

where educators are trained during lunch time. Many of the representatives wished they

could provide more of a mentoring model where they would be present in the classroom

with the teacher rather than providing traditional training. They believe that mentoring

could be more effective. Some of the school districts have parent support groups and

trainings specifically for the parents, but most of the groups primarily support the

educators. Newsletters were another method used for getting best practice information

into the hands of multiple educators, especially administrators and those not in the

classroom.

       Shawn Sriver, the Director of the Department of Education’s Division of

Educational Licensing and Development addressed training by relating licensure

requirements and the implementation of the skills teachers learn while college or

university courses. The Task Force questioned how teachers can be prepared to

effectively work in today’s classrooms without having a significant understanding of
                                                                                          30

special education issues. He explained that the National Council for Accreditation for

Teacher Education sets the standards most colleges and universities use. Indiana cannot

require these schools to teach specific classes. Students simply must show proficiency in

their chosen discipline through coursework and by passing the Praxis I and Praxis II

examinations. Neither of these examinations covers issues related to special education.

       Mary Glenn Rinne, Ed.D., also from the Division of Educational Licensing and

Development and Dr. Pat Swails from the Indiana Association of Colleges for Teacher

Education spoke with the Task Force about teacher training in Indiana. The Task Force

had requested a document a few months earlier that would lay out what colleges and

universities throughout Indiana were doing to address the growing need for educators

informed about autism. Ms. Rinne distributed that information to the group explaining

that some schools took considerable time in offering the information while others were

not as thorough. It was also noted that in some cases, autism was a topic within the larger

syllabus while at other schools autism was the focus topic of a class taught to all students.

Dr. Swails, from the Indiana Association of Colleges for Teacher Education, not only

reviewed what her school is doing to train emerging educators, but what Indiana

Association of Colleges for Teacher Education is doing to help guide member colleges

and universities. The discussion focused on teachers gaining more general skills so they

can work with any child but also gaining specific skills to teach their discipline. The

group talked about the struggle between abandoning some of the preparatory courses for

education and replacing them with courses on differentiating instruction and classroom

management. This issue is directly impacted by the Praxis I and Praxis II tests. Colleges

and universities have to be sure that they are preparing teachers for those exams. The
                                                                                            31

suggested replacement topics are not part of the exams. The speakers and the Task Force

agreed that, ultimately, all education students need to understand that they will have

students with special needs in their classrooms and they need to understand how to work

with them.

       The Task Force received an overview of the Indiana Designs Equitable Access for

Learning from Dr Susan Jacobs. This website (http://ideal.sf.edu/) provides educational

modules for educators, professors and all adult learners interested in improving how they

teach children with special needs. The modules are peer reviewed and many can be used

as a part of a college course. The trainings are diverse and include modules that are

specific to autism. The modules are free and are accessible to anyone with a computer.

       The language submitted to the State Advisory Council focused on the training of

teachers serving children with disabilities was completed with the help of Nina Brahm,

legal counsel within the Center for Exceptional Learners. As stated above, the section

was written to be more child specific rather than focus on the training needs of the

educators. This allowed the language to be more broad as to who would be involved in

the training (e.g., who works with the child) versus teacher specific. The Task Force

believed that this met with the spirit of the Individual with Disabilities Education Act and

supported educators.

       Andrew Ranck and Randy Krieble from the Family and Social Services

Administration spoke about two initiatives directly related to training. One was Outreach

Services and the other was IN-Train. Outreach Services is a project with the following

areas focused on training: the provision of formal training, technical assistance, phone,

mail and in-person consultation, and references, resources and current literature. This
                                                                                            32

coordinated effort is part of a 2-year contract to obtain clinical staff and facilitate

outreach best practices to unite each of the regionally based units. The staff includes a

director, a coordinator, a training director, a manager and human rights chair, an

administrative assistance and two secretaries. Under the umbrella of service, they also

have on staff three speech and language pathologists, one psychologist, two behavior

consultants, two registered nurses, three occupational therapists, one dietician, a physical

therapist, a consulting psychiatrist, a consulting physician and an adaptive equipment

technician. Together, this team works to systematically expand trainings within the state

and provide equal technical assistance to all areas. Outreach Services are a part of the

other FSSA initiative called IN-Train. This is a group of representatives from services

providers, state entities, self-advocates, and family members who focus on the training

needs of current service providers. Together, this group designed training for direct

support professionals and implemented a certification system through IvyTech.

        Currently, a grant pays for service providers to attend classes and offers the

opportunity for pay raises for the completion of the degree. The speakers also pointed out

that they do have an autism module developed by IIDC that is on the staff training

website which includes a power point, a training manual and video. There is also a set of

fact sheets that were designed by staff at the Christian Sarkine Autism Treatment Center

which includes introductory materials such as “What is Autism” and information

regarding functional areas upon which to focus and data-driven strategies that can be

used to improve services for individuals with autism spectrum disorders.

     Dr. Naomi Swiezy informally and anecdotally shared information about the

HANDS in Autism program, the outreach segment of the Christian Sarkine Autism
                                                                                            33

Treatment Center, at various junctures during meetings of the Task Force. The core

efforts of the HANDS in Autism program have centered on developing and evolving an

innovative training model. The HANDS in Autism training model was founded on the

belief that training should focus on: (1) student strengths, (2) comprehensive training, (3)

the educational process from assessment to goal development, (4) blending strategies

based in Applied Behavior Analysis (ABA) and evidence-based practices, and (5) hands-

on work with students with an autism spectrum disorder and with a range of strengths and

challenges in functional and academic skills. The training model incorporates best

practice teaching strategies by presenting initial information in didactic format followed

by trainer modeling, trainee practice, and trainer feedback. The HANDS program has

generally expanded the focus of the CSATC to include a variety of other educational and

outreach opportunities as well the development of collaborative classrooms in existing

special education classroom milieus in local districts. These collaborative classrooms

follow the same practices and principles inherent in HANDS missions and philosophy of

training and intervention and facilitate programming that increases local capacity to

educate and train professionals while also building bridges across community systems

(e.g., education, medical, home). For more information one may consult

www.handsinautism.org

Principle 4: System Collaboration

       This principle was the provision of guidelines and recommendations regarding

effective system collaboration, bridging, and partnership. The Task Force listened closely

for information on how entities throughout the state were collaborating. When

considering this principle, the group focused on four areas (a) who is collaborating, (b)
                                                                                           34

who is not, (c) what defines quality partnerships, and (d) what are the barriers to effective

collaboration? Not every speaker attended to each of these areas. However, the following

will describe what aspects of the principle were identified.

       Lilia Teninty from the Bureau of Developmental Disabilities Services (BDDS) at

the Family and Social Services Administration (FSSA) spoke about the waivers provided

by the state, what services can be provided under those services, the waiting list, and the

importance of parents signing their children up for the waivers when they are young. It is

imperative that schools partner with FSSA to correctly distribute information to parents

about the waivers and that parents are encouraged to sign their children up at a very early

age. The waiting list is extraordinarily long (i.e., over 10 years at present) and continues

to lengthen.

       Kristen Schunk reported that the 529 Plan was written to legislatively require

agencies to collaborate around the mental health needs of school ages children. The

Children’s Social, Emotional, and Behavioral Health Interagency Plan (2006) brought

together a Task Force which envisioned a “comprehensive, coordinated children’s mental

health system comprised of prevention, early intervention, and treatment across all state

systems (mental health, substance use, child welfare, juvenile justice, schools, Medicaid,

and primary healthcare)” (p.5). This is a long term effort that will rely heavily on the

collaborative efforts of the entities listed above. An update about this plan can be found

at:

http://www.doe.state.in.us/exceptional/pdf/Children's_Plan_FINAL_Updated%20August

%202006.pdf
                                                                                           35

       Liz Freeman-Floyd from the Indiana Autism Coalition identified the intended

members of the Interagency Coordinating Council recommended in Indiana’s

Comprehensive State Plan to Guide Services for Individuals with Autism Spectrum

Disorders. This collection of individuals includes individuals with ASD, family members,

and individuals from: Indiana Department of Education/Center for Exceptional Learners,

clinical, university based, and other entities focused on autism research and supported

through IDOE/CEL grant projects, Indiana Resource Center on Autism, Autism Society

of Indiana, Office of Medicaid Policy and Planning, Division(s) overseeing Aging and

Vocational Rehabilitation, Department of Mental Health and Addiction, Department of

Corrections, Department of Health and the Division of Children (Pieples & Freeman-

Floyd, 2006, p.1). The document goes on to clearly lay out actions that this Interagency

Council should oversee and promote. During the data collection phase prior to the writing

of the State Plan, it became known that there had been a thorough plan created in the

1980’s which was specific to autism services in Indiana. Though well written, there was

not a single entity identified to oversee the application and execution of the plan. The

authors of the current plan are working closely with FSSA to pull together an effective

team and to create an accountability system that will withstand the natural attrition found

within most organizations.

       Nancy Zemaitis, Teresa Grossi, Ph.D., and Jonathan Kraeszig from The 290

Group and the Vocational Rehabilitation identified aspects of the collaborative principle

within their work. Specifically, the speakers addressed the phenomenon of students

meeting the goals and objectives laid out in their IEP’s, but in a few cases the Bureau of

Developmental Disabilities has asked that these students stay in school. The speakers
                                                                                            36

believe that a stronger level of interagency collaboration has helped solve this issue so

students can become an active part of the post-secondary community. In addition, the

Department of Corrections and the Juvenile Justice System are working with the directors

of special education on transition issues at a local level. They are investigating ways and

means to move these students back to their local communities and how to strategize the

follow-along piece. There is a significant focus on incentives to get the students into the

work force. Without defined partnerships and a collaborative spirit, these students will

not have such strong opportunities.

       The Indiana Autism Academy members expressed the need for collaboration

between parents and educators and educators within the school setting. Without those

partnerships, the sometimes intricate and in-depth services these students need cannot

occur. The Indiana Autism Academy members talked about collaborations occurring

across school districts and within school co-ops to support the services needs of children

with autism spectrum disorders. They would like to see more collaborative partnerships

within buildings and with administrators. The barriers discussed most often were time

and funding.

       Leah Reed from the Center for Medical Home Improvement and the CareShare

website took the group through the CareShare website via a webinar. This Beta site

shows how families and medical professionals can share information about an

individual’s service needs. The site can be set up to show all of the partners who are

working to support the one individual but each partner can only edit their own areas.

Though the site is not intended to replace emergency systems, it is a possible system for

sharing important updates such as changes in medication, service locations, or therapies.
                                                                                             37

Parents can invite or uninvite professionals to have access to their child’s file. Because

families drive the site and give permission to professionals to share information by

inviting them to the site there are no FERPA of HIPAA issues. Currently, there is no cost

for a state to become a partner in this site. The group was intrigued by the site. Some

were very concerned about having information like that on a website and others did not

believe that all professionals would be comfortable posting information about their

patient on a website. For some, there could be an ownership of information issue, for

others there might be a level of insecurity they might experience when posting

information.

       Dr. Susan Jacobs from the IDEAL project was able to directly address the

principle of collaboration. The peer reviewers work collaboratively with the authors to

create quality modules. There is a collaborative relationship built between the participants

and the site creators when the participants come to the site and complete the coursework.

Finally, there is a collaborative relationship that continues between the Center for

Exceptional Learners and the site coordinators to ensure the needs of teachers are being

met so the education of children with special needs continues to improve.

       Dr. Pat Swails from the Indiana Association of Colleges for Teacher Education

talked about the collaborative efforts she and her colleagues practice when improving the

coursework on their respective campuses. There is also a collaborative relationship that

has been built with the Division of Educational Licensing and Development at the

Department of Education. This reciprocal relationship helps colleges and universities

understand what standards the state wants to see followed for licensure and it allows the
                                                                                           38

state to hear from post-secondary personnel on the issues and trends they are seeing in

teacher education.

        The collaborative relationships necessary for the Family and Social Services

Administration and Bureau of Developmental Disability Services are numerous. Andrew

Ranck and Randy Krieble addressed how these agencies work to build and maintain

partnerships with service providers, university programs (e.g., IRCA) and families across

the state. They also have worked to bridge effective partnerships with the Department of

Education. A barrier to that partnership is the money involved. Funds for a child cannot

flow from one system to the other, so when the child is in school but needs services

provided by FSSA, traditionally there has been a problem. The two state entities are

working to find creative ways to share these dollars. One example described earlier in the

report is the Medicaid reimbursements for schools.

        The information presented about the HANDS in Autism Program at the Christian

Sarkine Autism Treatment Center and Riley Hospital for Children presented in the

training section above notes the collaborative efforts to bridge medical, home and

educational settings through various training and other efforts. Please reference this

section for details.

                        Direct Outcomes and Recommendations

        Subsequent to the discussions held by Task Force Members, direct outcomes were

experienced and recommendations have been offered to the Department of Education’s

Center for Exceptional Learners as described in this report. The following section (a)

describes the actions the Task Force took during its time together, and (b) lays out the

recommendations that came from the work performed by the Task Force.
                                                                                         39


Direct Outcomes

       The Task Force was directly involved in work led by the Indiana Autism

Coalition and the Autism Society of Indiana. Those two entities joined together and were

contracted by Indiana’s Family and Social Services Administration to conduct a survey of

family members, service providers and individuals with autism spectrum disorders

throughout the state. Both organizations worked with members of the Task Force to

devise an applied method for the statewide survey. The method included (a) statewide

focus groups, (b) surveys for parents, service providers, educators, and individuals on the

spectrum, and (c) individual interviews with parents, leaders in the autism community,

and service providers. A Task Force member also provided support by editing the

resulting document titled Indiana’s Comprehensive State Plan to Guide Services for

Individuals with Autism Spectrum Disorders. The work laid out within the

Comprehensive Plan continues to impact decision-making at the legislative level and

within Indiana’s FSSA. Interested individuals can read the plan at:

http://www.in.gov/fssa/files/TheASDServicesCompPlan20070108.pdf

       The recommendations of this plan include the establishment of an interagency

council. This council will include representatives from government, service, and private

entities along with parents and those diagnosed with ASD. The representative of the

Department of Education’s, Center for Exceptional Learners will bring the

recommendations established within this document to that interagency council. In

addition, the DOE/CEL representative will work to establish more effective partnerships

with the other government entities represented within the interagency council.
                                                                                        40

       Another direct outcome of the Task Force was a symposium held in Brown

County, Indiana in October of 2007. The symposium was co-hosted by the Indiana

Special Education Administrators’ Services and the Indiana Association of Colleges of

Teacher Education. It was free to college and university level trainers who educate

teachers, school psychologists, speech and hearing therapists, occupational therapists, and

physical therapists. The purpose of the symposium was three-fold:

       1. to inform trainers about new, national university/college level autism

           standards established by The National Council for Accreditation of Teacher

           Education and the Council for Exceptional Learners,

       2. to demonstrate how Indiana’s current standards related to training about

           autism, and;

       3. to provide information on a useful, reliable, and free resource focused on

           supporting trainers addressing special education issues.

       Speakers included Cathy Pratt, Ph.D. of the Indiana Resource Center on Autism,

Mary Glenn Rinne, Ed.D. from the Division of Educational Licensing and Development

at The Department of Education, and Susan Jacobs, Ed.D. who presented on the Indiana

Designs Equitable Access of Learning (IDEAL) Project. The day was concluded with

Bob Marra, Ed.D., Assistant Superintendent of Exceptional Learners at the Department

of Education who presented an update on Article 7.

Recommendations

       During the course of the Task Force meetings, the members and guests discussed

anecdotal evidence, survey results and service provider data. The anecdotal information

came from both Task Force members and guests. These personal accounts were upheld
                                                                                             41

by the survey results and service provider data collected by both the Indiana Resource

Center on Autism and the project conducted by The Indiana Autism Coalition and the

Autism Society of Indiana. The recommendations which came from this information are

listed below by principle.

        Policy

        The policy recommendations range from suggestions of ways to implement

present policy to the creation of new policy. When possible, a specific entity responsible

for the present policy, the application of the policy, or for creating the policy is identified.

The Task Force on Autism Spectrum Disorders recommends that:

        The Center for Exceptional Learners at the Department of Education create and

        oversee the implementation of statewide trainings for educators and parents in the

        spirit of and changes to Article 7, Indiana’s Special Education law.

        The Department of Education join in partnership with The Department of

        Homeland Security on school safety training. It is recommended that this

        collaborative effort utilize Dennis Debbaudt’s expertise in this area. This action is

        supported by Indiana’s Legislative Commission on Autism.

        The competencies developed by The National Council for Accreditation of

        Teacher Education and the Council for Exceptional Children be infused into the

        teacher standards set by the Division of Educational Licensing and Development.

        The Center for Exceptional Learners become an active participant in the

        interagency council established through Indiana’s Comprehensive State Plan to

        Guide Services to Individuals with Autism Spectrum Disorders.

        Service provision
                                                                                          42

       The recommendations suggested under the principle of service provision focus on

improving, supporting, and in some cases, redesigning service provision in Indiana as it

relates to children with ASD. The principle of service provision and system collaboration

(Principle 4) are closely related; thus, some recommendations will overlap.

       Investigate more closely the concept of the Medical Home (creating a centralized,

       web-based location for patient information that is controlled by the family and

       invited members can share information about the client’s services and supports) to

       see if it is applicable to services in Indiana.

       Facilitate the development of standards, guidelines and specific plans that lay out

       proactive services for children and families throughout all service arenas.

       Move beyond the reported barriers to quality service provision in rural areas of

       the state.

       Training

       The recommendations identified in the area are based on the training needed by

educators, first responders, community members, parents, and service providers. In some

cases the recommendations are specific to an entity, in other cases the recommendations

are based on best practice.

       Pre-service teachers must:

           o    have opportunities to experience working with children who have special

               needs, specifically ASD.

           o receive guidance and mentoring in how to teach children with ASD.

           o be assessed more effectively in relation to their ability to work with

               students who have disabilities. Current exam methods (the use of PRAXIS
                                                                                   43

       I and PRAXIS II) do not require pre-service teachers to have any

       demonstrated skills or knowledge on how to best instruct children with

       disabilities.

Pre-service teachers, current teachers and others in the educational setting must:

   o    have consistent training on meeting the needs of children with ASD. The

       training must include shadowing and mentoring.

   o receive training in how to effectively collect and utilize behavioral and

       educational data.

   o receive training in how to create a climate that is collaborative, proactive,

       and supports the specific behavioral and curricular needs demonstrated by

       children with ASD.

   o receive training on social communication skills which are focused on

       enhancing the child with ASD’s pragmatic language.

   o receive training which includes information related to Indiana and Federal

       laws and guidelines which define the specific areas of training due to

       accountability and focus related to these defined areas.

   o participate in ongoing evaluation and accountability to demonstrate the

       skills and knowledge discussed above.

The particular training needs of various individuals in these settings should be

developed and outlined based on particular roles and interactions with the

children.
                                                                                        44

           o Vocational Rehabilitation counselors must have specific training on the

               unique gifts and needs of adolescents and adults with ASD to best

               facilitate the transition and success in VR.

           o School psychologists must receive hands-on training on how to more

               accurately assess children with ASD. The traditional methods utilized

               (I.Q. tests, etc) are not effective our appropriate tools to use.

           o Educational personnel, beyond classroom teachers, need to receive

               practical and hands-on/mentored training on how to effectively work with

               students who have ASD. The personnel include paraprofessionals, support

               staff, bus drivers, lunch room monitors, and other who have meaningful

               contact with the students.

           o Parents can provide a unique insight and should be included in trainings.

           o School Safety Officers must have training specific to the needs of children

               with ASD.

           o Medical professional training must include knowledge of a variety of

               methods inclusive of evidence-based strategies as well as an

               understanding of such issues as sensory processing differences,

               gastrointestinal issues, and immune system deficiencies.

       Systems collaboration

       The principle of systems collaboration guided the Task Force to recommend

strategies and actions that could lead to improved partnerships and the bridging of

services. The Task Force considered collaborations between current entities but also

considered what entities might be developed in the future.
                                                                                     45

Partner with other entities to provide seamless services (education, family and

social services administration, medical community).

Develop a systems of care (SOC) concept similar to that in the mental health

community in the medical and social services areas.

Create a plan to create a collaborative system where the Department of Education,

Vocational Rehabilitation, the Department of Mental Health, Family and Social

Services Administration, the Department of Corrections and other relevant

entities.

Develop a communication system that includes dissemination processes to

include rural areas, general educators and special services.

Create a support network for this communication system.

Utilize teaming to emphasize consistent and proactive practices.

Emphasize the consistency of information shared across and within school

districts.

Emphasize the provision of information to a wider network of personnel within

schools, families, practitioners, and others within the child’s system of care.

Continue the expansion of established state and university level partnerships

throughout the state.

Foster professional collaborative relationships that support the crisis and mental

health needs faced by families of children with ASD.

Build these collaborative relationships through ongoing training and professional

development opportunities.
                                                                                            46

       Assure that all training and professional development reflect collaborative efforts

       between medical, educational, home and community systems.

       Support shared capacity at a local level in recognition of such realities as staff

       turnover rates and limited resources.

                                        Conclusion

       During the 19 meetings held by the Task Force, a significant amount of

information about services for children with ASD in Indiana was collected, considered,

and discussed. The recommendations written by this Task Force are in harmony with the

feedback we received from parents, educators, providers and health care workers. In that

the Task Force focused specifically on the principles identified in partnership with staff at

the Center for Exceptional Learners, it is our hope that each of these points will be

considered when regulations and/or standards of practice are developed within the

Department of Education. The Task Force enabled a comprehensive look at the state of

the State with regards to several areas pertaining to autism spectrum disorders. Through

the process, new collaborative relationships were created, connections with others in the

Indiana support service network have been developed, and the relationships have led to

further collaborative efforts to develop some action plans related to diverse areas. It is the

hope of the Task Force that the recommendations provide information needed to provide

the insight and motivation for the development of work groups to facilitate working

towards the implementation of the recommendations posited above.
                                                                                            47


                                        References

Indiana Department of Education Division of Exceptional Learners (2005, July). Indiana

       Medicaid helps schools cover the cost of some health care services in student

       IEPs. Indianapolis, IN: Author

Indiana Department of Education (2006, June). Children’s social, emotional, and

       behavioral health plan. Indianapolis, IN: Author

ASD Expert Working Group (2005, May 16). The Autism Spectrum Disorders Roadmap

       to Services. Retrieved November 10, 2007, from http:www.aucd.org/docs/policy

       /autism/autism_roadmap_asd_service_071305.doc

Pieples, S., Freeman-Floyd, L. (2007) Indiana state plan to guide services for individuals

       with autism spectrum disorders. L.G.L. Nelson (Ed.), Family and Social Services

       Administration. (Available from

       http://www.autismindiana.org/IN%20Comp%20Plan%20to%20Guide%20ASD%

       20Services%202007.pdf) Indianapolis, IN.

Ranck, A. & Krieble, W. R. (2007, August 13). State of Indiana outreach crisis

       assistance and direct support staff training initiatives. (Available from Division

       of Disability and Rehabilitation Services, Room W451 – MS 26, 402 W.

       Washington Street, P.O. Box 7083, Indianapolis, IN 46207-7083).
                                                                                        48


Appendix I: Charter Document

                           Indiana Department of Education
                       Task Force on Autism Spectrum Disorders
                                  Charter Document
                                   January 26, 2006

Goal: To improve the academic and functional skill development of children with an
Autism Spectrum Disorder (ASD) through the development of regulations, and/or
standards of practice pertaining to: 1) the minimal training required for individuals
working in an educational placement with these children, 2) the guidelines for
collaboration between disciplines working in the educational placement (i.e., inclusive of
special educator, instructional assistant, general educator, administrator, resource
therapists), 3) the recommendations for bridging service to the child across caregivers in
the academic, medical, and home environments (inclusive of primary caregivers and
other family members), and 4) information that will help to inform policy making in the
legislature surrounding these and other issues.

Impetus:
  8) DOE would like to be proactive (i.e., as opposed to reactive) regarding issues
      surrounding service to children with an Autism Spectrum Disorder and their
      families through the special education system.
  9) DOE wants to increase collaboration with appropriate State entities, parents,
      family groups and advocacy groups to increase the awareness as well as effective
      and efficient utilization of community services for children with Autism Spectrum
      Disorders that will improve the overall education, development, and success of
      these children in the community.
  10) DOE needs to provide guidance to the Directors of Special Education regarding
      the range of community service options for children with Autism.
  11) DOE sees the need for standards regarding the training to and services from staff
      in the special education setting.
  12) With the increased legislative attention on policy decisions influencing the service
      to children across the Autism Spectrum in the public schools, the DOE seeks
      pooling of knowledge and expertise to make informed policy recommendations
      and platforms.
  13) In general, DOE seeks to bridge all areas of services related to the education and
      development of the individual with ASD in an effort to service the whole child.
  14) Article 7 is being rewritten and DOE would like input and recommendations from
      the Autism community.

Strategies:
   1) Focus on a holistic approach to the child and the family by encouraging
       coordination, collaboration, and integration of caregivers/services across settings.
   2) Assist in the determination of efficient use of resources and appropriate funding
       opportunities for services for children with Autism Spectrum Disorders within the
       school system.
                                                                                  49

3) Create partnerships between schools, other health providers, parents and children
   with Autism Spectrum Disorders by encouraging collaboration and coordination
   across these individuals/systems.
4) Provide guidelines and recommendations regarding appropriate training for
   families as well as providers in the special education system inclusive of
   administration, special educators, general educators, resource specialists, and
   support staff.
5) Establish a short-term and long-term vision for the Department of Education as to
   effective and appropriate service provision for children with an Autism Spectrum
   Disorder
6) Provide guidance to the Department of Education on state policy regarding issues
   affecting children with an Autism Spectrum Disorder and their families including
   rule promulgation and legislative actions.
                                                                                       50


Appendix II: Task Force Members

                      List of Indiana’s Autism Task Force Members

Name                                     Organization or Affiliation

Naomi B. Swiezy, Ph.D., HSPP             Christian Sarkine Autism Treatment Center,
Clinical Director                        Riley Hospital for Children
(Co-Chair)
Gary Collings, Ed.D.                     Indiana Special Education Administrators’
Director                                 Services,
(Co-Chair)
Loui Lord Nelson, Ph.D.                  Independent Researcher/Consultant,
President                                Reliable Alliance in Special Education, Inc
(coordinator)
Bob Marra, Ed.D.                         Indiana Department of Education, Center for
Assistant Superintendent of              Exceptional Learners
Exceptional Learners
Susan Pieples                            Autism Society of Indiana
President, parent, and self-advocate
Lilia Teninty                            Division of Disability and Rehabilitative
Director and parent                      Services/Family and Social Services
                                         Administration
Liz Freeman-Floyd                        Indiana Autism Coalition
President and parent
Kim Dodson                               ARC of Indiana
Associate Executive Director
Cathy Pratt, Ph.D.                       Indiana Resource Center on Autism, Indiana
Director                                 Institute on Disability and Community
Greg Wilson, MD                          Neurodevelopment Disabilities, Pediatric
                                         Developmental Behavioral Health and
                                         Pediatrics
Leah Nellis, Ph.D., NCSP                 The Bloomberg Center, Indiana State
Director                                 University
Ann Schnepf                              Clark County Special Education Cooperative
Director of Special Education
Sheila Wolfe                             The Autism Education and Training Center,
Executive Director                       Inc (AETC)
Kylee Bassett                            Department of Education, Center for
Legal counsel and sibling                Exceptional Learners
Kristen Schunk                           Indiana Department of Education, Center for
Director                                 Exceptional Learners
                                                                                 51


Appendix III: A Summary of State Reports

Please see the separate documents titled:

Autism Spectrum Disorder Task Force Report: A Summary of State Reports Part I

Autism Spectrum Disorder Task Force Report: A Summary of State reports Part II

These documents can be found on the same webpage as this document.
                                                                                     52


Appendix IV: Listing of Presenters

                    Tables listing the presenters according to principle

                                   Presenters on Policy

        Name                                       Agency/Topic

Lilia Teninty            Family Social Services Agency/ Division of Disability

                         Rehabilitative Services

John Hill                Department of Education – Center for Exceptional Learners

                         /Medicaid in Schools

Kristen Schunk           DOE-CEL, 529 Plan

Cathy Pratt              Indiana Institute on Disability and Community-Indiana

                         Resource Center on Autism/IRCA Survey

Liz Freeman-Floyd        Indiana Autism Coalition/ Statewide Comprehensive Plan

Nina Brahm               DOE – CEL/ Review of Rule 26 Committee/Advisory Council

                         and Article 7

Michelle Trivedi         Volunteer and insurance expert

Cathy Pratt              IIDC – IRCA/ Overview of Insurance Concerns for Families

Kim Dodson               ARC of Indiana/ Review of upcoming legislative session

Senator Marvin           Indiana Commission on Autism/update on commission

Riegsecker               activities.

Scott Minier             Department of Education Legislative Liaison

Nancy Zemaitis           DOE – CEL

Teresa Grossi            IIDC – Center on Community Living and Careers / The 290

                         Group (transition to post-secondary)
                                                                                     53


Statewide Educational   Indiana Autism Academy / Updates on current activities within

Representatives         schools.

Leah Reed               Center for Medical Home Improvement / Medical Home

                        Website Initiative

Bob Marra and Nina      DOE – CEL / Article 7 language

Braham

Randy Krieble           FSSA / Outreach Crisis Assistance and Direct Support Staff

Andrew Ranck            Training Initiatives



                           Presenters on Service Provision

         Name                                     Agency/Topic

Lilia Teninty           Family Social Services Agency/ Division of Disability

                        Rehabilitative Services

John Hill               Department of Education –Center for Exceptional Learners

                        /Medicaid in Schools

Kristen Schunk          DOE-CEL, 529 Plan

Cathy Pratt             Indiana Institute on Disability and Community-Indiana

                        Resource Center on Autism/IRCA Survey

Liz Freeman-Floyd       Indiana Autism Coalition/ Statewide Comprehensive Plan

Michelle Trivedi        Volunteer and insurance expert

Cathy Pratt             IIDC – IRCA/ Overview of Insurance Concerns for Families

Nancy Zemaitis          DOE – CEL

Teresa Grossi           IIDC – Center on Community Living and Careers / The 290
                                                                                     54


                        Group (transition to post-secondary)

Jonathan Kraeszig       Vocational Rehabilitation

Statewide Educational   Indiana Autism Academy / Updates on current activities within

Representatives         schools.

Bob Marra and Nina      DOE – CEL / Article 7 language

Braham

Randy Krieble           FSSA / Outreach Crisis Assistance and Direct Support Staff

Andrew Ranck            Training Initiatives

Naomi Swiezy            The Christian Sarkine Autism Treatment Center, HANDS in

                        Autism Program



                                   Presenters on Training

         Name                                      Agency/Topic

Nina Brahm              DOE – CEL/ Review of Rule 26 Committee/Advisory Council

                        and Article 7

Nancy Zemaitis          DOE – CEL

Teresa Grossi           IIDC – Center on Community Living and Careers / The 290

                        Group (transition to post-secondary)

Jonathan Kraeszig       Vocational Rehabilitation

Statewide Educational   Indiana Autism Academy / Updates on current activities within

Representatives         schools.

Shawn Sriver            DOE – Professional Standards Board

Mary Glenn Rinne        DOE – Professional Standards Board
                                                                                     55


Susan Jacobs            Ball State – Indiana Designs Equitable Access of Learning

                        Project (IDEAL)

Pat Swails              Oakland City University / Indiana Association of Colleges for

                        Teacher Education

Bob Marra and Nina      DOE – CEL / Article 7 language

Braham

Randy Krieble           FSSA / Outreach Crisis Assistance and Direct Support Staff

Andrew Ranck            Training Initiatives

Naomi Swiezy            The Christian Sarkine Autism Treatment Center, HANDS in

                        Autism Program



                         Presenters on System Collaboration

         Name                                     Agency/Topic

Lilia Teninty           Family Social Services Agency/ Division of Disability

                        Rehabilitative Services

Kristen Schunk          DOE-CEL, 529 Plan

Liz Freeman-Floyd       Indiana Autism Coalition/ Statewide Comprehensive Plan

Nancy Zemaitis          DOE – CEL

Teresa Grossi           IIDC – Center on Community Living and Careers / The 290

                        Group (transition to post-secondary)

Statewide Educational   Indiana Autism Academy / Updates on current activities within

Representatives         schools.

Leah Reed               Center for Medical Home Improvement / Medical Home
                                                                             56


                Website Initiative

Susan Jacobs    Ball State – Indiana Designs Equitable Access of Learning

                Project (IDEAL)

Pat Swails      Oakland City University / Indiana Association of Colleges for

                Teacher Education

Randy Krieble   FSSA / Outreach Crisis Assistance and Direct Support Staff

Andrew Ranck    Training Initiatives

								
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