EFL: An Overview

Essential for Living: A Journey to Life Skills

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The mission of Essential for Living is to provide children and adults with moderate-to-severe disabilities,
including but not limited to autism, a comprehensive life skills curriculum with social validity,
along with evidence-based teaching and measurement strategies and procedures,
that result in the dignity and quality of life these children and adults deserve

The idea for a new curriculum and teaching handbook for children and adults with moderate-to-severe disabilities first emerged in 2004 from conversations between Patrick McGreevy and Troy Fry, the authors of this paper. We had spent many years working with these children and adults, especially those with limited skill repertoires and severe problem behavior. 

Some of these conversations recounted our earlier experiences with non-verbal learners, who, when we first encountered them, did not have an effective alternative method of speaking and, as a result, could not ‘get their wants and needs met’. We recounted our experiences with functional assessment and functional communication training [FCT] (Carr & Durand, 1985). Along with many of our colleagues, we provided some of these learners with a functional assessment and a replacement behavior, permitting them to request one of the following: ‘attention’ by tapping someone’s arm, ‘a break from demands’ by making a gesture or presenting a card, or ‘something to eat’, ‘something to drink’, or ‘something with which to play’ by making a gesture or a generalized sign. Even when one of these behaviors replaced the problem behaviors, additional speaking and listening skills often became more difficult to teach, and a ‘speaking repertoire’ of ‘requests for specific wants and needs’ seldom emerged. With other children and adults we provided only procedures designed to reduce the occurrence of problem behavior or protect them from the outcomes of the same. 

Many of these same conversations recounted our later experiences applying B. F. Skinner’s analysis of language, known as ‘verbal behavior’ (Sundberg & Partington, 1998; Carbone, 2000-2019; Sundberg & Michael, 2001) with minimally-verbal and non-verbal children and adults, but especially those without an effective method of speaking. Along with some of our colleagues, we provided an effective method of speaking for each of these learners and began to build ‘speaking repertoires’ for them which included ‘requests for specific wants and needs’. Some of these learners with echoic responses were taught to use spoken words, while others were taught to ‘speak’ by forming standard, adapted, tactile, or idiosyncratic signs, exchanging or pointing to pictures or digital images, or selecting objects or words spoken by others. Thanks to B. F. Skinner’s analysis, along with that of Barry Lowenkron (1991, 2006), we were also able to efficiently teach various forms of listener responding.

In 1999 and 2000, many professionals were beginning to apply ‘verbal behavior’, but almost exclusively with children with autism, teaching developmentally-sequenced skills, at first from The Assessment of Basic Lan-guage and Learning Skills [the ABLLS](Partington & Sundberg, 1998), and a few years later from The Verbal Behavior Milestones Assessment and Placement Program [the VB-MAPP] (Sundberg, 2008). These instruments were composed of skills acquired by typically-developing children from 1-4 years of age and were designed to help young children with autism ‘catch up’ to these peers. Many older children with autism were being taught these same skills, but were ‘not catching up’. These children were experiencing barriers to the acquisition of language and pre-academic skills that, even with very high quality instruction, was essentially insurmountable. With no curricular alternative, instruction often continued with these same skills. 

Meanwhile, children and adults with other moderate-to-severe disabilities were largely not benefitting from Skinner’s analysis, that is, they were seldom provided with effective methods of speaking and professionals seldom built ‘speaking repertoires’ for them.

And so, in 2006 we began a journey that, in 2013, would result in Essential for Living. It was a journey that began tentatively as Language for Living, a curriculum and teaching handbook designed to bring a method of speaking and ‘verbal behavior’ as a speaker and a listener to ‘older minimally verbal and non-verbal children and adults with autism’, along with ‘children and adults with all other moderate-to-severe disabilities’. During this journey, it became increasingly obvious to us that, in many states, the Common Core State Standards, along with full inclusion, were having a direct, negative impact on the education of these children. They were being ‘exposed’ to academic lessons with limited to no pragmatic value, along abstract concepts and conditional discriminations with which they would struggle mightily. As a result, daily living skills, including leisure and vocational skills, along with tolerating skills became part of our agenda and Language for Living became Essential for Living

We invite you to join us as the Essential for Living journey continues…

Essential for Living (McGreevy, Fry, & Cornwall, 2012, 2014)is a curriculum-based assessment (CBA) instrument, that is, a criterion-referenced assessment instrument that is also a curriculum. These instruments have an extensive history in special education, early intervention, and transi-tion services for children and young adults with learning or developmental disabilities (Gickling & Thompson, 1985; Tucker, 1985; Deno, 1989; Shinn, 1989; Bagnato, 1997). These instruments are referenced against specific curricula and are used to inform and implement IEPs, ISPs, program plans, intervention plans, and behavior improvement plans. 

Essential for Living (EFL) is a functional, life skills curriculum-based assessment instrument designed for children and adults with moderate-to-severe disabilities, including but not limited to autism, who exhibit limited skill repertoires and problem behavior. EFL is referenced against criteria, in the form of specific skills within the instrument, that are necessary for safe, effective, and high-quality participation in family, school, and community living, and which are reasonable and appro-priate expectations of instruction for many of these learners. 

Some curriculum-based assessment instruments are also referenced against age criteria associated with typical child development or typical language development and include language skills, social skills, and milestones that are acquired by typically-developing children between the ages of one and four. These developmental instruments include The Verbal Behavior Milestones Assessment and Placement Program [VB-MAPP, 2nd. Ed.] (Sundberg, 2008), The Assessment of Basic Language and Learning Skills [ABLLS-R] (Partington, 2010), and The Early Start Denver Model [ESDM] (Rogers & Dawson, 2010).These instruments, with these references, are designed only for young children with autism or language delays for whom expectations of ‘catching up’ to their typically-developing peers and acquiring pre-academic and academic skills are both reasonable and appropriate. 

The majority of children with autism and many children with language delays, even after intensive inter-vention, continue to have difficulty acquiring abstract concepts, complex [conditional] discriminations, and meaningful answers to questions [intraverbal responses]. These children seldom experience general-ization [stimulus generalization], bursts of language [behavioral cusps], or the ‘emergence’ of new skills without instruction [response generalization, generative learning, or derived relations]. Even with high-quality instruction, these difficulties will often continue to function as barriers to the acquisition of additional language skills, along with pre-academic and academic skills. For these children, expectations that include ‘catching up’ to their typically-developing peers will no longer be reasonable or appropriate. Instead, expec-tations consistent with safe, effective, and high-quality participation in family, school, and commun-ity living should be considered and ‘life skills’ and Essential for Living shouldguide further instruction. This change in expectations will be difficult for the parents of many of these children and will necessitate thoughtful discussions over a period of time. But these discussions must occur or ‘ignorance will become our curriculum’ (D’Amelio, 1971) and ‘what we have not considered, we will be unlikely to change’ (Sagan, 1980). 

Many children with named developmental disabilities, like Down syndrome, Tay Sachs syndrome, Angelman syndrome, or Microcephaly, and unnamed pervasive, intellectual or developmental disabilities also experience the difficulties previously described. In recent years, some of these children have also been ‘diagnosed’ with [categorized as having] autism. Regardless of age or history of instruction, neither curricular references to typical development nor expectations for these children that include ‘catching up’ to their typically-developing peers are reasonable or appropriate. Expectations consistent with safe, effective, and high-quality participation in family, school, and community living should be embraced, and ‘life skills’ and Essential for Living should guide instruction and habilitation.

Essential for Living includes over three thousand skills sorted into domains on communication, language, daily living, social, functional academic, and tolerating skills, along with a domain on severe problem behavior,which encompass the core components of autism and many other developmental disabilities. Skills within these domains are sequenced from must-have, to should-have, to good-to-have, to nice-to-have, relative to safe, effective, and high-quality participation in family, school, and community living. The must-have skills are also called the Essential Eight:

1- Making requestsfor access to highly preferred items and activities and for the removal or reduction in intensity of specific situations,

2- Waiting after making requests,

3- Accepting removals — the removal of preferred items and activities making transitions, sharing, and taking turns

4- Completing brief, previously acquired tasks,

5- Accepting ‘No’,

6- Following directions related to health and safety

7- Completing daily living skills related to health and safety, and

8- Tolerating situations related to health and safety.

Skills within Essential for Living do not require response generalization or derived relations for children or adults to achieve safe, effective, and high-quality participation in family, school, and community living. In addition, skills within Essential for Living often inform the appropriate setting for instruction, by specifying the context in which these skills will be required in everyday living. 

Unlike other life skills curricula (cf. Killion, 2003 [The Functional Independence Skills Handbook — FISH]; Partington & Mueller, 2012 [The Assessment of Functional Living Skills — AFLS]), Essential for Living emphasizes communication and pragmatic language skills andis especially designed for learners with limited or no spoken-word repertoires. A substantial portion of the instrument is devoted to helping users determine if a non-verbal or minimally-verbal child or an adult needs an alternative method of speaking, which methods would be consistent with his sensory, skill, and behavioral repertoires, which methods would be Continuously Available to him, which methods would permit him to Frequently and Effortlessly ‘say’ what he wants and needs to say, and which methods are more likely than others to last a lifetime.

Essential for Living emphasizes interactions and discriminations that tend to occur in concrete situations. Many children and adults with moderate-to-severe disabilities can learn to perform specific skills in these situations fluently, even beyond performance levels typically exhibited by persons without disabilities (Lindsley, 1964; Sacks, 1970, 1985; Gold, 1978; Barrett, 1979).

IDEA [the Individuals with Disabilities Education Act] requires that students with disabilities who have reach-ed the age of 16 are required to have a formal transition plan. For students with moderate-to-severe disabilities whose previous IEPs have been largely guided by the Common Core State Standards, Essential for Living can easily be used to develop functional, life skills transition plans. 

Essential for Living is the only life skills curriculum that is based on B. F. Skinner’s analysis of the function of language as a speaker and a listener [verbal behavior] (Skinner, 1957; Catania, 1998; Michael, 2004; Sundberg, 2007; Greer & Ross, 2007), along with the pragmatic implications of this analysis for language intervention with children and adults with limited repertoires (Sundberg & Partington, 1998; Sundberg & Michael, 2001; Greer & Ross, 2007; McGreevy, 2009). In the context of this analysis, Essential for Living is also the only life skills curriculum based on the radical behaviorism of Skinner (Skinner, 1974), specifically addressing private events, that is, thoughts, feelings, and sensations, and how you might teach functional verbal responses when these events occur or compensate for the lack thereof. An understanding and implementation of Essential for Living, however, requires neither prior knowledge of these elements, nor previous experience with their application. 

Essential for Living is also the only life skills curriculum that permits the measurement of small increments of learner progress from problem behavior in the context of skill acquisition — to prompts and prompt-fading — to fluency — to generalization across settings and people — to maintenance over time. Each of the boxes used to record learner progress represents a visible improvement in  their quality of life. 

And, Essential for Living is the only life skills curriculum that includes a range of skills and skill repertoires specifically for children and adults with severe, multiple disabilities, medically-fragile or terminal conditions, or severe aggressive and self-injurious behavior. Essential for Living is also the only life skills curriculum that encourages users to fade prompts, unnecessary supports, and continuous forms of reinforcement that do not typically occur in everyday interactions.

Many skills within Essential for Living are required in frequently-occurring, everyday situations. Hence, with respect to their importance as instructional goals, these skills have social validity (Wolf, 1976; Kazdin, 1977; Wolf, 1978). Empirically-validated teaching procedures that are part of Essential for Living, along with the measurement of fluency and generalization across people and settings as outcomes of instruction, also address this important issue and continue to ‘help behavior analysis and special education find their heart’ (Wolf, 1978). 

Essential for Living encourages users, who record the occurrence of problem behavior, to display these data on an adaptation of the Standard Celeration Chart (McGreevy, 2012, in press), which insures an interpretation that is not influenced by the dimensions of the display itself. Essential for Living also permits the measurement of problem behavior and the supports these behaviors may require over months and years.

Essential for Living is currently used in public school classrooms. The communication, language, and functional academic skills of Essential for Living are linked to the Common Core State Standards, permitting the development of IEP objectives that are functional and individualized, and yet, to some degree, related to these standards. Essential for Living is also used inprivate schools and centers for children with autism, along with day activity and vocational settings for adults, and residential and hospital settings for both children and adults.

References

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