Abstract
The SKILLS curriculum is a web-based curriculum of (4k) targets for designing and managing applied behavior analysis-based treatment programs for children with autism and related disorders.
Category
Curriculum for Autism Treatment
Bottom Line.
Get this program if you want a comprehensive curriculum, can understand behavioral jargon, and want to allocate more of your time on therapy and less time typing out programs. This tool will allow you to focus your time and resources on teaching skills that matter without having to worry that you are missing steps in a sequence or teaching things sooner than you should. It received 4/5 stars only because of the learning curve required to navigate it and its incomplete feel at times (missing videos, etc.)
Experience
The Center for Autism and Related Disorders (CARD) provided me with a trial login for the SKILLS account, and I dove in immediately! The promise of almost 4000 skills (3372 by my count) available at my fingertips was enticing. After logging in, I was prompted to create a profile for the child for whom I would be programming (Little Johnny). In less than 5 minutes, I had Little Johnny in the system and ready for treatment. Once entered, I clicked his name and was taken to his dashboard.
The dashboard feature promises an overview of Little Johnny's progress through assessment, treatment, and mastery of skills at the click of a tab. At the top of this page, steps are numbered and displayed: (1) choose child, (2) start assessment, (3) choose activity, and (4) start treatment. There's a small button at the bottom right of this page that prompts a click when ready to continue (to Step 2: assessment).
The assessment step begins with a screener, which the SKILLS system uses my answers from 11 questions (e.g., Can your child stand without assistance?; Does your child answer questions in full sentences?) to select and present a list of curricular assessments. I dutifully answered the questions about a fictional Little Johnny and was taken to a dizzying list of assessments. Happily, before I begin each, I was provided with the number of questions involved allowing me to select an assessment that I currently had time to complete (Joint Attention, for instance has 14 questions while Basic Social Skills only has 2).
Since I had plenty of time, I selected Joint Attention and began diligently selecting yes/no/probe to each of the 14 questions. The probe option basically suspends the answer until you can actually probe the skill. I imagine this feature will reduce inaccurate assessments due to people guessing on items that they are not sure about. After reporting Little Johnny's joint attention skills, I clicked continue and was taken to a page to choose activities (Step 3). On this page, Little Johnny's deficits were presented as sections under which specific activities were described and listed in order of difficulty. Adding them to Johnny's treatment program was as simple as ticking a digital checkmark. In case there was confusion about an activity, I had the option of watching a treatment video and looking at activity summary sheets comprising material setup, Discriminative Stimuli (SDs), responses, examples, and a list of prerequisites (it is important to note that these summary sheets use technical language such as SD instead of instruction). This would probably prove difficult for someone with no training in behavior analysis. It does use lay-friendly language, however, for the sample Individual Education Plan IEP goals and benchmarks. I imagine each of these would be handy to print out and place in Little Johnny's program binder, if he were real.
After selecting Little Johnny's activities to learn, I continued on to Step 4, Start Treatment. On this page, all of the activities I had just selected show up and detailed SDs and responses are provided. The next step here is not so clear. After a little exploration (and another treatment video), I “opened” the first activity and am taken to the guide page for that activity. There are tabs for details, teaching steps, exemplars, and handouts and status. This is a more detailed version of the summary sheet which includes editable teaching tips and customizable prompt levels. From here I was able to view the programmed teaching steps (this activity, “responding to joint attention bids” does not have any pre-selected steps) or create custom ones (in case Little Johnny needs smaller steps in his programming). The status tab included the date it was added into the current program. While the options are interesting, I was ready to begin treatment, and found myself frustrated because I did not know what to do to next to actually start teaching. By now, I am used to clicking the continue button, a feature which normally resides at the bottom right of each page and is conspicuously missing now. At this point, I began clicking various hyperlinks and pictures in a digital extinction burst. Happily, it paid off, and I clicked the correct link, which opened a dialogue box allowing me to introduce the activity that marks this date as the introduction of that skill. I can then print off the activity brief and go find Little Johnny, it is teaching time!
Presumably, after some exemplary ABA-based therapy, Little Johnny would begin mastering tasks, and I would trek back through the steps again, except this time, after choosing Johnny (Step 1), I would move directly to the start teaching (Step 4). This may lead to some confusion at first, because I already did the teaching; but this is the place in SKILLS that I enter how my teaching impacted Johnny's skill set, selecting either “known” or “generalized” for each skill mastered. Once Johnny has mastered the requisite number of teaching steps and exemplars, it is time to choose another activity (Step 3). The order here seems a little counter-intuitive, but once experienced, it becomes fairly straightforward.
Finally, after entering this data, I now have access to a variety of charts and reports that summarize the progress of his treatment, curriculum lesson details, clinical timelines, and even a chart that organizes skills based on Skinner's verbal operants. Overall, this seems to be a powerful curriculum that has impressive breadth and provides organizational tools to provide the clinician the tools needed to maintain maximum efficiency in teaching and managing their caseload.
Aversive
Currently the SKILLS™ curriculum appears to be a work in progress. From webinars I have attended and material on the website, it appears that SKILLS™ is best conceptualized as a living document such that as the CARD team enhances and refines their behavioral programming, the curriculum will likely be updated. Additionally, this is made salient when it is noted that some of the activities do not yet have videos. While it is a downside now, the fact that it is evolving can easily be seen as a positive feature (especially to those focusing on the future). Currently there is no ability to enter/track individual data for programs. SKILLS only collects data on introduction and mastery of targets. There are hints that this may be a future feature.
My biggest gripe was that I wanted to do the entire assessment battery at once. Once I completed an assessment, the button that said “submit and continue” took me to Step 3 where I chose targets to train. There was a button below that said “submit and go back to assessment.” Because the dashboard categorized the steps numerically, it appears that the user should progress through each step in that order and will be finished at the conclusion of Step 4. However, once the first step is completed (select child), the remaining three (2: assessment, 3: activity choice, and 4: treatment) are meant to be accessed iteratively for each curricular segment. This is not apparent, and until I realized it, led to some frustration in navigating the site. This is likely to lead to a longer learning curve, but once understood, it is unlikely to interfere with usability. The user manual would have helped (in fact –did help – when I finally referred to it, after the fact), but the 65 pages were daunting. As a savvy computer technologist, I assumed I would be able to make it work without resorting to a manual. There are also video tutorials to guide the user through this process on the support center site.
Appetitive
The curricular organization is one of its strengths. SKILLS™ has eight curricular areas: Social, Motor, Language, Adaptive, Play, Executive Functions, Cognition, and Academic. Each curriculum comprises a number of different domains consisting of lessons that house the skills. Each skill is categorized as either a building block, fundamental skill, or expansion skill. The skills are age-referenced and the curricular system is designed to prompt for checks on skills as the child ages.
The SKILLS™ website design is pleasant and straightforward. While there were a few times I was left scratching my head and attempting to figure out what/where to click next, the design was in general user friendly and intuitive. Once I had gained experience with it (after adding/assessing the fourth fictional child), I was able to move through the assessment/treatment process readily.
SKILLS™ is an excellent tool for a team looking for a comprehensive curriculum for children with autism (I've yet to see one with more breadth and scope) that was created to be used in an ABA-based treatment program by experts in the field. Additionally, it provides some standardization that should appeal to researchers interested in effects on learning on a large scale.
Neutral
This program is handy if the user has something in mind that they want to assess/treat (i.e., to see how his social skills with peers are doing) that fits within the curricular domain. If, however, the desire is a broad overview of *all* the assessments and skills that have been assessed or trained, the user is out of luck. This feature (a button that would list everything on one screen) would benefit the usability of the site. However, the fact that the curriculum forces the user to focus on both scope and sequence may be intentional by the designers to minimize the likelihood that splinter skills are less likely to form. The use of technically precise language is a strength if the user is a behavior analyst. As such, this curriculum seems best used by a professional rather than picked up by a member of the lay population. For behavior analysts who balk at online curriculums, worrying that they will be replaced by them, the use of technical jargon should be comforting as it encourages parents to consult with a professional rather than replace them.
Cost
The price point of this curriculum can be a great thing for some while others may find it a little beyond the reach of their budget. For the professional, the cost is $50/month per child. However, when I attempted to purchase, the only options I noticed were for five or ten children. It is unclear whether I have to pay $250/month for five children even if I only have one or two, or whether there is a method to only pay per child's profile used.
For a parent, the cost is $75/month per child and $25/month extra for a second. Parents purchase these profiles one or two at a time.
Bonus Features
I explored, but did not include in the review several features of SKILLS™ curriculum. Their exclusion was a function of their value compared to the curriculum proper.
There is a behavior support plan feature to develop function-based interventions for decelerative targets.
Weekly tracking for treatment hours that will make billing easier.
This wasn't made clear when I was first examining/trying SKILLS™, but an account comes with a free subscription to www.cardelearning.com.
