The Burkhart Project in Autism Education
Needs Assessment
Part I: Identifying Information
In this section, we are interested in obtaining identifying information about you and the children and families you work with.
1. What best describes your current position? (Check one)
2. What best describes your work setting? (Check one)
3. How long have you been working with children with disabilities?
4. How long have you been working with children with autism?
5. If you work primarily with children in a specific age range, what is that range?
6. What best describes the geographic setting in which you work?
7. Are there any special characteristics of children with whom you primarily work (e.g., children suffering sexual abuse; children with developmental disabilities, teen mothers; youth with aggressive behaviors etc.)?
Part II. Information Needs In Working With Children, Families, and
Other Professionals
In this section, we are interested in finding out what kinds of information would help you be more effective in working with children with autism and their families.
8. Assessment of Children and Adolescents
About what types of assessment processes would you like more information?
(If you have several areas of information need, place a "1" by the most important area, a "2" by the second-most important area, and so on.)
___ Assessing communication skill development
___ Assessing social skill development
___ Assessing executive functioning development (organization skills, focus)
___ Assessing classroom environment (amount of noise and sensory stimulation, activity)
___ Assessing "goodness-of-fit" within classroom context (ability to interact with peers)
___ Assessing the role of stereotypic behaviors
___ Ongoing assessment and evaluation
___ Conducting strength-based assessments
___ Other:
___ Other:
9. Developing School and Home Partnerships
About what types of interventions would you like more information?
(If you have several areas of information need, place a "1" by the most important area, a "2" by the second-most important area, and so on.)
___ Developing individualized education plans
___ Coordinating interventions across environments (e.g., home and school)
___ Behavior management at school and in the community
___ Behavior management at home or out-of-home placement
___ Communicating with physicians
___ Coordinating related service personnel
___ Communicating between home and school environments
___ Community service providers (dentists, physicians, hairstylists, etc)
___ Obtaining information about specialized services (hippotherapy, other special programs)
___ Parent/family support groups
___ Other:
___ Other:
10. Problems Experienced by Children and Adolescents with Autism
About which problems would additional information help you work more effectively?
(If you have several areas of information need, place a "1" by the most important area, a "2" by the second-most important area, and so on.)
___ Sensory and movement disorders
___ Attention problems
___ Self-injurious behaviors
___ Aggressive/oppositional behaviors
___ Learning disorders
___ Need for environmental predictability
___ Communication disorders
___ Lack of eye contact
___ Repetitive behaviors
___ Difficulty developing relationships
___ Intellectual functioning problems
___ Echolalia
___ Visual disorders
___ Obsessions and tics
___ Eating disorders
___ Other:
___ Sleep disorders
___ Other:
11. Specific Interventions for Working with Children with Autism
(Place a "check" next to interventions that you currently use and an "X" next to those you would like to know more about.)
___ Incidental Teaching
___ Social Stories
___ Son-rise Program
___ Project TEACH
___ Applied behavioral analysis
___ Positive behavioral support
___ Focus on pivotal areas
___ Other:
___ Other:
12. Working with Families
About what types of practices would you like more information?
(If you have several areas of information need, place a "1" by the most important area, a "2" by the second-most important area, and so on.)
___ Involving families actively in educational planning
___ Developing individualized educations plans
___ Helping families care for a child with autism
___ Family preservation support
___ Family support services and respite care
___ Connecting families to other service providers/ programs
___ Coordinating interventions across environments (e.g., home and school)
___ Establishing effective communication channels
___ Support groups for parents
13. Maximizing Community Resources
Information about what types of practices would help you maximize community resources?
(If you have several areas of information need, place a "1" by the most important area, a "2" by the second-most important area, and so on.)
___ Obtaining and using community resources
___ Developing individualized educational plans coordinated across environments
___ Creating a community-based service array
___ Coordinating with other child-serving agencies
___ Connecting families to community resources
___ Early identification and intervention
___ Delivering culturally-competent services
Part III. Acquiring Information
We are interested in how, or from whom, you receive information about working with children with emotional and behavioral problems and their families.
14. Where you currently get information
In order to receive more information about the areas listed in Part II, what sources do you currently use?
(If you have several sources you might utilize, place a "1" by the most likely source, a "2" by the second-most likely source, and so on.)
___ Professional/academic library
___ Consultation with a teacher
___ Community library
___ Inservice trainings
___ Professional conference/workshop
___ Public health office
___ Resource center
___ Community mental health center
___ Resource materials (monographs,
manuals, etc.)
___ Local schools
___ Professional journals
___ Advocacy or support groups
___ On-line services (Internet/bulletin
boards)
___ Parent networks
___ Consultation w/a professional within
your discipline
___ Other:
___ Consultation w/an individual within
your discipline
___ Other:
15. Accessing other professionals
From what types of professionals do you get information about working with children and families?
(Use a scale of 0-2 to rate how often you access each professional: 0 = never, 1 = sometimes, 2 = often.)
___ Child welfare co-worker
___ University Professor
___ Child welfare supervisor/
administrator
___ Public health nurse
___ Mental health clinician/
counselor/therapist
___ Developmental pediatrician
___ Behavioral consultant/specialist
___ Other physician
___ Psychiatrist
___ Speech/language specialist
___ School counselor/psychologist
___ Occupational/physical therapist
___ School administrator/teacher
___ Parent advocate/liaison
___ Educational Diagnostician ___ Other parents
16. Preferred ways of getting information
If you were to receive information about serving children and families from a national resource center, what would be your preferred way(s) to receive that information?
(Please place a "1" by the most preferred way, a "2" by the second-most preferred way, and so on.)
___ World Wide Web
___ Catalogues of available resource
materials
___ Internet: E-mail, ListServ, Bulletin
board
___ Fact sheets/newsletters
___ Postal service (hard copies)
___ Conferences or workshops
___ 800 number
___ Journal articles/monographs
___ Videotapes
___ Conference calls
___ Faxes
___ Other:
___ CD training modules
17. Do you have access to the Internet?
18. Do you have an e-mail address? If so, what is it?
Part IV. Further Insights and Correspondence Information
19. What do you believe to be the largest barriers to improving services for children and families affected by autism?
20. What strategies have helped you most to provide effective services to children and families affected by autism?
21. What more can you tell us about receiving information on providing services to children and families affected by autism and/or collaborating with other service providers?
22. Other comments?
23. Would it be permissible for us to contact you in the future if we have further questions?
24. Would you like to be maintained on a mailing list to receive updated information?
Preferred Address (if you responded "Yes" to either of the above):
Name ____________________________________
Address __________________________________
Telephone and/or FAX______________________
e-mail____________________________________
Please return the completed survey to:
The Burkhart Project for Autism Education
Robin H. Lock, Ph.D. and Carol A. Layton, Ed.D.
Texas Tech University
College of Education
Box 41071
Lubbock, TX 79409-1071