NYC ASD Nest program was developed at Hunter College is currently active in 325 classroom across 54 NYC public schools, engaging 1500 students with ASD and 5,000 general education peers.

NYU ASD Nest Support Webpage (2020)

ASD Nest educators teach the general education curriculum, using specialized supports drawn from evidence-based and promising practices. Students are helped to develop competence in their social and behavioral functioning, in order to ultimately realize their full, unique potential as independent and happy adults.

Video below offers a more in depth overview of ASD Nest program.

^{Retreived from New York University: ASD Nest — Overview:  https://vimeo.com/61829323}

Video demonstrates how Nest program assists students access general educational experience to the best of their ability. It also describes Social Development Intervention model which works hand in hand with academic curriculum.  

Keonig et al. (2009) in their article titled "The ASD Nest Program", described the ASD Nest Model. Table below retreived from that article lists key elements of the this inclusive educational model. 

Collaborative approach from support team really comes through when looking at these elements: co-teaching, training for teachers, ongoing site support from NYU, and additional learning opportunities. Success of the program rests on the shoulders of a dedicated team. 

Key elements of the ASD Nest Program (Koenig, 2009)

Koenig (2009) also discussed the basic instructional strategies that are used in ASD Nest classroom. 

1. Visual Supports

Many children with ASD process information more accurately through their visual than auditory system (Roley et al., 2015). Maladaptive behaviors maybe stemming from their difficulty understanding directions. Visual aids such as pictures, words, drawings and demonstration are used during instruction. For example, daily visual class schedule where completed activities are moved to completed column or flipped over, supplement or replace verbal directions eliminating need for repetition. Difficulty in communicating their needs, explain feeling or emotions when overwhelmed is another reason for maladaptive behaviors. The Incredible 5-Point Scale (Buron & Curtis, 2003) displayed in the image below, is a visual tool which assigns numbers 1 to 5 to different levels or types of behavior or feelings. 

Buron's 5 Point Scale

The visual connection helps make behavioral expectations more concrete.

Here is a link to Kari Dunn Buron (2020) presentation on how to use 5-point scale.

There are anecdotal reports of parents and teachers speaking to visual strategies as unnecessary crutches that should be removed as soon the child is ready. However, if one consideres that we all rely on visual devices through electronics to keep us organized on daily basis those views have little merit. Expectations that students should wait for teachers to tell them about the schedule which I call a 'realtime walking verbal prompt' is more of a crutch. There has also been a debate in regards to visual supports effect on the development of ASD communication (Arthur-Kelly et al., 2009). Overall, it all comes down to the goals for the use of visual structure. Visual structure might be an additional mode of delivering content to the students. It would benefit all visual learners in ensuring that information is received or processed efficiently. It may be used as a support for communicating needs. It may also be used to decrease anxiety behaviors through seeing what activities to expect.

2. Addressing Sensory Challenges

Sensory integration dysfunction is a common co-occurring diagnosis in individuals with ASD (Ayres, 1970-1998). Adults with ASD provided insight into how the environment overwhelms their sensory systems and which modifications have helped them cope (Grandin, 1995; Stillman, 2002).  

Here is a video which can help one understand what sensory overload may feel like. 

^{Retrieved from https://youtu.be/K2P4Ed6G3gw}

As seen in the video, for learners with ASD just "staying put" and organized in the classroom or any other environment is challenging. ASD Nest classrooms are organized with sensory difficulties of the students in mind. The ASD Nest Program's occupational and physical therapists who are trained in sensory integration arena, work in close collaboration with the classroom teachers to create a sensory environment that meets the needs of all children. In figure from article by Koenig (2009), organization of the classroom environment is highlighted. 

Organization of Classroom Environment (Koenig, K. P., Bleiweiss, J., Brennan, S., Cohen, S., & Siegel, D. E., 2009).

Some strategies that I have employed include setting up a 'safe space' where a child who is overwhelmed can retreat to. Engage the children in movement activities which help the child adjust to current or upcoming overwhelming stimuli and stay focused. Use of equipment such as noise canceling headphones or weighted vests in addition to active strategies. Use the link to Sensory Integration Learning Module (Len, 2019) for further information. 

3. Addressing Behaviors & Choice Making

As dicussed earlier, the ASD Nest schools use classwide reinforcement systems as well as individualized behavior supports that require a differentiated response.  Koenig (2009) explains:

"The basic standard applied to selection of such systems is that they do not have negative components (e.g., nothing earned by a child is ever retracted and no negative feedback is provided], Children do not get crosses for poor behavior; they get checks or stars or something else for doing or attempting to do what is expected" (p.9).

Individualized Behavior Supports is used for children with ASD who have very individualized behavior needs that require a differentiated response. 

Children in the ASD Nest Program have frequent opportunities for making choices throughout the day. Utilizing preferred interests increases task engagement, attention, and the reduction of negative behaviors (Boyd, Conroy, Mancii, Nakao, & Alter, 2007).

4. Social Skills Development

For many children with ASD, acquiring more appropriate social skills and behavior is a challenging task. Direct instruction alone, or modeling alone or with direct instruction, may be insufficient in helping some children on the spectrum master new behavior. Koenig (2009) describes the process as following:

"Role play (is used), first by adults, then by adults with children, and then by two or more children together, is added to the mix, many more children finally "get it." Peer supports, in the form of peer buddies, are an important feature of the ASD Nest Program. There are 8 to 12 typically developing peers in each ASD Nest class. The first critical step in the process of implementing peer supports is identifying peers who display some mutual interest in each other. Then the adults assess the likelihood that the interaction wilt be mutually beneficial, with the typical child displaying a helping disposition. The teacher then facilitates the relationshipby providing multiple opportunities for the children involved to interact (e.g., seating them next to one another, putting them together for paired reading, making them line partners, assigning them jointly to classroom jobs and errands) and by providing either formal training or informal guidance to the typical peer mentor on how to be most useful to his/her partner. Note that some children with ASD can also serve as peer mentors in specific situations with appropriate guidance" (p.9).

Social Development Intervention (SDI) (Koenig, 2009)

In addition to the core curriculum strategies in the ASD Nest classrooms, the program utilizes a social development intervention (SDI) curriculum which focuses on "social communication, social problem solving, social skills, and pragmatic language development, and aims to promote the development of intrinsically motivated social interaction across environments" (Brennan & Engel, 2007; Brennan & Hough, 2008). Below is a table listing key elements of SID Program.

Social Development Intervention (SDI) (Koenig, K. P., Bleiweiss, J., Brennan, S., Cohen, S., & Siegel, D. E., 2009).

Research Results

Koenig et al., (2009) qualitative and quantitative data from pre-post test interview with 27 parents as well as teacher-rating of 31 students' problematic, sensory and prosocial behaviors demonstrated evidence of ASD Nest being an effective program that is successful in addressing parent concerns as well as positive academic, social, and behavioral outcomes. Students demonstrated decreased aggression, increased social initiation, and improved relationships with peers, as well as mastery of academic goals. 

The data comes from one class in one program. Larger sample would be important to include in the next stage to assess if every program had similar success. Interview data came from the parents of the children attending the program yet the students perception of the learning expereince was not explored. 

Below is a video made by NYU, which offers insight into parents' perspective of ASD Nest program. 

^{Retreived from New York University: ASD Nest - Parents Perspective (https://vimeo.com/61827876)}

Five yeas later, Keonig (2014) assessed implementation fidelity of ASD Nest program in 10 classrooms. A 30-item Guideposts Checklist was developed to measure adherence to the core components described in previous section and summarized below:

1. "Organization of the Classroom Environment: It is often the inability to regulate one’s own behavior in response to environmental demands, many of which have a sensory or social basis that contributes to behavioral challenges for individuals with ASD. The ASD Nest Classroom is organized to minimize distractions, to organize and to predict activities and routines, and to understand expectations (Barton et al., 2011; Odom et al., 2010).

2. Basic Instructional Strategies and Visual Aids: The use of visual aids may enable children with ASD who are better at visual processing than auditory processing to function more productively in the classroom. Visual supports provide students with increased predictability, help structure their environment, plan their day, and clarify expectations (Barton et al., 2011; Dettmer, Simpson, Myles, & Ganz, 2000; Mesibov & Shea, 2008; National Autism Center, 2009; Odom et al., 2010;).

3. Individualized Learning and Behavior Supports: Reduction of behavioral difficulties, often referred to as ‘‘impeding behaviors,’’ is one of the major tasks of school programs for children with autism spectrum disorders. Positive behavior supports (Carr, 2007; Crimmins, Farrell, Smith, & Bailey, 2007; Durand & Hieneman, 2008) are an integral component of the ASD Nest program. Systematic reviews have demonstrated the value of a Positive Behavior Support approach to working with students who have ASD (Bambara, 2005; Horner, Carr, Strain, Todd, & Reed, 2002; Howlin, Magiati, & Charman, 2009). Individualized supports serve to prevent impeding behavior, replace impeding behavior with more appropriate behavior that meets the same function, and respond to continued impeding behavior. The most successful strategies are proactive, and are designed to make problem behavior ineffective, inefficient, and irrelevant" (Keonig, 2014, p. 255) ^{see article for cited references}

Authors report results which indicate good implementation of organizational elements of the classroom, and use of autism specific strategies (i.e., visual aids for voice modulation, social stories). However, they also identified variable fidelity with other elements (high probability requests). Teachers seem to carry out interventions that fit within overall classroom structure and benefit the whole class, but have more difficulty implementing strategies from individual students plans which are focused on modifying individual behavior (Keonig, 2014, p.260).

Teachers' difficulty in adhering to individualized strategies is a bit concerning and would require further inquiry on how to support students and teachers to ensure the needs are met.

In this program evaluation students' perspective again was not considered. The effectiveness if interventions and student’s success was measured through grades and teacher scores. Teachers who are recruited to instruct in the ASD program are invested in it. This creates certain biases in grading students' performance. Also, students are major stakeholders in the program yet their feedback was not considered. In the future, students' overall experience in the classroom from both ASD and general education side should be taken into account. Lastly, decrease in adherence to individual student support plans and its necessity to overall students' success should be explored further. both teacher and students' perspective.

Concepts, strategies and methodology described as part of ASD Nest program has been applied in other domains. Related service providers (occupational, physical, speech therapist) incorporate environmental adaptation, visual structure and behavior management theory to their practice (Allen et al., 2017; Tomchek et al., 2017). Use of visual support and parent-child interaction to improve students' behaviors across environments has been featured in literature as well (Armstrong et al., 2015). In my practice, these strategies have been an integral part of therapy session for over 15 years and it is wonderful to see them applied in various settings to support students with ASD.

One of the areas where I would love to see further application of environmental adaptations is in the public parks, playgrounds and large gathering events. The understanding of how to adapt sound, lighting and individual's proximity to each other could help open additional opportunities for those with sensory processing challenges and promote inclusivity.

The goal of this review was to introduce reader to an inclusive education model for high functioning students with ASD. The review included articles on NYC ASD Nest model; literature to establish context; reviewed history of ASD and student's learner differences; information on the theoretical frameworks and curriculum development as well as, research focused on ASD Nest program evaluation.

More research in program evaluation is needed into existing ASD programs. Further exploration of adherence to fidelity through the years is necessary. As each Nest program is ran by a different principal, there might be changes or additions in the individual classes. For example, one school offers enriched curriculum in the Nest ASD program which is typically offered in the gifted and talented classrooms. Also, with teachers looking for ways to support the learner difference of students with ASD, I have observed emergence of multimodal pedagogical approach with the use of technology. Questions arise how do all these changes influence the fidelity of the NEST ASD program overall.

With significant resources dedicated to professional development when the program is launched and to support it in the early years, it would also be important to assess the change in dosage of professional education intensity for teaching staff externally versus internally by seasoned staff overtime.

Additional research is needed to assess the impact the Nest classroom environment has on neurotypical students and gain overall students' perspective about the program. Further, finding out from graduates with and without ASD about their experiences in Nest classroom is valuable.