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DMHAS Child & Family Agency A Scholar in Residence Workshop.

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Presentation on theme: "DMHAS Child & Family Agency A Scholar in Residence Workshop."— Presentation transcript:

1 DMHAS Child & Family Agency A Scholar in Residence Workshop

2 Nurturing the Healthy Development of Young People with Aspergers Syndrome

3 The Learning Clinic Brooklyn, Connecticut Presented by: Raymond W. DuCharme, Ph.D. Kathleen A. McGrady, Psy. D., ABDA Hilton Garden Inn, Glastonbury, CT April 04, 2006

4 Transition Needs and Services and Transfer of Rights Statement Presented by: Founder and Executive Director, The Learning Clinic Dr. Raymond DuCharme

5 The Learning Clinic 1990 - Congress Introduces Provision into IDEA Public agencies required to provide students with disabilities aged 16 and older with appropriate instruction in community experiences, development of employment, and other post-school objectives When appropriate, also provide instruction in independent living skills and functional vocational evaluations

6 The Learning Clinic 1997 - Congress introduces new requirements in the IDEA further expanding transition services All LEAs required to include statement of Transition Services in childs IEP The purpose: focus attention on how the childs education program can be planned to afford a successful transition to his or her goals for life after secondary school

7 The Learning Clinic Presidents Commission on Special Education analyzed outcome of 12 years of Transition Services Results: (Compared to nondisabled peers) Students with disabilities are unemployed and under-employed when they leave school Too many students with disabilities leave school without earning any type of diploma

8 The Learning Clinic Results: (Compared to nondisabled peers) (continued) Students with disabilities attend postsecondary programs at rates lower than their nondisabled peers Adults with disabilities are much less likely to be employed than adults without disabilities Unemployment rates for working-age adults with disabilities have hovered at the 70% level for at least the past 12 years

9 The Learning Clinic Conclusion: The Commission determined that statistics reflected failures in the 1997 Transition Services Structure and recommended the IDEA Transition Requirements be amended. Action: Congress made several changes to the Transition Requirements in response to those concerns. Result: The new definition of Transition Services has been amended to reflect the reauthorization's emphasis on achievement.

10 The Learning Clinic Transition Services: The term Transition Services is now defined to mean a coordinated set of activities for a child with a disability that: Is designed within a results-oriented process focused on improving the academic and functional achievement of the child with a disability to facilitate his or her move from school to post-school activities, including postsecondary education, vocational education, integrated employment.

11 The Learning Clinic Transition Services (continued) Is based on the individual childs needs, taking into account his or her strengths, preferences and interests. Includes instruction, related services, community experiences, the development of employment and other post-school adult living objectives and, when appropriate, acquisition of daily living skills and functional vocational evaluation.

12 The Learning Clinic New Changes: In addition, the law modifies the age at which student begin to receive Transition Services. Under the new law, the first IEP that will be in effect when a child is 16 years old must contain: Appropriate measurable postsecondary goals based on age-appropriate transition assessments related to training, education, employment, and, when appropriate, independent living skills. A description of Transition Services, including courses of study, needed to assist the child in reaching those goals.

13 The Learning Clinic Changes to the Existing Law: Under the old IDEA, IEPs for children aged 14-16 needed to include a statement regarding the childs Transition Services. This was intended to focus on coursework to effectively prepare children to receive Transition Services at age 16. IEPs developed for children aged 16 or older were required to include a description of needed Transition Services. The new law eliminates the requirement for children aged 14-16.

14 The Learning Clinic Changes to the Existing Law: (continued) Now, children with disabilities must be provided Transition Services starting in the school year that they turn 16. Should a participating agency fail to provide the Transition Services, the LEA must reconvene the IEP team to identify alternative strategies to meet the Transition Objectives for the child set out in the program.

15 The Learning Clinic Continued Provisions of the Prior Law: As under the prior law, if a child with a disability is convicted as an adult under state law and incarcerated in an adult prison, the childs IEP need not contain a statement of Transition Services if that child will age out of special education prior to release from prison. The IDEA also retains the requirement regarding transfer of IDEA rights from parents to child when the child reaches the age of majority.

16 The Learning Clinic Continued Provisions of the Prior Law: At least one year before a child reaches the age of majority under state law, the IEP must include a statement the child has been informed of the rights under the IDEA that will transfer to the child on reaching the age of majority. These rights include all rights accorded to a parent of a disabled child when the child is a minor. The purpose of the statement is to clarify who holds those rights when the child reaches adult age.

17 The Learning Clinic Transition Program A Model for Student based Independence Transition to Community-

18 The Learning Clinic Pervasive Development Disorder Category of Diagnosis that includes Autism, Retts Disorder, Childhood Disintegrative Disorder, Asperger Syndrome, and PDD NOS. Historically, other diagnostic labels in this category have included Childhood Schizophrenia and Autistic Psychopathy.

19 The Learning Clinic Who is the Asperger Individual?

20 The Learning Clinic Asperger Syndrome Criteria DSM-IVICD-10 Qualitative impairment in social interaction XX Restricted repetitive and stereotyped patterns of behavior, interests, and activities XX No general language delay XX No delay in cognitive development XX Normal general intelligence (most) X Markedly clumsy (common) X No delay in development of: age appropriate self-help skills adaptive behavior (excluding social interaction) curiosity about environment X

21 The Learning Clinic Asperger Syndrome Criteria Pragmatic language skill deficits not part of DSM-IV or ICD-10 criteria but should be included for differential diagnosis.

22 The Learning Clinic Other Developmental Issues Deviation from normal development Do not Outgrow Developmental Deficits Stress Impairs Performance Co-Morbid Diagnosis Impairs Overall Functioning

23 The Learning Clinic Cognitive Functioning Medications

24 The Learning Clinic Psychological Symptoms Age / Time

25 The Learning Clinic Clinical Symptoms and Learning Disabilities Grade

26 The Learning Clinic Asperger Syndrome Pervasive Developmental Delay C O G N I T I O N Memory Higher Order Process Analysis, Synthesis, and Evaluation Organization Flexibility

27 Asperger Syndrome Pervasive Developmental Delay C O G N I T I O N Narrow Band of Knowledge Problem Solving Deficit Verbal-Performance IQ Attention Shift Problem: Too Short or Too Long Limited Perspective / Restricted Point of View

28 The Learning Clinic L A N G U A G E Pragmatics Syntax Meaning: Connotative Denotative Asperger Syndrome Pervasive Developmental Delay

29 The Learning Clinic L A N G U A G E Processing Speed Expression Duration Asperger Syndrome Pervasive Developmental Delay

30 The Learning Clinic S P E E C H Prosody Pedantic Elocution Volume Asperger Syndrome Pervasive Developmental Delay

31 The Learning Clinic Asperger Syndrome Pervasive Developmental Delay M O T O R Fine Control Gross Control Coordination Regulation Proprioceptive Feedback

32 The Learning Clinic S E N S O R Y P R E C E P T I O N Visual Integration Kinesthetic Sense Tactile Accuity Gestalt Integration of other Senses Asperger Syndrome Pervasive Developmental Delay

33 The Learning Clinic S O C I A L Cue Identification Responsive to others (Isolate) Social Interaction Initiative Rude / Insensitive to Social Conventions Aggressive: Verbally & Physically Asperger Syndrome Pervasive Developmental Delay

34 The Learning Clinic S O C I A L Boundary Acceptance Maintain Social Roles (e.g., student, son, daughter, friend) Self-Regulate with and without Stressor Asperger Syndrome Pervasive Developmental Delay

35 The Learning Clinic Competing Clinical Behaviors Perseveration Obsessive Thought Rigid Cognitive Style Inability to Shift from Personal View to Data - Based Decision

36 The Learning Clinic Competing Clinical Behaviors Confabulation Affirming False Information Stealing Sexually Inappropriate Actions and Statements Pornography Interests / Continued

37 The Learning Clinic Competing Clinical Behaviors Violation of Boundaries Cognitive Disorientation and Distortion / Continued

38 The Learning Clinic Suicide Ideation Data

39 The Learning Clinic Suicide Ideation Data Seasonal Frequency 10 8 6 4 2 0 January – December 2005 Winter (10) Spring (7) Summer (4) Fall (3) Suicide Ideation Data: Jan-Dec 2005 Total No. of Students Observed: 66 Total No. of Students with S.I.s: 16 (Males - 9) (Females - 7) % of Students with S.I.s: 24% Dec-Feb Mar-May Jun-Aug Sep-Nov Total Number of S.I.s Jan - Dec 2005 = 24

40 The Learning Clinic Suicide Ideation Data Number of Repeat Incidents by Season 10 8 6 4 2 0 January – December 2005 Winter (7) Spring (5) Summer (1) Fall (2) Suicide Ideation Data: Jan-Dec 2005 Total No. Students with Repeat S.I.s: 7 (7 of 16 = 44%) Dec-Feb Mar-May Jun-Aug Sep-Nov Total Number of Repeat S.I.s Jan - Dec 2005 = 15

41 Suicide Ideation Data Number of Incidents by Student Age Group January – December 2005 7/8 (1)1 10/11 (2)3 11/12 (1)3 12/13 (1)1 13/14 (1)1 14/15 (1)2 15/16 (1)1 16/17 (2)4 17/18 (3)3 18/19 (2)3 20/21 (1)2 Student Age Groups (Number of Students by Age Group) Number of S.I.s by Age Group No. of Students: 16No. of Incidents: 24

42 The Learning Clinic Suicide Ideation Data Number of Incidents by Gender January – December 2005 No. of Students: 16 GenderNo. of S.I.s% of S.I.s Males1563% Females938%

43 The Learning Clinic Suicide Ideation Data Number/Percentage of Incidents by Diagnoses January – December 2005 Diagnoses Bipolar1250% Depression312.5% (Bipolar & Depression / Combined)(15)(62.5%) Aspergers416.7% Schizophrenia28.3% ODD/Intermittent Exp DO28.3% ADHD Comb/GAD14.2% No. of S.I.s % of S.I.s

44 The Learning Clinic Suicide Ideation Data Number of Ideations vs. Suicide Attempts January – December 2005 Suicide Ideation: 16 Students 24 Ideations (16 Repeats) Suicide Attempts: 16 Students 0 Attempts Ideations: 24 Attempts: 0

45 The Learning Clinic What are the Priorities of the Asperger Syndrome Student?

46 The Learning Clinic Priorities of the Asperger Student 1. Independence How to find and use resources and self-advocate 2.Work Experience Paid employment and volunteer work

47 The Learning Clinic Priorities of the Asperger Student 3A.Shared Living versus Living Alone Advantages and disadvantages of each 3B.Resources How to find resources, e.g., doctors, therapists, etc.

48 The Learning Clinic Priorities of the Asperger Student 4A.Social Activities How to find resources for fun activities? How to make friends and find others with common interests? How to deal with the tendency to isolate?

49 The Learning Clinic Priorities of the Asperger Student 4B.Medication How do you know when you need medication Who do you go to for help

50 The Learning Clinic Priorities of the Asperger Student 5.College Experience What it takes to be successful in college 6.Problem-Solving How to partner with others to solve problems

51 The Learning Clinic Priorities of the Asperger Student 6. Problem-Solving / Continued Expressing issues openly Independent problem-solving versus teaming

52 The Learning Clinic Which Asperger Symptoms Compete with Independence? Degree of Anosognosia Age Over time, symptoms become egosyntonic

53 The Learning Clinic How Do Students Assess and Comment on Their Experience?

54 The Learning Clinic How Can We Assess Readiness for Independence? The Learning Clinic Pragmatic Skills Survey The Learning Clinic Transition & Independent Living Skills Assessment

55 The Learning Clinic Independent Living Skills

56 HousingHousing Acquisition & Leases Home Management NutritionMeal Planning & Preparation Dining Clean-up & Food Storage Money Mgmnt.Budgeting & Taxes Banking & Credit Consuming Transportation Leisure Legal Health Time Mgmnt. Personal SafetyPersonal Safety - Home Personal Safety - Community Personal Safety - Relationships Personal Presentation Community ParticipationCommunity Resources Community Service Vocational ReadinessCareer Planning Employment Post-Secondary Education Healthy Relationships Participation in Therapy Independent Living Skills Significant Differences Between Treatment & Non-Treatment Groups in November 2005. Treatment Group Scored Significantly Higher than Non-Treatment Group in 2 Categories: Housing Acquisition & Leases Vocational Readiness/Employment Money Mgmt/Consuming Personal Presentation Independent Living Skills The Learning Clinic Treatment Group vs. Non- Treatment Group November, 2005

57 HousingHousing Acquisition & Leases Home Management NutritionMeal Planning & Preparation Dining Clean-up & Food Storage Money Mgmnt.Budgeting & Taxes Banking & Credit Consuming Transportation Leisure Legal Health Time Mgmnt. Personal SafetyPersonal Safety - Home Personal Safety - Community Personal Safety - Relationships Personal Presentation Community ParticipationCommunity Resources Community Service Vocational ReadinessCareer Planning Employment Post-Secondary Education Healthy Relationships Participation in Therapy Independent Living Skills Significant Differences Between Treatment & Non-Treatment Groups from November 2005 to February 2006. Treatment Group Scored Significantly Higher than Non- Treatment Group in 4 Categories: Housing Acquisition & Leases Money Mgmt/Banking & Credit Money Mgmt/Consuming Personal Presentation Independent Living Skills The Learning Clinic Treatment Group vs. Non- Treatment Group Nov 2005 – Feb 2006

58 HousingHousing Acquisition & Leases Home Management NutritionMeal Planning & Preparation Dining Clean-up & Food Storage Money Mgmnt.Budgeting & Taxes Banking & Credit Consuming Transportation Leisure Legal Health Time Mgmnt. Personal SafetyPersonal Safety - Home Personal Safety - Community Personal Safety - Relationships Personal Presentation Community ParticipationCommunity Resources Community Service Vocational ReadinessCareer Planning Employment Post-Secondary Education Healthy Relationships Participation in Therapy Independent Living Skills Significant Decrease in Skills for Treatment Group Only from November 2005 to February 2006 Treatment Group Scored Significantly Lower in these 3 Categories: Nutrition/Meal Planning & Prep. Nutrition/Clean-up & Storage Community Resources/ Community Services Independent Living Skills The Learning Clinic Treatment Group Nov 2005 – Feb 2006

59 HousingHousing Acquisition & Leases Home Management NutritionMeal Planning & Preparation Dining Clean-up & Food Storage Money Mgmnt.Budgeting & Taxes Banking & Credit Consuming Transportation Leisure Legal Health Time Mgmnt. Personal SafetyPersonal Safety - Home Personal Safety - Community Personal Safety - Relationships Personal Presentation Community ParticipationCommunity Resources Community Service Vocational ReadinessCareer Planning Employment Post-Secondary Education Healthy Relationships Participation in Therapy Independent Living Skills Significant Decrease in Skills for Non-Treatment Group from November 2005 to February 2006 Non-Treatment Group Scored Significantly Lower in these 4 Categories: Housing/Home Management Nutrition/Meal Planning & Prep. Nutrition/Dining Nutrition/Clean-up & Food Storage Independent Living Skills The Learning Clinic Non-Treatment Group Nov 2005 – Feb 2006

60 The Learning Clinic Independent Living Skills Areas in which Students showed Significant Progress from Nov 2005 – Feb 2006: (6 0f 24) Housing Acquisition & Leases Banking & Credit Consuming Personal Safety in Relationships Personal Presentation Community Service Areas in which Students Showed Significant Regression from Nov 2005 – Feb 2006: (3 of 24) Nutrition/Meal Planning & Prep. Nutrition/Clean-up & Storage Community Resources/ Community Services 25% 12.5% Percentage of Living Skills Significantly IMPROVED (25%) or REGRESSED (12.5%) from November 2005 to February 2006. Treatment Group Nov 2005 – Feb 2006

61 The Learning Clinic What Is on the Horizon for Asperger Students? Early Diagnosis Pediatric Training Teacher Training Psycho - Education Treatment Cognitive Behavioral Therapy

62 The Learning Clinic What Is on the Horizon for Asperger Students? Technology Distance Coaching (remote video monitoring) Computer Checklists and Prompting Computer Assisted Instruction (CAI)

63 The Learning Clinic What Is on the Horizon for Asperger Students? Technology / Continued Kurtzweil Dragon Naturally Speaking

64 ... because every child can succeed ! end


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