Presentation on theme: "Autism Spectrum Disorders"— Presentation transcript:
1 Autism Spectrum Disorders Getting to Know Your StudentsPresenter: Teresa MayCBRSD Autism Specialist
2 A developmental disability significantly affecting verbal and nonverbal communication and social interaction.Source: A Guide to Federal and State Education Requirements in Massachusetts, 2000
3 What is Autism Spectrum Disorder? ASD is a neurological condition that affects a person’s ability to effectively communicate and interact with others.It is a Pervasive Developmental Disorder that effects boys four times more often than girls.It is a “spectrum disorder” that affects individuals differently and to varying degrees
4 Pervasive Developmental Disorder Autism spectrum disorders lie under the umbrella of Pervasive Developmental Disorders. They include Autistim, Asperger’s, CDD, Retts, and PDD-NOS. The spectrum ranges from profoundly severe to high functioning/asperger syndrome.Profound (severe) Autism Moderate Mild (High Functioning) Asperger Syndrome
5 Autism Continuum Measured I.Q. Severe Gifted Social- Emotional InteractionAloof Passive Active but OddCommunicationNon-verbal VerbalMotor SkillsAwkward AgileFine MotorUncoordinated CoordinatedThe symptoms of autism fall on a continuum from mild to severe in many domains. Each individual is affected differently. It is common for a child to exhibit an extremely uneven profile.IQ: For example, a child with a low measured IQ may have above average word recognition or spelling skills. They may be able to read or spell the word “big” but unable to choose the big object. One child loves to read VCR manuals but would be unable to program a VCR or explain the directions. Another child may have a high measured IQ but be unable to function successfully in the social environment of the classroom without extensive assistance and modifications. Cognitive assessment of these students is complex and the measured IQ is typically an underestimate, particularly at younger ages.Social ranges from isolation to active but not typical.Communication ranges from nonverbal to quite chatty but lacks development of fluent reciprocal communication.Gross and fine motor skills are quite varied.Sensory impairments reflect actual sensory differences and are unique to each student.SensoryHypo Hyper
6 Asperger Syndrome (AS) First described by Hans Asperger in 1944 (Mildest and highest functioning end of ASD)Abnormalities noted in 3 broad aspects of development Social interaction and emotional relatedness Unusual patterns of narrow interests Behavioral and stylistic characteristics involving repetitive /perseverative features
7 Asperger Syndrome (con’t) Students more likely found in general education classrooms and often undiagnosed or misdiagnosed as ADD, ED, LD, or just oddGenetic factors more prevalent in AS. Often family history of autism, most often on the father’s side
8 Characteristics: Higher cognitive abilities (average to superior) Lucid language by 4 yearsPresent with considerable pragmatic language difficultiesSpeech often stilted and repetitive; conversations revolve around rote, factual topics
9 Additional Characteristics Often engage in ritualsWorry excessively when they do not know what to expect
10 Core Areas of Deficit Speech and Language Deficits Non-Verbal Echolalic/sterotypical languageHyper-VerbalSocial Skill DeficitsRange from isolative to indiscriminately socialLimited/Repetitive Behavioral RepertoireSelf StimulationRigidityPerseverativeInflexibility
11 Communication Deficits Severe delay or complete absence of speechImmediate or delayed echolaliaPoor auditory processingOdd voice quality/volumeUnderstanding of language is literal/concrete(e.g., “listen up.” “That’s cool.”“Knock it off.”)May repeat sounds/questions/phrases
12 Strategies to address Communication needs Language occurs throughout day and is taught by everyoneUse augmentative communication to stimulate verbal language (e.g. PECS)Use visual cues to facilitate understanding of abstract concepts (e.g. pictures, drawings, written words)BE CONCRETESymbols for the, to, for, with…
13 Communication Strategies (con’t) Teach for generalization by teaching in variety of settings, using different materials (e.g., color red: apple, stop sign, shirt, crayon)Auditory processing deficits: allow extra time for student to respond
14 Deficits in Pragmatic Language Turn-taking skills (within play and conversation)Gestalt processing (seeing the big picture)Perspective-takingProblem solvingOrganization
15 Additional Issues with Pragmatics Social ExpectationsProximity, eye contact,intonationConversational skills- Talking too much- Interrupting- Changing topics withouttransition(From Gail Hallenberg, M.S.,CCC-SLP)
16 Strategies to Improve Pragmatic Language Teach rules of communicationTeach conversational skills step by step, using visual aides and representationsRole playingStart with easier tasks andadd complexity as the student gains skills and confidence
17 Strategies to Improve Pragmatic Language Work on different contexts and generalizationRepetition/practiceAlways explain “why”-- Helps students see the perspective ofothers(From Gail Hallenberg, M.S., CCC-SLP)
18 Social Skill DeficitsInfants/children irritable and hard to comfortIsolativePoor/no eye contact; odd eye gazeInappropriate giggling or laughingNo understanding of “friendship”
19 Social Challenges for Students with AS Self observation/ evaluation of impact on othersPerspective taking; empathyApplying problem solving skillsDealing with change/novel stimuliBody awareness/personal space
20 Additional Social Challenges Coping with change/not getting your own wayUnderstanding subtle/ complex verbal and nonverbal communicationProcessing and understanding emotionMastering the increasing complexity of games and rulesLearning to enjoy social contact
21 Strategies for Improving Social Skills Shape desired behaviorsTeach and practice appropriate social skills in natural environmentsEstablish a “friendship system” for community integrationHave neurotypical peers or adults prompt/cue appropriate social skillsCapitalize on child’s strengths in integrated settings
22 Addressing Social Skills in the School Social StoriesModel desired social skillSocial skill scriptingSocial skills discussionDirect teaching of desired social skill
23 Application to Natural Settings Opportunities to apply new skills in a natural peer contextStart with more structured situations and then try with less structures; provide enough support to ensure successCoaching should still be given before and after, as neededShould be practiced across all settingsSchool clubs, teams, activity groupsRecess, P.E., lunchMainstreaming classroom
24 Academic ChallengesChildren adapt poorly to others and changes in routinesDo not use toys for intended purpose (e.g., spins, lines up, flips, etc.)
25 Academic Challenges (con’t) Uneven development of skills: - Decodes words but unable to comprehend meaning - Good computation skills, but unable to apply - Excellent visual matching skills - Gross/fine motor skills range from superior to very poor
26 Academic Challenges Verbal abilities higher than performance skills Lack higher level abstract thinking and comprehension skillsImpressive vocabularies give false impression that they understand (may be parroting what read or hear)
27 Academic Challenges (con’t) Excellent rote memory skills, but mechanical in natureExhibit poor problem solving skillsLiteral and concrete thinkersReadingWriting16 X 3 = 48
28 Strategies that Address Academic Challenges Avoid surprisesVisual Schedules assist with daily routines and transitionsProvide predictable structured, safe, environmentsUse priming techniquesVisual supports
29 Visual Supports Today’s Schedule Breakfast Speech – Ms. Jane OCR – Ms. NelsonWritten LanguageRecessMathSocial StudiesLunchReading ComprehensionArt or MusicHomework ReviewDismissal
30 Strategies that address Academic Challenges Break tasks into smaller partsTeach how to use toys/games appropriatelyStress “functional use” of academic skillsFade cueing
31 Educational Strategies for Academic Challenges Individualized academic programming designed to offer consistent successMake learning rewarding, not anxiety provokingRedirect away from following their own impulsesInsure student’s understanding of presented material via his/her demonstration of it
32 Academic Strategies (con’t) Break reading comprehension into smaller parts and analyze 1 section at a timeExpectations must be set for amount and quality of work produced. Start small and increase as skills developEarning time toward doing what interests them is often a good motivator to do what is expected.Big job:Clean your deskLittle chunks:1. Put pencils in pencil box2. Close covers of all books3. Throw away all wrinkled/torn papers4. Put important papers in a folder5. Put books in a neat stack
33 Sensory Deficits Sensitivity to environmental conditions Hyper or hypo sensitivity to auditory, visual, smell/taste, tactile/kinesthetic
34 Response to Sensory Input Under/over reaction to soundEye contact avoidanceFocus on details of objectsAvoids specific foods/odors/textures, etc.
35 Strategies to Address Sensory Differences Remove environmental conditions, if reasonable (e.g., odors)Desensitize in small steps (consulting with O.T.)Implement sensory diet, as prescribed by O.T.Artist Director activity
38 StrategiesSimplify abstract concepts. Use visuals as much as possibleTeach the difference between general knowledge and personal ideas to help with writing skillsLove
39 Emotional Vulnerability Often don’t have the emotional resources to cope with the demands of the classroom (esp. from 3rd grade on)Easily distressed due to inability to be flexible and lack of organizational skillsIntolerant of making mistakes, low self-esteemProne to depressionRage and tantrum reactions common response to stress and frustration
40 Educational Strategies: Emotional Vulnerability Provide high level of consistency to prevent outburstsTeach students strategies to cope with their stress:Make list of concrete steps to follow when they become upset (e.g., 3 deep breaths, count fingers of left hand 3 times, ask to take a break outside of classroom, write steps on card, etc.)Be alert to changes in behavior that signal depression: More disorganized, inattentive, isolative, crying/suicidal remarks, increased levels of stress, etc.
41 Troubleshooting Problem Situations Approach problem situations with an open mind, and reserve (behavioral) judgments!Analyze problem situations, taking into account knowledge of both the student and his/her disabilityDevelop an action plan based upon the student’s needsBe proactive in the application of supports
42 BEHAVIOR Basic Overall Guidelines All behavior is a form of communicationInvestigate WHY its occurringInability to communicateConfusion/fear caused by change, sensory stimuliPain caused by sensory stimuli, illness, accidentFrustration/anger due to limited communication/social skillsGet something desired (food, toy, attention)End disliked activityMeet sensory need (increase or decrease input)Opportunity to make a commentHabitual not having alternative
44 All behavior communicates. What may appear to be an act of willful noncompliance, may be, in actuality, the student’s idiosyncratic attempt to send a message that s/he is unable to get across in any other more conventional way. Moreover, since it is the caregiver’s judgments that determine how the student will be perceived, what the caregiver does not know can, and often does, jeopardize the student’s learning.
45 BehaviorIf you try to force negative behaviors to stop without understanding WHY thenThe behavior will increase in occurrence and intensityAnother negative behavior will emerge to replaceReplace with appropriate behavior based on needs of childFocus on instruction rather than disciplineProvide alternate acceptable behavior useful to student
46 Behavior Coordinate all personnel – consistency is essential Reinforce appropriate behavior frequentlyUse meaningful reinforcementsDuring crisisMove to quiet calm spaceProvide familiar people, places, objectsAllow calming, repetitive, stereotyped activities
47 Behavior If child loses it Engage pre-planned intervention Keep voice calm, actions simple and visibleAssure class student is OKGet closure when calm (sequence paper, books, charts, clean up/apologize, transition)Break
48 Difficulties encountered Organization requires an understanding of what one wants to do and a plan for implementation. These requirements are sufficiently complex, interrelated, and abstract to present formidable obstacles for students with autism.Developing systematic habits and work routines, checklists, visual schedules, and visual instructions concretely showing autistic students what has been completed, what remains to be done, and how to proceed.
49 Difficulties encountered Distractibility takes many forms in the classroom: reacting to outside car noises, visually following movements in the classroom, or studying the teacher’s pencil on the desk instead of completing the required work.Identifying what is distracting. it might be visual stimuli, it might be auditory. environmental modifications can be made to the physical make-up of a student’s work area, the presentation of work-related tasks, or many other possibilities.
50 Difficulties encountered Sequencing is another area of difficulty. These students often cannot remember the precise order of tasks because they focus concretely on specific details and do not always see relationships between them.Consistent work routines and visual instructions compensate for these difficulties. Visual instructions can highlight sequences of events and remind autistic students of the proper order to follow. The visual picture remains present and concrete, helping the student to follow the desired sequence. The establishment of systematic work habits is also helpful; a student who always works from left to right can have work presented in the correct sequence.
51 Difficulties encountered Difficulties with generalization. Students with autism frequently cannot apply what they have learned in one situation to similar settings. Appropriate generalization requires an understanding of the central principles in learned sequences and the subtle ways in which they are applicable to other situations. Focusing on specific details, students with autism frequently miss these central principles and their applications.
52 Some things to try Use simple, concrete language. Less is better! Key words and phrases that work include:“The rule is…”“Make a good choice.”“If…..then…..”
53 Some things to try Visuals The importance of visuals cannot be underestimated . As Temple Grandin, who has Asperger’s Syndrome, explains in Thinking in Pictures (Vintage, 1996): ‘Words are like a second language to me’.Use visuals for schedules, directions, introducing new activities and more.Show examples
54 Examples of Visual Supports First/Then scheduleVisual Class Rules “real photo” daily schedule
57 Some things to try Show, Don’t Tell difficulty sequencing tasks means that the instruction ‘Look at the article and fill in both sections of the answer sheet’ may as well be given in Klingon. Instead of telling, show your pupil what to do and guide them through the start of the activity.
58 Some things to try Rewards give out points for appropriate (not just “good”) behavior and effort at completing tasks. The points can be recorded on a chart. When each student gains five points they get a small reward. (prizes can be free choice time)
59 Effective Strategies Less is More Use plain language, check that the student is clear about what he/she needs to doDevelop visual schedules, rules, instructionKeep the routine the same. Let the student know in advance if there will be a change and go through the change with them to reduce anxietyHandle group work in a sensitive way. Student must be clear about his/her role in the groupUse detailed and clear instructions. Communicate important information in visual form
60 General Interventions Utilize step by step approachEmploy visuals whenever possibleAvoid power strugglesBe aware of sensory needs (need for movement)Move at an appropriate paceWrite and provide “instruction manuals”Structure transitionsProvide behavioral supports across areas (social, language, behavior)
61 General Interventions Utilize the child’s strengths/interestsImprove self-awareness and self-esteemTeach student about strengths, weaknesses, and disability awarenessTeach their classmatesProvide buddy and mentoringCreate an accepting classroom environmentWatch as opposed to listen to themDon’t be deceived by verbal skills
62 Modifications Physical arrangements Remove/minimize stimuli Modify requirementsReduce length, amount, steps, complexityMove to new space early (buddy system)Take a Break (react to first signs of stress. Escalation is usually rapid)quiet areawalkcalming/sensory experiencesTime to observe from distancenew activitiesinteractions with new objectsDon’t push – gradually move closer…fully include
63 When you tell me, I forget When you show me, I remember When you involve me, I understand
64 Fragile – Handle With Care Even though there are many things about me that are unique, in the ways that really matter I am just like other children.
65 I learn best from people I trust, and I learn to trust when I sense that people like me. Please try to see the world through my eyes, for I can’t see it through yours.
66 And please know that even though it may not seem so, I really am trying to adapt to a world that my neurological challenges prevent me from understanding without your help
67 . If you keep these things clearly in mind, you will be less apt to label me a behavior problem, and more likely to teach me the things I need to know so that I can function with greater understanding and competence in a world that is often inhospitable to my needs.