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Autism Spectrum Disorders

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Presentation on theme: "Autism Spectrum Disorders"— Presentation transcript:

1 Autism Spectrum Disorders
Getting to Know Your Students Presenter: Teresa May CBRSD 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 Interaction Aloof Passive Active but Odd Communication Non-verbal Verbal Motor Skills Awkward Agile Fine Motor Uncoordinated Coordinated The 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. Sensory Hypo 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 odd Genetic 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 years Present with considerable pragmatic language difficulties Speech often stilted and repetitive; conversations revolve around rote, factual topics

9 Additional Characteristics
Often engage in rituals Worry excessively when they do not know what to expect

10 Core Areas of Deficit Speech and Language Deficits Non-Verbal
Echolalic/sterotypical language Hyper-Verbal Social Skill Deficits Range from isolative to indiscriminately social Limited/Repetitive Behavioral Repertoire Self Stimulation Rigidity Perseverative Inflexibility

11 Communication Deficits
Severe delay or complete absence of speech Immediate or delayed echolalia Poor auditory processing Odd voice quality/volume Understanding 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 everyone Use 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 CONCRETE Symbols 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-taking Problem solving Organization

15 Additional Issues with Pragmatics
Social Expectations Proximity, eye contact, intonation Conversational skills - Talking too much - Interrupting - Changing topics without transition (From Gail Hallenberg, M.S.,CCC-SLP)

16 Strategies to Improve Pragmatic Language
Teach rules of communication Teach conversational skills step by step, using visual aides and representations Role playing Start with easier tasks and add complexity as the student gains skills and confidence

17 Strategies to Improve Pragmatic Language
Work on different contexts and generalization Repetition/practice Always explain “why” -- Helps students see the perspective of others (From Gail Hallenberg, M.S., CCC-SLP)

18 Social Skill Deficits Infants/children irritable and hard to comfort Isolative Poor/no eye contact; odd eye gaze Inappropriate giggling or laughing No understanding of “friendship”

19 Social Challenges for Students with AS
Self observation/ evaluation of impact on others Perspective taking; empathy Applying problem solving skills Dealing with change/novel stimuli Body awareness/personal space

20 Additional Social Challenges
Coping with change/not getting your own way Understanding subtle/ complex verbal and nonverbal communication Processing and understanding emotion Mastering the increasing complexity of games and rules Learning to enjoy social contact

21 Strategies for Improving Social Skills
Shape desired behaviors Teach and practice appropriate social skills in natural environments Establish a “friendship system” for community integration Have neurotypical peers or adults prompt/cue appropriate social skills Capitalize on child’s strengths in integrated settings

22 Addressing Social Skills in the School
Social Stories Model desired social skill Social skill scripting Social skills discussion Direct teaching of desired social skill

23 Application to Natural Settings
Opportunities to apply new skills in a natural peer context Start with more structured situations and then try with less structures; provide enough support to ensure success Coaching should still be given before and after, as needed Should be practiced across all settings School clubs, teams, activity groups Recess, P.E., lunch Mainstreaming classroom

24 Academic Challenges Children adapt poorly to others and changes in routines Do 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 skills Impressive 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 nature Exhibit poor problem solving skills Literal and concrete thinkers Reading Writing 16 X 3 = 48

28 Strategies that Address Academic Challenges
Avoid surprises Visual Schedules assist with daily routines and transitions Provide predictable structured, safe, environments Use priming techniques Visual supports

29 Visual Supports Today’s Schedule Breakfast Speech – Ms. Jane
OCR – Ms. Nelson Written Language Recess Math Social Studies Lunch Reading Comprehension Art or Music Homework Review Dismissal

30 Strategies that address Academic Challenges
Break tasks into smaller parts Teach how to use toys/games appropriately Stress “functional use” of academic skills Fade cueing

31 Educational Strategies for Academic Challenges
Individualized academic programming designed to offer consistent success Make learning rewarding, not anxiety provoking Redirect away from following their own impulses Insure 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 time Expectations must be set for amount and quality of work produced. Start small and increase as skills develop Earning time toward doing what interests them is often a good motivator to do what is expected. Big job: Clean your desk Little chunks: 1. Put pencils in pencil box 2. Close covers of all books 3. Throw away all wrinkled/ torn papers 4. Put important papers in a folder 5. 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 sound Eye contact avoidance Focus on details of objects Avoids 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

36 Lunch Break

37 Behavior Support First Then

38 Strategies Simplify abstract concepts. Use visuals as much as possible Teach the difference between general knowledge and personal ideas to help with writing skills Love

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 skills Intolerant of making mistakes, low self-esteem Prone to depression Rage and tantrum reactions common response to stress and frustration

40 Educational Strategies: Emotional Vulnerability
Provide high level of consistency to prevent outbursts Teach 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 disability Develop an action plan based upon the student’s needs Be proactive in the application of supports

42 BEHAVIOR Basic Overall Guidelines
All behavior is a form of communication Investigate WHY its occurring Inability to communicate Confusion/fear caused by change, sensory stimuli Pain caused by sensory stimuli, illness, accident Frustration/anger due to limited communication/social skills Get something desired (food, toy, attention) End disliked activity Meet sensory need (increase or decrease input) Opportunity to make a comment Habitual 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 Behavior If you try to force negative behaviors to stop without understanding WHY then The behavior will increase in occurrence and intensity Another negative behavior will emerge to replace Replace with appropriate behavior based on needs of child Focus on instruction rather than discipline Provide alternate acceptable behavior useful to student

46 Behavior Coordinate all personnel – consistency is essential
Reinforce appropriate behavior frequently Use meaningful reinforcements During crisis Move to quiet calm space Provide familiar people, places, objects Allow calming, repetitive, stereotyped activities

47 Behavior If child loses it Engage pre-planned intervention
Keep voice calm, actions simple and visible Assure class student is OK Get 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 schedule Visual Class Rules “real photo” daily schedule

55 Visual Rules for desk


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 do Develop visual schedules, rules, instruction Keep 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 anxiety Handle group work in a sensitive way. Student must be clear about his/her role in the group Use detailed and clear instructions. Communicate important information in visual form

60 General Interventions
Utilize step by step approach Employ visuals whenever possible Avoid power struggles Be aware of sensory needs (need for movement) Move at an appropriate pace Write and provide “instruction manuals” Structure transitions Provide behavioral supports across areas (social, language, behavior)

61 General Interventions
Utilize the child’s strengths/interests Improve self-awareness and self-esteem Teach student about strengths, weaknesses, and disability awareness Teach their classmates Provide buddy and mentoring Create an accepting classroom environment Watch as opposed to listen to them Don’t be deceived by verbal skills

62 Modifications Physical arrangements Remove/minimize stimuli
Modify requirements Reduce length, amount, steps, complexity Move to new space early (buddy system) Take a Break (react to first signs of stress. Escalation is usually rapid) quiet area walk calming/sensory experiences Time to observe from distance new activities interactions with new objects Don’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.


Stephen Shore, My life with Autism Teacch Temple Grandin Tony Atwood Resources for Educators Donna Williams – Artist with autism

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