Presentation on theme: "Brenda Smith Myles www.asperger.net The Cycle of Tantrums, Rage, and Meltdowns and Strategies to Help Prevent Them Brenda Smith Myles www.asperger.net."— Presentation transcript:
1 Brenda Smith Myles www.asperger.net The Cycle of Tantrums, Rage, and Meltdowns and Strategies to Help Prevent ThemBrenda Smith Myles
2 Theory of Mind Difficulty in … Predicting Reading intentions Understanding emotionsExplaining own behaviorPerspective or referenceReading and reacting to others’ interestsUnderstanding social interactionsGreat victims because they can’t read intentions. Often threatened by bullies.Doesn’t know what comes next.Can’t tell if teacher is happy, sad, angry. Jason’s inability to tell if any of his teachers were happy, angry, etc … Do anyone of your teachers like you? Mrs. Jones would like me out of her class. Does that count?
3 Language and Social Challenges Nonverbal communicationInitiating and maintaining social interactionsLiteralnessPerspective takingHidden curriculumCause/effect relationshipsDifficulty conveying own thoughtsMay not use social “niceties”Can you count from one to ten? Can you count higher?You can’t take food into the movies.
4 Central Coherence Idiosyncratic focus Preference for the known Difficulty in choosing and prioritizingDifficulty seeing connectionsLack of compliance
5 Problem Solving “One way of viewing a problem” Stuck thinking Sees facts instead of a wholeProblems with cause and effectDoes not see problems as having more than one optionProblem solving is often literalTries a locker combination six times.Initiate on playground and child does not respond in expected way--strikes out. Does not generalize it to a later situation.
6 Use Their Own Kind of Logic Sense of social justiceUse logical, but the logic is very unique based on that student’s perspectiveSpencer and his examsIf my parents love me and they have one child, how much will they love me if they have two children? 1/2 as much.This is called Pseudo-Logic
7 Executive Function Difficulty in … Thrive in a predictable environment Imitating othersPlanningStarting and stoppingOrganizing (time, self, space)Thrive in a predictable environmentImitates others: big behaviors only. Behaviors that get a noticeable reaction.The “finished line”.Can’t break down long-term projects into small pieces.Loses everything.
8 Do Not Understand the Seemingly Obvious ExpectationsAssumptionsUnstated social rules, mores, guidelinesThis is often called the Hidden Curriculum
9 Special Interests and Obsessions Narrow interestsNot permanentOften appear “uncontrollable”Role of the interest: interest; fun; security, comfort; relaxation; stress reduction
11 Anxiety and Sensory Issues Anxiety pervades the everyday life of a child with AS even if she does NOT report it!Sensory issues impact EVERYTHING!
12 Behavior Basics Behavior always occurs for a reason Children and youth with ASD have difficulties detecting how they feel and do not know how to calm themselves downThe ability to verbalize what they are to do and doing it are two different skillsBehaviors are generally not on purpose
13 Top 10 Situations that Trigger Insistence on Sameness Event delayedMaterials run outItem misplacedSequence changedMomentary separationAnnoying behaviorActivity interruptedLosing a gameObject breaksEvent cancelledHow many of these could have triggered the boy’s meltdown – 2, 5, 6, & 9Green, Sigafoos, Pituch, Itchon, O’Reilly, & Lancioni (2006). Assessing Behavioral Flexibility in Individuals with Developmental Disabilities. Focus on Autism and Other Developmental Disabilities, 21(4)
16 Note: The role of verbalizations in escalation. Rumbling StageMost important stageBuilding up to rageSome thinking ability still intactIndividual children have their own patterns of “rage behavior”Note: The role of verbalizations in escalation.
24 Recovery Stage The child or youth may sleep for awhile. He/she may apologize or be contrite.Withdrawal may occur; a fantasy world may be the target.The student may deny meltdown.Some do not remember what happened during the Rage Stage.
31 ColtonColton is in the 6th grade. He has problems getting along in school. He likes to be in control and gets upset if he perceives something is wrong. Colton’s ability to control his behavior varies from day to day. Colton enjoys school despite having challenges with others who do not follow his way of thinking.The Incredible 5-Point Scale by Buron & Curtis
32 Looks Like Feels Like I Can Try To Kicking My head will Call myor hitting probably explode mom to go homeScreaming, Nervous Go see Mr.almost hitting PetersonQuiet, rude Bad mood, Stay away fromtalk grumpy kidsRegular kid Good Enjoy itPlaying A million bucks Stay that way
33 Colton’s Social Narrative Control is a funny thing. It helps to learn more and more about myself.It’s okay to want to be in control. Being in control can you make you feel more relaxed about things.Sometimes I have lots of control. I am relaxed and feeling good. I call this being at a 1 …
34 The Incredible 5-Point Scale YELLINGLOUDCONVERSATIONWHISPERNO SOUND
35 The Incredible 5-Point Scale YELLINGLOUDCONVERSATIONWHISPERNO SOUND
41 Stress Thermometer Most stressed ever When my Lego toys fall apart Ask for helpWhen I have hard homeworkCall my mom for helpPutting stuff in my backpack after bus arrivesTells us that they are thinking differently. What seems little to us actually makes his world fall apart.Pack before bus timeNo stress
43 Trained Social Peer Group Develop “lunch bunch” with chosen peersDefine new skill for student (i.e. topic maintenance, giving compliment)Demonstrate how peers can encourage and demonstrate social skills during “lunch bunch”Generalize skills throughout day
45 Factors That Make Social Situations More Challenging
46 EVIDENCE-BASED PRACTICES (EBP) What are EBP?What criteria are used to define them?How were these criteria identified?Have they stood the tests of time?
47 DEFINITION OF EBPPractice supported by research findings and/or demonstrated as being effective through a critical examination of current and past practices.
48 REPORTS ON EBP Centers for Medicare and Medicaid Services (CMS) National Autism Center (NAC)National Professional Development Center on Autism Spectrum Disorders (NPDC)
49 NPDC ON ASD ON EBPAt least two experimental or quasi-experimental designs carried out by independent investigators or …At least five single subject design studies by three independent investigators or …A combination of one experimental or quasi- experimental designs and the single case designs from independent investigatorsNo comprehensive treatment or multi-element programs or intervention packagesSome interventions were grouped together
50 NAC ON EBP Developed a Scientific Merit Rating Scale (SMRS) Research designIndependent and dependent variableParticipant selection and assignmentGeneralizationUsed a 5-point rating scale with 3,4,5 indicating rigorSome interventions were grouped togetherCategorized as established, emerging, unestablished
51 CMS ON EBP Used NPDC on ASD criteria Used NAC’s definitions of EBP Categorized as established, emerging, unestablished
52 OVERVIEW: EXAMPLE EBP CMS NAC NPDC Antecedent Package (0-16) (17-21) Modifications of events that typically precede the occurrence of a target behavior. These alterations are made to increase the likelihood of success or reduce the likelihood of problems occurring.(3-18)Includes choice; cueing/prompting; environmental enrichment/modification; errorless learning; incorporating special interests, thematic primingAntecedent-based Interventions(EC-MH)Includes using highly preferred activities, changing schedule/ routine, implementing preactivity interventions, offering choices, altering the manner in which instruction is provided, and enriching the environment
57 Centers for Medicare and Medicaid Services (CMS) www.sharedwork.org EBPCMSNACNPDCTask Analysis(EC-MH)Technology-based Treatment(0-16)(E-MH)Computer-Aided InstructionCenters for Medicare and Medicaid Services (CMS)National Autism Center (NAC)National Professional Development Center on Autism Spectrum Disorders (NPDC)
58 TEXAS AUTISM RESOURCE GUIDE FOR EFFECTIVE TEACHING (TARGET) Evaluation for Identification and Programming and Issues Related to Eligibility and DiagnosisEducational Implications (Characteristics)EvaluationInterventionsGlossary
59 INTERVENTIONS“The best measure of effectiveness of an intervention is whether it is effective for a particular individual. It is of utmost importance to collect and analyze data when using interventions with a student with ASD. If an intervention results in positive change for a particular student and you, as an educational professional, have data to support that, then that intervention is evidence-based for that student.”
60 EVALUATION: AREAS Autism Screening and Assessment Academic Achievement Adaptive Behavior AssessmentCognitive AssessmentDevelopmental AssessmentEmotional and Behavioral AssessmentFunctional Behavioral AssessmentMotor AssessmentSensory AssessmentSocial and Relationship AssessmentSpeech-Language AssessmentTransition and Vocational AssessmentOther
64 INTERVENTIONS Activity-based Interventions Adult-Mediated Social Skills InstructionThe Alert Program for Self-RegulationApplied Behavior AnalysisAuditory TrainerAugmentative and Alternative Communication SystemsCartooningCategorization/Sorting StrategyChainingChoice MakingCircle of FriendsCognitive Behavior ModificationComprehensive Autism Planning SystemAND OTHERS …
71 Training Outcomes Related to Training Components Knowledge of ContentSkillImplementationClassroomApplicationPresentation/ LecturePlusDemonstrationPracticePlus Coaching/ Admin SupportData Feedback10% %0%30% %0%60% %5%95% %95%Joyce & Showers, 2002