Kathy Eckard Autism Specialist, HPS 828-324-8884

I can…describe at least 1 of the 5 deficit areas that effects those with ASD and a strategy with which it could be strengthened.

Definition Autism spectrum disorder (ASD) is a range of complex neurodevelopmental disorders, characterized by social impairments, communication difficulties, and restricted, repetitive, and stereotyped patterns of behavior. Although ASD varies significantly in character and severity, it occurs in all ethnic and socioeconomic groups and affects every age group.

Change in Definition-DSM V-2013 The separate diagnostic labels of Autistic Disorder, Asperger’s Disorder, and PDD-NOS have been replaced by one umbrella term Autism Spectrum Disorder (ASD). More thorough and strict criteria for ASD diagnosis The revisions have been made with the hope that the diagnosis of autism spectrum disorders will be more specific, reliable, and valid.

Prevalance of ASDAutism Speaks, 2013 The Centers for Disease Control and Prevention estimates that 1 in 88 children in the United States has been identified as having an autism spectrum disorder (ASD), according to a new study released.  Autism spectrum disorders are almost five times more common among boys than girls – with 1 in 54 boys identified.

Cause? Underlying biological/genetic cause that produces organic and/or physical changes during brain development, resulting in atypical cognitive and social development and behaviors Tends to occur more frequently than expected among individuals who have certain medical conditions, including Fragile X syndrome Research indicates other factors besides the genetic component are contributing to the rise in increasing occurrence of autism, such as environmental toxins (e.g. heavy metals such as mercury) and diet (gluten free). The vast majority of research indicates it is not caused by vaccinations

Deficits The DSM-V provides five deficit areas to consider as diagnostic criteria for identifying individuals with ASD: • Communication • Socialization/Social skills • Restricted interests • Sensory integration • Behavior

Early Signs • Lack of eye contact • Lack of joint attention (i.e., attention to the same item or topic as another person) • Lack of reciprocal conversation (i.e., ability to engage in verbal turn taking) • Atypical sensory/motor processing

Core Deficits • Difficulty identifying important global concepts and elements of tasks • Difficulty processing auditory information—understanding, retaining, and retrieving; • Difficulty generalizing skills—teach skills in context; • Difficulty with sequencing information or steps in a task; • Difficulty transitioning between different activities and places; • Difficulty with time concepts and time management; • Atypical and/or uneven academic, social, or emotional development (e.g., high functioning in some academic areas, low functioning in others).

Communication Deficits in speech development and production Echolalia Abstract and inferential thinking Understanding figurative language—idioms, metaphors, similes, and irony— multiple meanings and sarcasm Organization and time management, completing multi-step tasks and procedures Reciprocity and perspective-taking during conversations; Initiating, terminating, and repairing a conversation;

Strategies- Communication Comprehension • Pre-teach new concepts and vocabulary to students prior to group • Model procedures, expectations, thinking strategies, or directions • Post visual reminders of the lesson’s essential questions • Identify auditory signals that alert students to important information or indicate when and where students should focus their attention • Pair verbal instructions with visual cues • Provide visual supports for lectures • Identify verbally and visually when transitions will occur.

Strategies-Communication Expressive • Develop a functional communication system • Create assessments that do not rely heavily on essay or short answer questions • Provide communication supports that facilitate student independence

Sensory Integration and Regulation • Hypersensitivity/hyposensitivity • Attention and focus • Regulation of activity level • Transitions between activities and places • Control of impulses, behavior, and/or fear in dangerous situations • Fine or gross motor skills, motor planning, or coordination • Oral motor • Recognition of personal space- their own and that of others’

Strategies for Accommodating Difficulties with Sensory Integration and Regulation Physical Layout of the Classroom • Consider desk location • Display visuals with instructions, routines, behavioral expectations, and schedules • Delineate work areas, sensory areas, leisure/free time areas • Provide a bumpy seat for the student’s chair during seat work • Provide a quiet/respite area

Movement Activities that Promote Task Engagement and Focus • Provide opportunities for rhythmic, sustained movement-trampoline, swinging, marching, or bouncing on a ball • Provide a sensory task before seat work. • Provide additional opportunities for movement • Brain Gym-crossing the mid-line • Use timers

Socialization/Social Skills • Engaging in reciprocal social interactions • Maintaining eye contact during conversations • Attention to nonverbal aspects of communication- gestures and facial expressions • Adapting and conforming to rules governing social behavior • Feeling empathy because they tend to intellectualize feelings or play behaviors • Demonstrating age appropriate social skills • Initiating or engaging others appropriately in social situations • Initiating, terminating, and holding conversations video

Strategies for Improving Socialization Skills • Provide explicit instruction of conversation etiquette • Rehearse skills needed for appropriate social interactions • Practice newly learned social skills with puppets, peers, or adults •Teach to associate different facial features with emotions • Introduce procedures for using a stress thermometer or tension gauge • Schedule frequent daily review of social stories •Have conversation about differences • Video role play

Behavioral Issues • Ritualistic and compulsive • Impulsivity • Stereotypic behaviors • Aggression • Inappropriate social interactions

Strategies for Minimizing Behavior Difficulties Ritualistic and Compulsive • Intervene early before behavior becomes a habit • Teach students when ritualized behaviors may appropriately occur during the day (e.g., structure when hand washing can occur) Impulsivity • Use social stories to teach social skills/minimize negative behaviors • Rehearse appropriate behaviors the student should use

Stereotypic • Develop a menu of appropriate sensory interventions to aid with sensory. regulation and heightened anxiety or stress • Develop a daily sensory schedule Aggression • Remove or minimize environmental stressors that trigger aggressive behavior Redirect with visual supports Minimize the use of words • Restructure necessary stressors to ease transitions • Clearly identify all components of task • Provide clear directions Inappropriate Social Interactions • Rehearse appropriate social interactions • Reward appropriate behaviors • Use social stories

Research Based Practices Effective w/ ASD ~The National Professional Development Center on Autism Spectrum Disorders Prompting Time Delay Reinforcement Task Analysis and Chaining Shaping Computer-Assisted Instruction (CAI) Differential Reinforcement of Other/Alternative Behaviors (DRO, DRA, DRI) Discrete Trial Teaching (DTT) Extinction Functional Behavioral Assessment (FBA) Functional Communication Training (FCT)

Research Based Practices continued Peer-Mediated Instruction/Intervention Picture Exchange Communication System Pivotal Response Training Positive Behavioral Intervention and Support Response Interruption & Redirection Self-Management Social Skills Groups Social Stories Stimulus Control and/or Environmental Modification Video Modeling Visual Supports Voice Output Communication Aids

Community Resources http://www.disabilityscoop.com/2014/02/06/feds-clarify-tracking-devices/19085/ http://nationalautismassociation.org/big-red-safety-boxes-now-available/

Resources http://www.autisminternetmodules.org/dash.php?cat=dash_tab_mn http://www.myautism.org http://nationalautismassociation.org http://www.autism-society.org http://www.autism.com http://www.child-behavior-guide.com/ http://www.thegraycenter.org/social-stories http://www.thewatsoninstitute.org/teacher-resources2.jsp?pageId=2161392240601226415747290 http://www.disabilityscoop.com/autism/ http://www.do2learn.com/disabilities/Overview.html http://www.positivelyautism.com/free/ http://www.filefolderheaven.com

Bibliography http://www.nea.org/assets/docs/HE/autismpuzzle.pdf http://ec.ncpublicschools.gov/disability-resources/autism-spectrum-disorders