Strategies for Supporting Young Children

Strategies for Supporting Young Children
Proactive Strategies Social Communication Sensory Supplies for this Section:  Supplies for the whole workshop (see introduction) Examples of visuals, learning activities, schedules, etc Print this presentation in the form of “handouts” with 3 slides per page. This presentation contains a large number of slides which depict pictures of visual supports, schedules, and strategies. It is recommended that the presenter limit the number of slides actually printed in the handouts in an effort to save paper. Only print the slides that contain written content or is believed to add specific value to the trainees. Outline: Activity and Introduction (slides 2-6, 9 minutes) Activity- List Situations (slide 4, 5 minutes) Proactive strategies – environment (slides 7-26, 30 minutes) Activity – Shopping Experience (slide 8) Activity – Find the Mistakes (slide 11) Activity – Child Profile (slide 26) Strategies – visual supports (slides 27-38, 10 minutes) Activity – Name this Object (slides 30-33, 1 minute) Strategies – visual structure (slides 39-44, 10 minutes) Strategies – schedules (slides 45-62, 40 minutes) Activity – Transition Schedule (slide 66, 5 minutes) Video (slide 68) – MUST HAVE INTERNET CONNECTION Successful support strategies (slides 69-89, 50 minutes) Task Analysis (shirt) –slide 76 – MUST HAVE INTERNET CONNECTION Activity-Mind Map (slide 88) Activity – Child Profile (slide 89) Closing (slide 90, 1 minute) Strategies for Young Children w/ ASD Virginia Autism Council 2010

Proactive Support Strategies
Physical environment Visual supports Visual structure Schedules Support strategies associated with success What do we mean when we talk about “proactive”? FreeDictionary.com defines proactive as Acting in advance to deal with an expected difficulty = Proactive steps can prevent a problem behavior What are proactive support strategies? Arranging the environment Visual supports Visual structure Schedules – transitions As well as other support strategies How do we use proactive strategies to help support the young child with autism? Strategies for Young Children w/ ASD Virginia Autism Council 2010

Before we start to look at types of proactive support strategies, let’s examine the purpose of using them. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Activity List situations that might cause problem behaviors for young children with autism In your groups at your table, list situations that might cause problem behaviors for young children with autism spectrum disorders. Give participants 5 minutes for listing situations and reporting out. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Considerations When Supporting a Young Child with ASD
Difficult activities Non-preferred activities Repeated demands Boredom Transitions New or unfamiliar situations Sensory overload Janzen, J. (1996). Understanding the Nature of Autism, p. 53., San Antonio, TX: Therapy Skill Builders. Did any of you list any of these as situations that are associated with problems with young children with autism? This is a list of situations or activities that might cause challenges or difficulty as we support children with autism. As we support those with autism, and in order for us to be proactive in our approach, we must remember these and take then into consideration. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Please help me feel: Safe Calm In control Prepared We are going to start the training by talking about proactive strategies. We want to ensure we are helping the child to feel -- safe and accepted, calm and in control, and prepared. Strategies for Young Children w/ ASD Virginia Autism Council 2010

1. Physical environment The first proactive support strategy we will discuss is: Environment Strategies for Young Children w/ ASD Virginia Autism Council 2010

Activity Activity Think about a store you don’t like shopping in - now tell me why you don’t like to shop there. (as a presenter you might have to give an example e.g., I dislike shopping in Wal-Mart because it is crowded, the lights are harsh and it is noisy) Think about a store you do like to shop in. Why? This activity should take no more than 5 minutes Strategies for Young Children w/ ASD Virginia Autism Council 2010

Physical Environment Assess need for physical structure
Initially provide more structure; fade as appropriate Establish clear physical and visual boundaries Minimize potential visual and auditory distractions Develop areas for specific activities Many of the comments from the last slide related to the physical environment of the stores. We are going to think about the physical environment at home and we are also going to consider the environment at preschool because we have some little ones with autism under the age of three who attend preschool through their school division or in their community. We are going to use the word “preschool” throughout this presentation but know that it refers to any group setting for young children – day care, child care and preschool. We also are going to refer to young children with autism as “he” while recognizing that there are many girls who also have an autism spectrum disorder. So we need to remember, whether at preschool or at home: All learning occurs within a physical environment. So we need to think about the structure of the current physical space where the young child with autism spends his time. So, when we have a young child with an ASD in preschool, we want to structure the environment for the child or children in the group who need the most structure. EVERYONE else will adjust and the increased structure is often beneficial to everyone. At preschool, it can help young children with autism if we create smaller spaces that have a particular function so the child can learn to connect that space with what happens there. For example, we can develop basic areas for activities within the preschool routine: group (where circle time happens); play; transition (where schedule is); learning (1-on-1 & independent); meals and snack. Also, there should be a “break” area at preschool and also at home (this area should not be used as a negative consequence). With young children, we often need to provide more structure as they are early learners and, as they get older and develop more skills, we can begin to fade the structure in many cases. When structuring the environment for children, think first of your own spaces and structure at work and at home. For example, at work, you may have a desk in an office. Sometimes there is a breakroom and other places where staff can meet for lunch or at other times during the day. At home we may do our work at our computer that sits on our desk. Many families also have common areas in the house where family members usually get together, like the kitchen and living room. Many homes also have areas for privacy, like a bedroom and a bathroom. We also might have places in our home where we just relax, like on our sofa in the living room or in a hammock in the yard. Just like us, young children with autism benefit from having a physical environment at home and at preschool that is structured in a way that makes it clear to them the function of the different areas. This structure helps with behavior and with learning. Let’s first consider the preschool environment for young children with autism. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Physical Structure: Preschool
Clear physical and visual boundaries Minimal visual and auditory distractions Established teaching areas 1:1 Break Area Large Group Individual Learning Area Schedule Area Teacher’s Desk Computer Coat Area Look at how this preschool classroom room is set up. The coat area is close to the door, the schedules are in the middle of the room, there is a break area in the corner. When setting up a preschool classroom, you want to avoid placing quiet areas next to ones intended to be noisy. The areas should have clear physical boundaries. You want to try to limit visual and auditory distractions next to the area where you want the child to concentrate. Door Circle Time Individual Learning Area 10 Strategies for Young Children w/ ASD Virginia Autism Council 2010

Physical Structure: Preschool Find the Mistakes
Independent Learning Area Schedule Area Circle Time Break Area See if you can find the mistakes on this one. Schedule area on the far side of the room Break area next to the door Independent learning area next to the door and the computer 1:1 area next to the computer This activity should take 5 minutes We want to be careful how we set up the preschool environment – this is one of the first things we should look at when we have an issue with learning/behavior. Teacher’s Desk Large Group Area Independent Learning Area Door 1:1 Computer Strategies for Young Children w/ ASD Virginia Autism Council 2010

Here is an example of a preschool classroom
Here is an example of a preschool classroom. What is helping to provide structure in this space? The toys are on the shelves; what you can’t see very clearly is that each shelf is labeled with pictures of the toys that are to go with them. Carpet and bookshelves are used as physical boundaries. Any suggestions on how to improve the structure in this area? One idea: organize toys better. Say we will cover that in a minute. Strategies for Young Children w/ ASD Virginia Autism Council 2010

This is a photo to show you how a preschool teacher used masking tape to mark off the area where children are to wait when being transitioned from one activity to another. The longer tape line is used as a visual support that tells the children this is where the play area ends. Strategies for Young Children w/ ASD Virginia Autism Council 2010

This is an example of how a preschool teacher set up her bookshelf with play things on it. The bins are clear so the children can see the contents and then each bin is labeled. In some classrooms, teachers may also use a picture of the contents on the front of each bin. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Here is another example of how toys can be organized
Here is another example of how toys can be organized. This is a simpler arrangement than what we saw in the previous slide. You can see the photo of each toy on an area of the shelf that shows the child where on the shelf it belongs - so the child can match the picture with the toy and get the toy in the right place. This teacher changes her toys from time to time and doesn’t keep too many available at once. Strategies for Young Children w/ ASD Virginia Autism Council 2010

This preschool teacher uses a laminated mat for each child at circle time. The children learn that they sit on the mat during circle. Each child’s mat has his picture on it and his name. In addition, each mat is a different color. The teacher has made smaller versions of these mats and uses the smaller versions at the table for lunch and at each child’s cubby. This consistency helps each child know where his place is, whether at circle, at snack or lunch, and also when it is time to get his backpack to go home. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Here you can see how a preschool teacher set up her room with a clear visual for the children telling them where they are to line up. What you can’t see very clearly in this picture is that the schedules are hanging right beside the door above the footprints. This is a quick overview of some things to consider when setting up the preschool environment. Ask: Any other ideas you have used or that you have seen preschool teachers use that may help a child with autism? Strategies for Young Children w/ ASD Virginia Autism Council 2010

Physical Structure at Home and the Importance of Routines
Have specific areas at home designated for specific activities Help children learn routines It can be much easier to think about how a preschool classroom can be structured for a young child with autism than to think about how to structure a home setting. At home, there are family members of different ages with different needs for space and structure. Also, home is naturally a setting that is – and should be - more relaxed than a classroom would be. And many families don’t want tape on their floor or labels all over the house. But there are some environmental modifications that families can consider that can make their daily routine with their young child with autism go more smoothly and can help him learn new skills and gain independence. Before we consider environmental modifications, we first need to think about routines. Having a routine helps all young children learn new skills and also learn good behavior. When families have a regular routine for their young child with autism and try as much as possible to do routines in certain places in the home, this helps with learning and with behavior. Simple routines start very early with most children. Here is a classic example of an early play routine: A parent covers her baby’s face and says “where’s baby?” The baby pulls off the cover and the mother says “peek-a-boo” and the baby, almost always, will laugh – and may even be laughing before the cover comes off because he can anticipate what is going to happen. When we repeat routines, children learn their roles and can learn to initiate the routine themselves. Initiating play can be very challenging to young children with autism so routines, repeated over and over again, whether a play routine like peek-a-boo or a daily living routine, like brushing teeth or taking a bath, help children anticipate what is going to happen and increases their participation and, ultimately, their initiative and their independence, because they know the steps – they know what is going to happen next and they know what they will be doing. Once we have routines established, then we can think about environmental modifications and visual supports to help a young child learn to move through the routines, participating and then initiating. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Mealtime Routines Children will develop their own routines if allowed. For example, some young children snack throughout the day, wandering around with a sippy cup and picking up a bite to eat whenever they choose. This is their routine for eating. Some families find that over time this routine causes some concerns – maybe their child is eating a limited number of foods, perhaps their child has a poor appetite at mealtimes, or maybe he does not understand about sitting with the rest of the family at the table for a meal at home or out in the community. The child whose family has him learn from an early age to sit at a particular table and in a particular chair in order to have a meal or a snack will know, when seated at this table in this chair, that it is time to eat. He will be on his way to developing mealtime behavior that will be beneficial not only at home but at school and when going out to eat in the community. Sometimes adding a special plate and cup to the place setting just for that child can be an additional signal to the child that it is time to eat – and choosing tableware for the child that has some importance to him can make it more fun, such as selecting a place setting that has the child’s favorite cartoon character on the plate and placemat. Then, when eating at a new location, the parent can bring along the plate or placemat to help with the experience of eating in a new location. Having something familiar in a new but similar situation can help a child know what to do and then be successful. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Play Routines Another example is structuring a place to play at home. Parents who have children with autism often find it challenging to engage their child in play. While there are various strategies to engage young children in play and we will be discussing some of them later on in this training, one way is to have a specific place at home set up for play so, when a child is there, he knows that it is playtime. For example, if play with puzzles and crayons and blocks with mom or dad always happens on the rug in the playroom or in an indoor pop-up tent, these locations become the signal or cue to the child that now it is playtime with a parent. Selecting a place to play that has a specific boundary can help. Strategies for Young Children w/ ASD Virginia Autism Council 2010

A Place to Take a Break A third example is creating a place at home for the child to take a break. While we know that preschool can be stressful, sometimes we forget how stressful and overstimulating home life can be too – maybe there is company in the home, maybe there is a lot of vacuuming going on (and the child is sensitive to noise), maybe there are several siblings who are actively playing – and the young child with autism needs a place to go to take a break from the home routine. Some parents have a corner with pillows and some other favorite items where their child can retreat. Others may have a bean bag chair, a rocking chair or a blanket draped over a table so the child can have some private space. The pop-up tent shown in the last slide can also be a good retreat but it shouldn’t be used for multiple purposes – if it is for play time, set up another place for a child to take a break. By structuring the environment to have a place at home that is calming to the child and then by teaching him to go there when he is becoming stressed, the child has learned a way to cope with stress in a positive manner – instead of screaming, running through the house, hitting himself or hitting others, this child has instead learned to take a break to this quiet place until ready to rejoin the family routine. Designing a place to take a break usually involves considering a child’s sensory needs. We will be talking more in this training about sensory strategies that help young children with behavior and also with learning and moving successfully through the daily routine. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Organizing Clothes and Toys
Not only does it help to have certain places in the home for daily routine activities like eating, playing and taking a break, it can also be helpful to learning and behavior to organize the items that are most important to the young child. Families can organize their children’s clothes to help teach dressing and where to put clean clothes after laundry. They can do this by using a picture label on each drawer in their child’s bedroom – the label shows what it is in the drawer, likes socks or shirts, and this can help with finding clothes in the morning when getting dressed and with learning to put clothes away after they have been laundered. Families can also organize toys. Most young children have many toys. Some families have their toys organized with most toys kept in particular places but other families have a more relaxed approach to where toys are kept. In these households, sometimes toys are kept in a large box altogether and other times they may be scattered all over the house. Sometimes the more relaxed approach can create frustration over time for the child who doesn’t know where a particular toy is or who can’t find all the parts. This can also become frustrating for the parent who may struggle with the disorder. To develop organization of toys at home, families can take some hints from preschool teachers who organize their classrooms. Let’s think about the preschool classrooms we just viewed and how the toys were organized. While most families don’t want their homes to look like school, shelving and inexpensive clear plastic bins for toys in the home can help a child and parent with toy organization. And, while most parents aren’t going to put labels on all furniture in the home, having picture and word labels on the plastic bins on the items most important to the child can help a child and parent be organized. An additional benefit from putting toys on shelves is to develop the skill to request. The picture on this slide is from a preschool classroom. You can see favorite toys on the shelf at the top of the picture. This shelf is too high for any of the children in the classroom to reach. If you look toward the bottom at the red arrow, you can see picture cards velcroed to the beige strip for two of the toys. The children in the classroom who are not yet using words use the cards to request to play with a toy. Parents can use this simple strategy at home by keeping favorite toys on a high shelf where they can be seen but not reached by their child. In order to play with the toys, children learn to make requests, using words, gestures and/or pictures. We will be talking more about developing communication during this training and how this strategy, of keeping favorite items in sight but out of reach, can be very instrumental in creating the need to talk. When we have a child with autism, we often need to create the need for communication and can do this in the way we structure the environment. If children can reach everything they want, they may not see the need to communicate. We will talk more about communication strategies in the communication section. As families begin to think about organizing their home environment and incorporating visual strategies, it can help to start with one thing – perhaps a label for the current favorite toy. Families should not feel overwhelmed, thinking they need to do everything at once. We also need to be respectful of families – some may not want to do this. We can explain the benefits and then let them choose what, if anything, they would like to do. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Home and Safety Parents of all young children have to be vigilant about safety and parents who have children with autism are often especially challenged to keep their little ones safe. Often young children with autism enjoy (and are very good at) climbing, take longer than other children their age to understand danger, may not respond to discipline strategies such as time out and a stern word when they engage in dangerous activities, and seem to have quite a bit of energy all day and often well into the night. So structuring the home environment to keep a young child with autism safe is challenging. Strategies some parents have used include installing a Dutch door or stacking two baby gates at the bedroom door at night to keep their child in his room, firmly attaching bookshelves, dressers and other pieces of furniture to the walls in case they are climbed, and installing latches and locks up at the top of doors to prevent children from entering or exiting certain rooms in the house. Ask for other strategies participants have seen families use. Ideas: screen doors inside, bells on doors, Project Lifesaver, crib tent, car seat vest that zips in back -Prevention is often the best strategy to avoid accidents – so, for example, if a child uses a particular chair to gain access to something high up, remove the chair. -Prevention also helps families avoid having to say “no” to their child all day long. -Prevention is also much better than dealing with a behavior after it happens. It is important, too, when teaching safety to be consistent. If some days the parent allows the child to climb onto the bookshelf and other days tells the child “no” and takes him off as he climbs upward, the child gets an inconsistent message and is unsure of the rule. All children, and especially children with autism, need consistent messages about safety. Strategies for Young Children w/ ASD Virginia Autism Council 2010

When Should You Assess Your Environment?
New environment / setting New expectation New behavior observed Increased independence is not occurring Activity is unstructured Life becomes hectic You should assess the environment, first, when there is any change….change in environment or a change in expectation. Ask whether the environment will increase or decrease the child’s independence in this situation. You should also assess whenever there is a change in the child’s behavior. The environment is the first thing we look at when we see a behavioral change – after we have ruled out any medical concerns – or issues such as hunger, being tired, etc.. If you wonder if the environment is causing concerns, observe the child to get clues about what he is doing/where the challenges are and how you might be able to restructure the environment to make it more clear what the child is to do (or not do!). Making changes to the environment can be one of the easiest changes to make to help with learning and behavior. Here’s an example – a preschool classroom added a new set of shelves. One end of the shelves had open ledges that we like steps and the child with autism began to climb up those steps and stand at the top of the shelves. A simple solution was to rearrange the room and moving the shelves with the step end to a corner so the child could not easily access the steps. This same child liked to climb into the windowsills in his preschool classroom. The teachers figured out if they kept baskets and other things in the windowsill, he stopped climbing. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Assessing the Physical Environment
Free of distractions Free of excess sensory stimulation Freedom for mobility Organized and accessible materials Accessible schedules Activities clearly defined There are a variety of considerations when assessing the physical environment. This slide provides a checklist you can use to determine if your physical environment is appropriately structured and will help the child remain calm and in control, while optimizing learning. -Free of distractions – As discussed, the area should be free of anything that may distract the child. This will differ from child to child. When thinking about distractions, think about televisions, windows, noise ,etc. -Sensory stimulation - Due to difficulties children with ASD experience in modulating sensory input, we need to look at the home and preschool environment and consider the child’s sensory system. -Moving around – the space at home and preschool should promote independence. The child should be able to get to activities through his daily routine but there also needs to be attention paid to the child’s safety. -Clearly defined -Activities designated -Materials – in order to promote independence and help with predictability ensure materials are organized and accessible -Schedules – we will talk about schedules later in this presentation, but for those who use them, the schedule should be in a logical place that is easily accessed. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Activity: Child Profile
What accommodations do you use to help young children with ASDs be successful in different environments? 2. What environmental structure and strategies are most successful? Take a minute and think about what you have learned. See if you can apply any of the strategies. Think about what you just learned about structuring the environment for young children with ASDs. Go to the Child Profile and complete Proactive Supports - Questions 1 and 2 Have participants look at their Child Profile and fill in questions 1 & 2 under Proactive Strategies. If you have time, you can have participants take out graph paper and sketch how they might structure their environment either at a preschool or at home. (Note to trainer: you can use either graph paper to have participants draw a classroom or home or you can do the activity as a think- pair- share activity depending on time) Give anywhere from 5 minutes to 10 minutes. Strategies for Young Children w/ ASD Virginia Autism Council 2010

1. Physical environment 2. Visual supports Strategies for Young Children w/ ASD Virginia Autism Council 2010

Why Use Visual Supports?
Provide a permanent prompt Provide a reminder of what to do or not to do Display information visually and concretely Why should we use visual supports? Visual supports will ultimately result in increasing independence and / or reducing interfering behavior. The visual support will provide a permanent prompt. Unlike an auditory instruction, a visual support is permanent – long lasting. Auditory instructions, on the other hand, are transient. Many of our children with ASD have strengths in visual processing making this a great support strategy for a wide array of skills. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Are Visuals Just for Children and Adults with Autism Spectrum Disorders?
We are going to show you a few pictures. We want you to identify the object or picture. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Name this Object Play-Doh
Strategies for Young Children w/ ASD Virginia Autism Council 2010

Name this Object Lego Strategies for Young Children w/ ASD Virginia Autism Council 2010

Name all Four Yield ahead, speed limit 45 ahead, stop light ahead, stop sign ahead Strategies for Young Children w/ ASD Virginia Autism Council 2010

Name the Icons on the Phone
Icons on the phone. For example, the clock is a visual for time. The sun is an icon for weather, the road sign is an icon for a map or GPS. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Name this Object Recycle Bins After the slides have been identified -
These examples show how we use visual cues to identify common objects that we see in our everyday routine – we don’t even need the entire label - by the color, shape and design, we know what the objects are. These kind of visual cues we get from our environment help us to better understand our environment and successfully move through our day. These examples show how we all use visual cues all the time. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Timer Here’s an example of a visual support that tells a child when the time is up. When the red disc is gone, time is up. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Traffic Light Here’s another example of a visual support to help a child know when time is up. The clothespin moves from the green light, to the yellow light, and then to the red light when it is time to stop. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Choice Menu Within a routine, there are often choices a child can make. Here is one way to use a visual support to show the play time activities from which a child can choose. You can set up a choice menu with just two choices for a child who is just learning about making choices and using visual supports. You can use objects, photos or colored line drawings for the choice menu. What you choose depends on the child’s skills in identifying objects, photos and the cartoon-like drawings above. At the beginning, when a child is just learning, you may have to use a gentle physical prompt to help the child take a card off of the choice board and hand it to you and then you hand him the toy that is on the card to help him understand the connection between the card and the toy. You will want to fade your prompt as soon as you can so the child does not get dependent on your prompting to make a choice. And you don’t always have to have pictures to offer choices – it is fine to hold up a blue shirt and a red shirt and ask the child what he wants to wear. You can use a choice menu like this for play, mealtimes, selecting which shirt to wear, and for many other parts of the daily routine. Giving a child choices helps with behavior. We all like to have some control over what we do with our time. Making choices also helps with learning to take initiative. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Menu Strategies for Young Children w/ ASD Virginia Autism Council 2010

Physical environment Visual supports Visual structure We are now going to discuss visual structure. When I say visual structure what comes to mind? What do you think of? What are things in your own world that are visually structured? (Have audience provide ideas of visual structure.) Strategies for Young Children w/ ASD Virginia Autism Council 2010

Why Use Visual Structure?
Provides organization Makes the activity clear and logical Provides a clear beginning and ending Increases independence Now let’s talk about how visual structure helps the young child with autism with play and learning. Read/paraphrase slides Strategies for Young Children w/ ASD Virginia Autism Council 2010

Here is an example of how visual structure can be added to a learning task so that it is clear to the child the pattern to create. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Here is another example of a natural visual structure with the color matching that helps a child know how to correctly complete the puzzle. Strategies for Young Children w/ ASD Virginia Autism Council 2010

And another. These are just three of many possible examples of how visual structure can help with play and learning and also increasing independence. Strategies for Young Children w/ ASD Virginia Autism Council 2010

And here is an example of how adding visual structure to a daily routine activity – sorting silverware – can help a child learn. This activity is both meaningful (child can relate to the materials and activity) and it is functional (has some every day use for the child). Strategies for Young Children w/ ASD Virginia Autism Council 2010

Physical environment Visual supports Visual structure Schedules Strategies for Young Children w/ ASD Virginia Autism Council 2010

Visuals Are for Everyone!
This is an example of how most of us use visuals to organize our daily lives. So schedules aren’t just for individuals with ASD! We make lists, we use a calendar, and we use other kinds of visual strategies to keep us on track. Have the audience show you their schedules. Ask, who has the largest one. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Why Use Schedules? Clarify expectations Increase predictability
Increase choice Increase independence Decrease challenging behavior Just like visual structure with play activities can help children understand expectations and be successful, visual schedules can help children be successful too. Some think that visual schedules are only for older children and adults, but young children can benefit from visual schedules too. Many of the young children we see will be going off to preschool – or already are in preschool – and there are schedules there. If they are not already in preschool it can be helpful to introduce them to a schedule prior to going to preschool to help them move through part of their daily routine. Some think we only use visual schedules and supports before a child learns to say words and then we don’t use them anymore once a child is talking but most of us, as we have already discussed, use visual strategies throughout our lifetime to keep us organized and on track. Paraphrase slide. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Why Use Schedules? Individuals have: Schedules provide:
Strengths in visual processing Difficulty using verbal information Schedules provide: Visual information that is static Listed on the left are some characteristics of individuals with autism spectrum disorders. On the right are justifications as to why visual schedules provide support. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Why use schedules? Individuals have: Need for structure Need for preparation Difficulty with sequencing and organization Schedules provide: Concrete daily activities that are sequential and organized Listed on the left are some characteristics of individuals with autism spectrum disorders. On the right are justifications as to why visual schedules provide support. When we talk about schedules we can talk about a variety of different types. The schedule should be individualized for the young child. Additionally, the child may benefit from having more than one kind of schedule and using different schedules in different situations. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Types of Schedules Object Photographs Line drawings Colored
Black and white Written There are many types of schedules – this slide shows a progression of schedules from the most concrete to the more abstract. You can use all one modality or may use a mixed modality schedule. Object schedules can use the real thing or a meaningful piece of the real thing (e.g., a small piece of rope from a swing). You can sometimes use miniatures with magnets on them to create an object schedule. You can also use photo schedules. Who has heard of TOBIs? Describe True Object Based Icons. Cut out photos/exact shape It can be very helpful when developing visual schedules for young children to use a digital camera and photograph favorite toys, family members, drinking cup, etc. As they are learning about pictures and what they mean, it can help with learning to see familiar objects, like their own sippy cup, instead of generic ones. These could also include pictures from boxes or cartons of the food or toy the child likes. Line drawings include B & W and colored. Sometimes, color is a distracter. You must know what the child understands. Does the child understand symbols or does he need a concrete representation? Most young children will need schedules and other kinds of visual supports that use objects, TOBIs or photos of the actual items with which they are familiar. Written schedules are for older children as they are designed for individuals who can read. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Deciding the Type of Schedule to Use
When you are trying to decide where to begin with a schedule with a child with an ASD, observe the child and see what is meaningful to him/her. Assess what the child best understands and/or shows as a preference: objects, pictures, text. Remember to teach the use of the schedule in addition to learning what the icons mean. The method used to communicate can tell you a lot about what may be used as a schedule. Additionally, if you are unsure what to use, provide the more concrete schedule. You want to ensure learning, support, and understanding. When in doubt…ASSESS Assess what the child best understands and/or shows as a preference: objects, pictures, text. Here are some simple questions to answer when you consider what to choose for a young child with autism. -When you name an object around the house or classroom, do they look at the correct object? Will they go get it when you ask? If yes, they understand the name of that object. See how many objects they know. -When you show them a picture book and ask them to show you a picture of a ________, can they do that correctly? When they see packaging of a toy – maybe a Dora doll, do they look at it and say “Dora”? If yes, they have an understanding that pictures have names. If you show them a picture of, for example, a ball and then show them a ball and a truck, can they match the ball to the picture of the ball? If yes, they are showing you their understanding that the picture and the object are the same. A general suggestion is to start with a photo schedule and, if the child seems to be struggling, step back to using objects. And, if the child does not seem to understand the names of objects, you need to begin by teaching that skill. Use simple language as much as you can and label objects during the daily routine. You can also set up a more structured way to teach object names. For example, put two objects familiar to the child in front of him and ask him to give you the ____. If he does, praise him. If he does not, guide his hand to the correct object and then give him praise. Do this through the routine – as he is getting dressed – and there are socks and shoes sitting there, ask him to give you the socks – and, if he doesn’t reach, or starts to reach for the shoes, guide his hand to the socks and praise him. Observe the child Determine what he understands Determine type of communication used Assess skills When in doubt, begin with more concrete schedule Strategies for Young Children w/ ASD Virginia Autism Council 2010

Schedule: Objects This is an example of a preschool object schedule.
Strategies for Young Children w/ ASD Virginia Autism Council 2010

Schedule: TOBIs Here is an example of a True Object Based Icon or TOBI schedule. First, the child has a drink. Then he brushes his teeth. Then he plays ball. TOBIs can be used for any age. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Schedule: Photographs
This is an example of a photo schedule. First the child works on the computer and then can slide. A word of caution with photo schedules – and using photos for any purpose with a young child who is just learning about pictures: Be careful when you take the picture not to get other items in the picture. For example, when taking a picture of the computer, make sure there is not a program up or a reflection on the screen (like in the picture above). Also, the computer picture is “busy” but, if this is the actual computer that the child uses and he sits in this chair at this table, then this picture is OK because it is what the child sees. However, if you were wanting just a generic picture of a computer, this photo would not be a good choice because there are so many other objects in the photo. When you can’t take photos of a child’s own belongings or you feel the child is ready for more generic photos, a great place to get free photos and also clip art is google.com/images. Computer Slide Strategies for Young Children w/ ASD Virginia Autism Council 2010

Suppose you wanted to take a picture for the word “crayons
Suppose you wanted to take a picture for the word “crayons.” A child would have a hard time knowing that the picture above was meant to mean “crayons” even though there are crayons in the photo. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Instead, take a picture of crayons like this
Instead, take a picture of crayons like this. The crayons are against a solid background. Black is ideal as a background, but sometimes a lighter color background helps the objects show up better, like the lighter background in this picture. Try to be consistent with the background for an individual child – a consistent background is hard, though, when taking pictures of things outside, like the child’s swing or bike, so you have to do the best you can to eliminate any other distractions. As the child begins to develop their skills with picture cards, you can begin to use color to help children learn categories. For example, you can use a red background for all pictures of food, a green background for all pictures of toys, etc. When developing schedules for young children who are not yet reading, add the word for each picture. Some young children with autism learn to read very early and so may begin to recognize the words. Also, having the word with each picture helps the preschool teacher or the parent use the same word each time when talking about the picture with the child. Consistency in labeling the picture really helps with learning. And, for many children, over time, the pictures will be faded and the child will use visual supports that only have the word. So, it is important to include the word in the schedules and in as many other visual supports as you can. crayons Strategies for Young Children w/ ASD Virginia Autism Council 2010

Schedule: Colored Line Drawings
This is an example of a picture word schedule. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Schedules Are Individualized
Full Day Schedule Part Day Schedule Here are two picture word schedules. Be cautious about using a whole day schedule (whether objects, photos or line drawings), especially for young children as seeing the entire day can be overwhelming for the child who is just getting used to visual schedules. At preschool, lunch time is a natural “split” in the day so the preschool teacher could have a morning schedule and then an afternoon schedule. At home, parents may start with a visual schedule for the part of the day that is most challenging (for example, the bedtime routine) OR the time of day when they want to introduce a new skill or activity - with the idea that the visual schedule will help their child move through that part of the routine. A schedule that focuses on one small part of the day is called “mini-schedule.” And we need to remember that most families won’t need a visual schedule for their entire routine. For the parts of the routine that are going smoothly, a visual schedule is likely not needed unless a family or teacher wants to teach a new skill – then a visual schedule might be very helpful. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Morning Home Schedule breakfast bus car preschool
In this picture, you can see one way to show a change in a routine. The international “no” symbol is used to show that the child will not be taking the bus to preschool as usual, but will be riding in a car instead. This helps the child learn to visualize how one thing can be substituted for another. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Morning Preschool Schedule
This preschool teacher uses a frame that moves from activity to activity as the morning progresses. Other teachers may remove the picture altogether once the activity is completed. With a schedule, whether used at home or school, it is important to add in new activities from time to time. Not only does this help a child become flexible but, if the schedule stays the same every day, the child will likely memorize it and will move through the routine based on memory. Instead, we want the child to learn to refer to the schedule throughout the routine and not simply rely on memory – so we want to have changes in our routines. But, for routines, such as toothbrushing, those steps are basically the same each time and we want to keep steps in those kind of daily living activities the same each time to help with learning. Over time, though, we want the child to be able to do these routine activities in new locations, like when they visit a relative’s house. So, after the child is good at toothbrushing, for example, at one sink in the house, you can switch him to another sink to brush his teeth. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Mini-Schedules Provide structure within an activity or event
Outline steps or sequence of the activity Visually display steps of the activity Break activity into small parts A mini-schedule is a great strategy for increasing independence. A mini-schedule provides additional structure within an activity or an event. It outlines visually, using objects, pictures, line drawings, or text the steps of the activity or event. The mini-schedule allows you to break down the event or activity into small parts – small parts that are doable and manageable to the child. – Of course, how much an activity or event is broken down is individualized. It depends on the need of the child and how much support they need to complete an activity. Examples include, a mini-schedule for P.E., for lunch, a field trip, getting dressed in the morning. (Add other examples.) Strategies for Young Children w/ ASD Virginia Autism Council 2010

Mini-Schedules Designed to provide structure within an activity or event: - Choices during play time at home - Activities during centers - Field trip schedule This is a mini-schedule for taking a child to the YMCA to go swimming. YMCA Go swim Change clothes Change clothes Strategies for Young Children w/ ASD Virginia Autism Council 2010

Mini-Schedule for Bedtime Routine
Here is a picture mini-schedule for a bedtime routine that can be used at home. Let’s think for a minute about teaching a child how to use a schedule. It is not enough to just make sure they know what the pictures mean. You might need to give a lot of assistance at the beginning to help a child use the schedule correctly. It is better to give the assistance at the beginning and have the child be successful – and then fade the assistance – than it is to have a child be unsuccessful when you start to use schedules and thus start off with failure. Explain how this schedule was used with a child with autism. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Mini-Schedule for Toileting
This is an example of a toileting schedule Strategies for Young Children w/ ASD Virginia Autism Council 2010

Mini-Schedule for Handwashing
And here is a schedule for handwashing from a preschool classroom. It could also be used at home. It is nice, when possible, to use the same schedule with the same pictures at home and at preschool. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Activity Create a schedule for a child who experiences difficulty transitioning from the playground to the car. Have participants draw an impromptu schedule to assist a child having difficulty transitioning from the playground to the car to go home. Allow 10 minutes for this activity including sharing out time. Tell them: You are working with a family who tells you that they go to the playground every Saturday. Everything goes well until it is time to leave and then their child has a big tantrum. They want you to help them figure out how to have a smooth transition from the playground to their car. How would you incorporate the use of a visual support to help this family with this situation? Strategies for Young Children w/ ASD Virginia Autism Council 2010

Schedule for Outings Here is an example of a schedule that may help the child in the activity we just did. As each step is completed, the card is pulled off. This schedule can be hung over the back of the front seat in the car, facing the child as he sits in his car seat, so he can see what is next. The parent knows that leaving the playground is very hard for her child, so she plans a positive activity (lunch at McDonald’s) which can help the transition from the playground go more smoothly. Tell participants as an FYI – these photos are from google images. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Video http://www.youtube.com/watch?v=XaiHCalHysY
This video is on YouTube and was created by Ocali, the Ohio Center for Autism and Low Incidence. You will need Internet access. This video depicts use of a picture and icon based schedule (takes 3 minutes). Once you have watched the video, ask the audience to share ways they could use this strategy to support a young child with autism. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Physical environment Visual supports Visual structure Schedules Support strategies associated with success Strategies for Young Children w/ ASD Virginia Autism Council 2010

Considerations when Supporting a Child with ASD
Difficult activities Non-preferred activities Repeated demands Boredom Transitions New or unfamiliar situations Sensory overload Janzen, J. (1996). Understanding the Nature of Autism, p. 53., San Antonio, TX: Therapy Skill Builders. Remember this list of situations that are associated with challenges with young children with autism? We looked at this in the beginning of the training. As you work with children with ASD, each of these should be considered as a “red flag.” Keep in mind, these are common areas of difficulty. In this presentation, we have really focused on being proactive. This is essential as we support young children with ASD. If we are aware of “trigger” areas, we can proactively structure situations to address the issue before any problems arise, and can also be successful in teaching and supporting the child for independence. In the upcoming slides, we are going to discuss these areas, and outline strategies to address each. We will not focus on the last one listed – sensory overload - during this section on proactive strategies as this will be discussed in great detail later in the training. Strategies for Young Children w/ ASD Virginia Autism Council 2010

What Makes an Activity Difficult?
Not understanding purpose of the activity Not understanding steps of the task Not knowing how much has to be completed Being pushed to move faster Being pushed to do more Difficulty focusing due to external stimulation / distractions Any of us are challenged by a difficult task, so it stands to reason this would hold true for a young child – especially one with autism. It is essential that the child understands what they are doing, why they are doing it, and also how much of it. Behaviors will likely occur when children don’t see an end to an activity. You just completed a five page report and turned it into your boss and he/she asks you to write 5 more pages; you are told you need to have it back to him before lunch. You take it, walk back to your work space and close the door. How might you feel and what might you say or do? Do you know the exact expectations? Do you know when this task will be over? How do you feel when you are in an exercise class and you are doing push ups but the instructor doesn’t tell you how many you have to do? Now let’s think about the young child. There are so many things the child has to learn and many are difficult when he is just starting to learn how to do them. Eating with utensils, washing hands, taking a bath, and getting dressed are some examples. These are all difficult activities for young children – and a time when we often see challenging behaviors. It is also essential the child is taught and moves at a pace that is appropriate for him. As noted earlier, we must also consider the distractions for the child and any sensory needs. Sometimes we want to avoid teaching a young child a difficult task because we think we will get resistance and we know it is quicker to just do it ourselves. However, it is important in the early years to begin to teach a child all kinds of things, even those things that may be challenging for the child – and for us! Strategies for Young Children w/ ASD Virginia Autism Council 2010

Strategies to Address Difficult Activities
Clarify Information! What is to be done How much is to be done How long activity will be performed What to do when finished The beginning and end of activity For children with autism to be successful we need to not overwhelm them with a lot of information but we must make the expectations clear. In order for this to happen, we must ensure we make clear what is to be done, how much, how long, and what to do when finished. There must be a clear beginning and ending to the task. The first consideration is to make sure the child understands the activity. We have to make the task as concrete as possible. We might use objects of visuals to make an abstract concept more concrete. So far in this training, we have talked about how to do this – we can do this with visual supports, strategies, and schedules. What are some ideas for helping the child to understand what activity is to be completed? Have the audience provide ideas. What are some ideas for helping the child to understand how much or for how long it is to be completed? Have the audience provide ideas. -timer with red disc -stop sign visual support -singing a song Strategies for Young Children w/ ASD Virginia Autism Council 2010

Make abstract tasks concrete! Provide visual example Provide concrete instructions We must work to make abstract concepts as concrete as possible – We can do this by using visual supports and structuring the activity. Some helpful ideas include: -Provide a visual example – for example, if we would like for the child to pick up his blocks, we might have a picture of all the blocks in the basket. Remember how we looked at a few slides in the beginning of this section that showed visual structure to help develop independent toy play. -Provide concrete instructions – use simple, key words Strategies for Young Children w/ ASD Virginia Autism Council 2010

Break activity into small parts! Break difficult task into parts Sequence steps Teach one step at a time and build sequentially Teach discrete steps until mastery For young children with autism to be successful we need to break activities down into small parts, slow down, take things one step at a time, and not overwhelm them with a lot of information. We can take any skill and break it down into small, teachable parts. This is called task analysis. When thinking about teaching a new skill, it can be helpful to do the skill yourself and write down each step. Here’s an example of looking at a skill and breaking it down into smaller steps and then using a strategy called backward chaining: When teaching dressing (an activity that many young children don’t have much desire to learn and that has many steps), one strategy is to start with the final step of dressing - pull up the pants from the knees. The parent does all the dressing steps except for this final step. Once that step is mastered by the child, the parent teaches her child how to put feet into the pants’ legs and then pull the pants all the way up. And so on. This breaks down the task of dressing, which has many steps, into manageable parts. The child does not feel so overwhelmed. Remember wait time! Having photos of the steps of dressing to point to as the steps are completed can help make the task more concrete. And remember to limit your talking as you are teaching and to use simple words. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Task Analysis: Washing Hands
1. Grasp both knobs and turn on water. 2. Put right hand on soap pump and left hand under soap spout. 3. Press pump two times. 4. Rub hands together. 5. Place hands under water. 6. Rinse off all soap. 7. Turn off water 8. Dry hands on towel. Here’s an example of a task analysis for hand washing. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Can you list the steps for folding this shirt?
Task Analysis: How To Fold a Shirt Can you list the steps for folding this shirt? Optional activity: The video demonstrates how complex some every day activities appear until they are broken down into discrete steps and practiced – and how important it is to give clear directions to children learning a new skill. ***To view the video, press escape to the working slide view and then double click on the icon. After viewing return to the presentation view. Get out a piece of paper and write down the steps for folding the shirt. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Teach the Skill! Teach systematically Make learning as natural – and fun - as possible Make learning as reinforcing as possible Use a structured prompting system Young children have so many skills to learn. When a child does not have autism, he often learns skills by watching, listening or both. Often, the adults in his world do not have to specifically teach a skill, step by step. When a young child has autism, many skills have to be specifically taught. Children with autism often do not learn by watching or following verbal directions unless it is an activity that is highly motivating to them. While many young children with autism seem to like getting undressed, most are not motivated to get dressed or wash their hands. These are skills, however, that they must learn. Therefore, we must teach a skill systematically. Have a plan and how you will teach a given skill or sequence of skills. We want to ensure we are teaching in the natural environment and take advantage of natural cues. Whenever possible, we want to incorporate favorite interests. For example, if we are teaching a young child to take a bath and he loves dinosaurs, have a washcloth with a dinosaur and a plastic dinosaur in the tub. Reinforcement is critical to good teaching. We need to motivate children to learn, change behaviors. Reinforcement can be provided in a variety of different ways. For example, the most natural would be a break from the demand. Determine a prompting system that you will use to teach the skill. On the next slide, we will discuss this further. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Strategies for Prompting
Assess the child performing the skill Determine level of independence Determine when assistance is needed Determine how much assistance is needed Assessment is needed to determine the level of prompting required to learn the skill. You do not want to provide too little or too much in the way of prompting. Both will waste time and can lead to frustration – on your part and the child’s. For each component of the skill, you must assess and determine the level of assistance needed. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Strategies for Prompting
Use the system of least prompts Wait for a response Provide a verbal instruction Provide a gestural prompt Provide physical assistance Provide assistance only as necessary Allow for adequate processing time There are many different ways to provide prompting, however, one systematic and simple way to do so is to use a system of least prompts. This requires the parent or teacher to wait for a response. If the response does not occur or if the response is incorrect, then a prompt is given. Each time a prompt is given, the adult waits and if again is not correct, intensifies the level of prompt. This continues until the child has demonstrated the skill. With this system, wait for a response, then provide a verbal instruction, provide a gesture prompt, provide physical assistance. With each step, the adult provides a bit more prompting until the child performs the task. That is how the system of least prompts works. For very young children who are just learning to do a skill, we often have to initially provide them with more supportive prompting to help them be successful – and then we move to less supportive prompting as we see they can perform the skill. During this time, model using least to most prompting for the audience. Have the second presenter attempt to pick up a pencil from the floor. Provide least to most prompting to assist him/her in picking up the object. Now, have the second presenter clap her hands. Before providing a prompt, have the audience tell you how to prompt using least to most. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Points to Consider Don’t assume child can perform task
Provide necessary supports to clarify Use motivation Restructure the situation for success Re-teach if needed Intervene at first signs of agitation When teaching new skills to a young child with an autism spectrum disorder, it is likely you will run into difficulties. In this case, we need to look at the situation and identify what is possibly causing the problems. When the child is not completing an activity like we think he should and making mistakes, we need to look at the situation and identify what is possibly causing the problems. Determine if the task is too complex. For most young children, this is likely a factor. Let’s think about the dressing example again. Expecting a young child to complete the entire sequence may be too much. Restructuring the task and reducing the steps you expect the child to do on his own may help create success. Then, even with the simplest of steps, ask yourself honestly: does the child understand what he is to do? We need to make sure that our directions are clear and that we add in visual supports along with our words when needed as young children with autism often have a hard time listening to and understanding our verbal directions. This goes back to the “repeated demands” that can cause problem behaviors – and often it is because the children don’t understand what we want them to do. Sometimes, too, we saw them follow a direction yesterday perfectly. Then, today, we ask them to do the same thing and they don’t respond. We feel that they are exhibiting bad behavior today and are giving us a hard time because we saw them follow that direction yesterday - we believe they can do it if they want to! While we need to remember that inconsistency in performance can be something we see with individuals with autism, we often will find, if we look closely at the situation, there might be something different about today when you gave that direction as compared to yesterday. Here are some questions to ask yourself: Did they not get much sleep last night but slept well the night before? Had they eaten breakfast yesterday when you gave the direction but today they haven’t eaten and are focused right now on eating? Yesterday, did you give the direction using just a few key words, like “get your shoes” and showed a picture of shoes as you gave your direction - and today did you say “you need to find your blue shoes because it is cold outside and we need to go see your grandmother” and didn’t include the picture as you spoke? Were you in a more relaxed mood yesterday when you gave the direction and today you are anxious, running late, with too much to do and so your tone of voice sounds more stressed? Did you get their attention yesterday before you gave the direction but today you gave the direction while they were distracted by cartoons on TV? Some other things to consider: Are you using appropriate prompts: e.g., least intrusive to most intrusive? (give an example here). Are you using visuals and structure to help provide support? Is the child motivated? If you do run into challenges, intervene immediately. Don’t be afraid to restructure the situation or reteach a skill. And, when a young child is not learning like we think he should be or is making mistakes, we need to assume that they have not yet learned to do the skill correctly. They need our help and patience to teach and teach again until they know what to do. And a reminder: when you give a direction to a child, only give it if you are going to follow through to make sure the child does what you have asked him to do. Often children with autism act as if they do not hear what others say to them. If you call their name or give a direction, like “get your shoes” and you get no response, gently go over and guide the child, using the least amount of prompting needed, to get his shoes and then praise him. If you give a direction and get no response and then do not follow through, the child learns he doesn’t have to listen to your words. Strategies for Young Children w/ ASD Virginia Autism Council 2010

What Is a Non-preferred Activity?
Working on tasks that are not liked Working on tasks for too long Limited or no access to preferred tasks Repeating meaningless tasks or activities Most of us don’t like to work on tasks we don’t like. A non-preferred task can include things that are boring, are repetitive, or last too long. I may like playing the piano, but if I have to do it too long, it becomes non-preferred. Also, when we think about this, we want to think about access to preferred tasks as well. Sometimes a task is not so challenging if I get to do things I like to do. For example, going to a work function may not be non-preferred if you also get to talk to your best friend while you are there. While you may talk to people you don’t want to, overall the task is not non-preferred because you got to intermix things you like. What are some non-preferred activities for young children? Waiting for the doctor, sitting in the cart while parent shops, waiting for parent to get off the phone So, how do we address this with young children with autism? Strategies for Young Children w/ ASD Virginia Autism Council 2010

Strategies to Address Non-preferred Activities
Use the Premack Principle Provide breaks Provide interesting and meaningful activities Mix preferred and non-preferred tasks Gradually increase time on task Provide reinforcement for task completion One thing is certain, we all have to do things that we don’t want to! One way to address this is using the Premack Principle. This is also called the “Grandma” principle. First, do the non-preferred task, then you get a preferred activity or item. Eat your peas, then you get a cookie! Here’s another example: John’s mom tells him he must sit in the cart while she grocery shops and, once they are finished, John can play for five minutes in the arcade that is near the exit to the store (and this is a favorite activity for John). She shows him two pictures – one of John sitting in the cart and the other of John playing in the arcade. She points to John in the cart and says “First, the cart while Mommy shops. Then games.” Premack's Principle states that more probable behaviors will reinforce less probable behaviors. The “first – then” board demonstrates this concept. It is very powerful, use it! Another strategy to help John learn to sit in the cart is for John’s mom to gradually increase the amount of time she shops with John instead of expecting him to sit for a long time from the very beginning. She may start with only buying a very few items so that she gets finished quickly. She still uses the “First-then” so that John gets to go to the arcade at the end of the shopping trip. As John gets accustomed to sitting in the cart and experiences success with good behavior for brief periods of time, she will, over time, gradually shop for more items. She is slowly increasing the amount of time she expects him to sit in the cart. We can also motivate the child by providing frequent breaks from the activity. We like breaks – we have breaks at this training, at work, etc. A break can help break up a monotonous task and keep the individual engaged. As you think about scheduling, try to think about adding in interesting and meaningful activities. Think about this from a personal perspective. You don’t want to clean the house, then the garage, then do yard work. Instead, you may clean the house, then talk to a neighbor, or read a book. You would then clean the garage later. As you consider the schedule, it is often helpful to mix preferred and non=preferred activities to keep engagement high. Think back to the previous slides. We already discussed the power of gradually increasing a skill and using reinforcement. These are effective strategies for non=preferred activities too. Strategies for Young Children w/ ASD Virginia Autism Council 2010

First - Then And here is an example of “First – Then.” First the child puts on shoes and then he gets to go outside to play on the slide. A different variation of “First – Then” is “Now – Next.” For example, you could have a picture of lunch with the word “Now” over it and then have a picture of a bed for naptime with “Next” over it. Strategies for Young Children w/ ASD Virginia Autism Council 2010

What Creates a Transition?
Moving from one activity to the next Moving from one setting or situation to the next We often see difficult behaviors at the time of transition. Paraphrase slide Strategies for Young Children w/ ASD Virginia Autism Council 2010

What Creates a New or Unfamiliar Situation?
Change in a planned activity or event Introduction of new activity Change in environment Spending time with a new person Being in a new location Attending new event or activity Transitions can be difficult for all of us and can be harder for the person with autism. Also, unfamiliar situations or new situations can be problematic. What are some unfamiliar situations or new situations that are unpleasant or dreaded? Have audience provide answers (for example, going to doctor, meeting new person, etc.) Interruptions or unexpected changes to your plan such as schedules, routines, activities, travel routes can cause stress. Additionally, permanent changes can be stressful. For young children with autism, consider changes at home (moving?), preschool (new teacher or classmates?), etc. Consider also the activities or events that are new to the child – or haven’t happened enough yet to be familiar. For example, going to the doctor or dentist or shopping in a new store. What are some unfamiliar situations or new situations that might be stressful to a young child with autism? Have audience provide answers. When “behaviors” occur, use the ASD lens to figure out what is happening. Try to put yourself in the place of the child – what might he be thinking? Strategies for Young Children w/ ASD Virginia Autism Council 2010

Strategies for Transitions, Novelty, and Change
Because transitions and change can be difficult for children with autism, we need to try to anticipate the needs of the child and pre-plan as much as possible. For example, a child has sensory issues related to the sense of touch. His mom buys him a new shirt. What might she do to help this child adjust to a new shirt? (cut the tag out, wash it a few thousand times) Or suppose you know that you are going away for the weekend and your mom is coming to take care of your kids? What might you do? -picture of grandmother -keep schedule the same One family experienced regular changes in their routine because the little girl’s father worked away from home two days a week and worked at home on the computer in the basement the rest of the week. The child was having a difficult time understanding when his parent would be home and when he would be away so the parents took a picture of the father at home at the computer and posted that in the kitchen on the days he was home so the child would see it throughout the day and would know he would see his dad off and on throughout his routine when he would come up from the basement. On the days the father was gone, they posted a picture of his car. This simple strategy stopped daily melt-downs and many repeated questions about whether or not the father was home – the mother used this visual support to help her daughter manage the regular change in their routine. For changes and transitions in the day to day routine, prepare for the child using visual supports and simple words; we have just discussed some ideas, like using a timer so the child learns, when it sounds, he will be transitioning to something else. Or give the child a five minute or two minute warning also helps if he is ready to understand the concept of time. Or, if the child is watching TV, you can say “when this show is over, it is time to get dressed.” For transitions, minimize time child has to wait for the next thing to happen. And, while waiting, give the child something to hold/something to do. Ensuring a child has something he finds soothing/comforting during difficult or long transitions can help. Things we need to consider when planning are changes in situations, settings, activities, clothing, food, or people. It helps when we give people important visual information re: up-coming events/activities rather than relying on auditory information. We need to give a visual understanding of when an event will not occur as well as when one will occur. Prepare when possible Provide warnings / reminders Display information visually and concretely Outline steps or sequence of activity Use calendars, schedules and mini-schedules Strategies for Young Children w/ ASD Virginia Autism Council 2010

Strategies for Transitions, Novelty and Change
Make transitions interesting and fun! Build in choice Tie new situations to old learning Implement priming Whether a preschool teacher or parent, being positive and having fun helps with transitions and during all parts of the daily routine. Young children often respond especially well to singing, and singing during transitions, toy clean-up, toothbrushing, waiting in the checkout line at the store, and during stressful times can be soothing and make the situation more pleasant for everyone. Singing also is a strategy to try when wanting to get a child’s attention or to give an instruction. Build in choice whenever possible to help with transitions. We have talked about offering choices during play. Use choices when moving from one activity to another whenever you can. Let’s say the child needs to take a bath and also brush his teeth and you don’t really care which comes first. Offer a choice. Or, when you have to move from a preferred activity to a less-preferred activity, build in a choice. For example, if watching TV is a preferred activity and getting dressed is not preferred, as you move into the dressing activity, you can hold up two shirts and say “which shirt would you like to wear today?” With changes and transitions, remember the Thomas plate and cup? Using the same plate and cup for a meal at a friend’s house is a way to tie a new situation to old learning. Priming is preparing a child in advance for the activity or situation – so the child is ready. So the parent we just mentioned who is going away may show her child pictures of the grandmother and talk about that she is coming to stay for a while. The preschool teacher can use the same strategy to prepare the class for her substitute. Priming can also be used for children who attend preschool – the family finds out what the upcoming theme is – let’s say it is zoo animals – and so they will talk about zoo animals at home and try to borrow from the library the same book that the teacher is going to read during circle. Social stories are a good strategy to try too. While there are young children who will not fully understand, this is an important strategy to begin early in a child’s life. And we should not underestimate the amount of understanding any child may have. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Proactive Strategies Activity Mini Schedules Physical Environment
Visual Structure Schedules The purpose of this session was to introduce you to strategies for proactively supporting the young child in order to help him learn and decrease the chance of difficult behavior. Each table will make a mind map on chart paper of proactive strategies you may use to support a young child. An example of a mind map is on this slide. Choose a specific activity where you may support a young child with autism and write this in the center of your paper. Surrounding the activity, fill in the shapes with specific proactive strategies that could help the child learn this activity. You can make the mind map look however you choose. Allow 15 minutes for people to brainstorm and then report out or they can do a final gallery walk: groups rotate around the room looking at other mind maps and write down anything that group has that they did not. Visual Supports Strategies for Young Children w/ ASD Virginia Autism Council 2010

Activity Child Profile
3. Identify any particular procedures or problematic situations. 4. List two to three proactive strategies that could be helpful for this child. The final activity in this section is to complete your profile. Strategies for Young Children w/ ASD Virginia Autism Council 2010

Closing Points Seek to understand the challenges the child faces when processing the environment Provide structure and supports to help the child feel safe and accepted, calm, and in control Strategies for Young Children w/ ASD Virginia Autism Council 2010

Strategies for Supporting Young Children

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