Autism Spectrum Disorders Ayanna Peake CCS School Psychologist and Autism Support Staff –
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Transcript of Autism Spectrum Disorders Ayanna Peake CCS School Psychologist and Autism Support Staff –
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Autism Spectrum Disorders
Ayanna PeakeCCS School Psychologist and Autism Support Staff –
Burns Zone
Wendy FitchCCS Lead School Psychologist and Autism Support Staff-
Shelby and Crest zones BCBA
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Autism Support Framework for Cleveland County Schools
Burns ZoneAyanna Peake
AU Psychologist
Crest ZoneWendy Fitch
AU Psychologist
ADOS Team
Intervention ClassesPreschool (Jefferson)Elementary (Marion)Middle School (SMS)High School (KMHS)
Transition ClassElementary (Marion)
Self-Contained Classes Elementary (NSS)
Middle School (NSS)High School (NSS)
System Wide ABA Tech
Shelby ZoneWendy Fitch
AU Psychologist
Kings Mountain Zone
Summer BachmanAU Psychologist
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About autism spectrum disorders and interventions….
Think about the disability Consider environmental supports
Target skills to teach
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“Autism spectrum disorders are lifelong conditions that require intervention throughout the lifespan. Only when a basic level of health and comfort is established, reinforcement is available, the environment is made predictable through structure and visual/ tactile supports, and task demands are carefully designed can skills be effectively taught and demonstrated.” (Aspy and Grossman, 2008)
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What is autism?
A developmental disorder of neurobiological origin that is defined on the basis of behavioral and developmental features
Present from birth or very early in development
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Autism affects essential human behaviors:
Communication
Social Interaction
Behavior
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Communication Impairment Delay in or total lack of development in spoken language
(with no attempts to communicate through other methods such as gestures or mime)
If they have speech, marked impairment in the ability to initiate or sustain a conversation with others
Stereotyped & repetitive use of language or idiosyncratic language
Lack of varied, spontaneous make believe play or social imitative play appropriate to developmental level
A person with autism will have at least one of these characteristics
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Common communication differences
Makes sounds repeatedly or states word or phrases repeatedly (e.g., humming, “you know”)
Immediate or delayed echolalia (reciting lines from movies, repeating another person’s questions or statements, repeating sounds)
Interprets words/conversations literally/ difficulty understanding figurative language/multiple meanings/ humor/sarcasm/synonyms
Difficulty with rules of conversation (interrupting; asking inappropriate questions; difficulty maintaining conversations)
Difficulty using gestures/ facial expressions Difficulty asking for help Makes irrelevant comments Difficulty expressing thoughts and feelings Speaks in an overly formal way
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Social Interaction Impairment Marked impairment in the use of multiple, nonverbal
behaviors (eye to eye gaze, facial expressions, body postures & gestures to regulate social interaction)
Failure to develop peer relationships appropriate to developmental level
Lack of spontaneous seeking to share enjoyment, interests, or achievements with others (lack of showing, bringing, or pointing out objects of interest)
Lack of social or emotional reciprocity
A person with autism will demonstrate at least two of these
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Common Social Differences Difficulty recognizing the feelings and thoughts of
others (“mind blindness”/ can’t take another’s perspective)
Can have different emotional response than is expected for social situations
Uses poor eye contact Has difficulty maintaining personal space/ physically
intrudes on space of others Lacks tact or appears rude Has difficulty making/ keeping friends Has difficulty joining an activity Is naïve/ easily taken advantage of or bullied
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Tends to be less involved in group activities than most same aged individuals
Has difficulty understanding others’ nonverbal communication (e.g., facial expressions, body language, tone of voice)
Has difficulty understanding jokes “Rule” bound and can tend to lecture others Talks at people instead of with them May display potentially “challenging” behavior to escape
uncomfortable/ difficult situations
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Restricted Repetitive and Stereotyped Patterns of Behavior, Interests, and Activities
Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal in either intensity or focus
Apparently inflexible adherence to specific, nonfunctional routines or rituals
Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)
Persistent preoccupation with parts of objects
A person with autism will display at least one of these
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Restricted patterns of behavior, interests, and activities
Expresses strong need for routine or sameness Expresses desire for repetition Has eccentric or intense preoccupations/
absorption in own unique interests Asks repetitive questions Seems to be unmotivated by customary rewards Displays repetitive motor movements (flaps
hands, paces, flicks fingers, etc.) Has problems handling transition and change Has strong need for closure or difficulty stopping
a task before it is completed
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Autism is:
Best characterized as a spectrum of disorders that varies in: Severity of symptoms Age of diagnosis Association with other disorders
(intellectual disability, attention deficit disorder, OCD, bipolar disorder, etc.)
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POP QUIZ!!!!
Piece of paperNumber 1-10
Writing utensil
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What comes next?
OTTFFSS__
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Autism spectrum disorder:
Group of developmental disabilities including:
Autistic Disorder Asperger’s Syndrome Rett’s Disorder Childhood Disintegrative Disorder Pervasive Developmental Disorder, NOS
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What is the difference between autistic disorder and Asperger’s?
Autistic disorder: significant impairment in social interaction and communication presence of restricted repetitive behavior
Asperger’s Syndrome: implies near normal to above average cognitive abilities and at least superficially normal expressive and receptive language skills; impairment in social interaction
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Consideration: In Asperger’s,there are qualitative impairments in communication, including conversation skills, may ask repetitive questions, have unusual volume, pitch, or stress in vocalizations, and make literal interpretations
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Common feature of all autism spectrum disorders is the qualitative impairment in social interaction
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Problems with social interaction can include:
Difficulty initiating or responding to conversation
Difficulty using or responding to nonverbal gestures
Lack of or inconsistent eye contact Impairment in responding to others’
feelings
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The lack of social skills often exhibits itself in ways we do not attribute to a social deficit:
Yelling or calling out inappropriate statements at inappropriate times
Aggression/ destruction Echolalia/ jargon/ scripting Inappropriate touching of others/
inappropriate comments
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Further complicating the issue for AD students
Often misunderstood by us because of their good verbal and cognitive skills and good academic skills
Too often, we view the atypical social behaviors as intentional or evidence of lack of impulse control rather than skill deficit
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We know what autism looks like, right?
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If you know one child with autism…….
You know one child with autism!!!
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Important to remember:
Not all students who have an autism spectrum disorder are alike
Characteristics of ASD manifest themselves differently in each individual
Programming has to be individualized and monitored consistently
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People with autism spectrum disorders typically have:
Difficulty understanding verbal and nonverbal communication and
Difficulty learning appropriate ways of relating to other people, objects, and events
Repetitive behaviors or unusual interests
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Key Characteristics and Possible Adaptations
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Insistence on sameness
Can be easily overwhelmed by minimal change; highly sensitive to environmental stressors
Anxious, tend to worry obsessively when they do not know what to expect
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Insistence on Sameness
Provide a predictable/ safe environment
Minimize transitions Offer consistent daily routine: Use
schedules– either pictures or words or a combination
Avoid surprises– prepare the child in advance for any changes in the schedule
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“And it is best if you know a good thing is going to happen, like an eclipse or getting a microscope for Christmas. And it’s bad if you know a bad thing is going to happen, like having a filling or going to France. But I think it is worst if you don’t know whether it is a good thing or a bad thing which is going to happen.” Christopher John Francis Boone, from The Curious Incident of the Dog in the Night-Time, by Mark Haddon (2003).
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Common reasons for behavioral breakdowns
Need for sameness ; consistency Need for predictability Anxiety Environmental/ sensory needs Difficulty with movement, self-help skills,etc. Level of coping skills Ability to effectively communicate emotions and
needs Ability to interpret language directed to them
(verbal and nonverbal)
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The BIG “3”
Visual supports Social skills instruction Reinforcement
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Importance of visual supports
Provide predictability and organization needed
Can prevent behavior difficulties Aid in teaching skills/ facilitate learning More easily understood by individuals with
communication problems Think of visual input and instruction as the
“first language” of students with autism spectrum disorders
Allows the student to review information more than once
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Examples of visual supports
Daily schedules- words/ pictures or combination of both
T-chart depicting contrasting information (e.g., kind/ unkind words”)
Cue card with “reminders” or classroom expectations
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John’s PBS Stamp TrackerDATE: / / 09-10 DAY OF WEEK: M / T / W / TH / F
Time Task STAMP EARNED BONUS STAMP
7:40-8:00 Wait in Gym and read AR book when 1st bell rings.
8:00-8:25 Follow Discovery teacher's directions
Participate in Discovery/PBS lessons
8:30-9:55 Take needed materials out of cubby in Mrs. Smith’s room.
Participate in SRA lesson
Turn in any homework from previous night.
Mrs. Smith’s Class
Participate in Language Arts lesson.
9:55-11:00 Turn in any homework from previous night.
Participate in Math Lesson
Mrs. Jones’ ClassWork on homework assignment Friday: 10:45-11:15 OT
11:00-11:20 Break Time: Choice of: UNO / Computer (CCS approved websites) / Walking
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Kind Words Rude Words
Good job!Great idea!Nice job!Awesome!Yeah!
So whatYou’re stupidThat was dumbThat stinksDuh!
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Impairment in Social Interaction
Demonstrate an inability to understand complex rules of social interaction
Talk at people instead of them Do not understand jokes, irony, or metaphors Poor ability to initiate and sustain conversation Display potentially “challenging” behavior to escape
uncomfortable/ difficult situations
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Impairment in Social Interaction
Need to be taught how to react to social cues and be given repertoires of responses to use in various social situations (teach them what to say and how to say it)
Explain to them when they have been unintentionally insulting, tactless, or insensitive
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Teaching Social Skills
We have to plan instruction for social skills just like we do other skills such as reading, math, and writing
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Evidence based strategies for social skills instruction
Social stories Video modeling Role playing/ Modeling Skills Streaming (more formal
programs) Self-monitoring checklists
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General tips
Model two way interactions and let them role play
Encourage active socialization Behavior specific praise Limit time spent in isolated interests
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Social Stories
Social stories are brief, individualized short stories that describe a social situation and provide a specific behavioral response (e.g., appropriate social responses within defined context)
Provide instruction regarding the who, what, when, where, and why of a social situation
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Social stories:
Help ensure child’s accurate understanding of social information for a given setting and provide a “how-to” instruction for initiating, responding to, and maintaining appropriate social interactions
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Social Stories:
Help individuals: Adjust to changes Adapt behavior based on social cues Learn specific skills
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Social Story example
Angelo: Joining in a Game I like playing with other kids at recess. The
most fun times I have are when I join kids who are already playing soccer on the playground. I do this by asking in a nice, gentle voice “Can I play with you?” If they say yes, then I ask “Show me how to play.” When I join other kids who are playing, I really feel like I have friends and that I belong to the group.” (Adapted from Matson et al., 2006).
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Writing a social story
Descriptive sentences Perspective sentences Directive sentences
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A word about reinforcement
Reinforcer is any consequence that follows a behavior that makes the behavior MORE likely to occur in the future
Everyone has their own set of reinforcers
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Reinforcement
A situation or event that follows a behavior and makes it more likely that the behavior will occur in the future
Reinforcement is essential to acquiring new skills
Reinforcement is required to maintain behavior
Sometimes avoidance of the activity is more reinforcing than participating in the activity
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Ways to identify reinforcers
Observe the activities a student engages in frequently or appears to enjoy
Allow the student to choose from a variety of items or events
Most precise way: repeatedly provide the consequence following a behavior and see if behavior increases over time
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Sometimes, avoidance of an activity carries a greater incentive than does participation
Example: a student who struggles with social interactions may find playing computer games to be more rewarding that interacting with peers
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For some individuals with ASD, pursuing their own wishes is often more valuable than the risk of displeasing others
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Ultimate goal of our interventions is to help individuals develop skills for a successful life
Reinforcement is essential to the process of acquiring new skills
Punishment does not teach a skill
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Take Away Points
If I have taught one student with Autism,
I have only taught ONE student with Autism.
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There are many common features that lead someone to receiving a diagnosis of Autism or an EC placement of Autism,
How Autism is expressed (strengths, weaknesses, problems, successes) depends on 2 key things: Individual student Their environment
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We can NOT “cure” the individual student or make them non-Autistic.
We can identify skills that the individual student is strong in and those that the student is weak in. For any weak areas/skills deficits,
students with Autism MUST have explicit instruction in this area AND a chance to practice the skill to mastery.
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We can change the environment.
Students with autism are extremely sensitive to their environment.
Usually changes in their behavior are a direct result to changes in their environment.
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In the environment we can provide additional supports (modifications, accommodations, IEP goals, BIP, consultations with staff, counseling, etc.) to help the child bridge the gap between their skill deficits due to Autism and the expectations of them in their environment.
This is no different than leveling the playing field for a student who has a learning disability or who has a physical impairment.
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But this just looks like a defiant/rude/lazy/crazy…. student
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Often times the behaviors or skill deficits in question are things that “typical” students or adolescents just do.
For a typical student/adolescent, after being exposed to certain things in their environments for 12+ years, they just get it.
This is especially true when correcting or disciplining a student with Autism. They may say or do things that most of their peers would never say or do.
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For example, most “typical” students can reason with teachers when they are being corrected, and they can follow the rational of why consequences are happening.
Most students with Autism simply don’t get it; over explaining or talking/rationalizing until they get it is only going to frustrate you and them.
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Ok, are you serious…What is the bottom line?
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The Bottom Line…
If we want our students with Autism to be successful, we have to be invested in active problem solving, communication, and team work.
We also have to be invested in creating an environment and school culture that respects them and their differences and that is tolerant of the unique challenges they present.
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Interesting books:
Let Me Hear Your Voice by Catherine Maurice
Emergence, Labeled Autistic by Temple Grandin
Look Me in the Eye by John Elder Robeson
The Curious Incident of the Dog in the Night-Time by Mark Haddon
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Resources
www.autism-resources.cm www.autism-society.org www.autismsociety-nc.org www.nichd.nih.gov/autism/ www.cdc.gov/ncbddd/dd/ddautism.h
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Thanks for all you do!!