St C C Ed Asst 08 02 webweb4.uwindsor.ca/users/m/mgragg/main.nsf... · Autism Spectrum Disorders...
Transcript of St C C Ed Asst 08 02 webweb4.uwindsor.ca/users/m/mgragg/main.nsf... · Autism Spectrum Disorders...
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www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 1
Autism Spectrum Disorders Autism Spectrum Disorders (ASD)(ASD)
Welcome!Welcome!
You can download this handout from www.uwindsor.ca/autism under “Workshops”
Email [email protected]
www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 2
What are ASD’s?What are ASD’s?
Behaviour Communication
Social
difficulty with changeintense interestsrepetitive
“sticky”
low social interest� friendships for level
not reciprocalweak sharingeye contact
weak nonverbal
no/delayed speech� 2-way conversation
not reciprocalweak nonverbal
weak play
and
SensoryIssuesAnxiety
www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 3
Autism is…Autism is…
� a spectrum disorder• from very delayed to above average
abilities
• from mild to moderate to severe autistic behaviours
�developmental• abilities & symptoms may improve
with good programming
www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 4
Autism: Associated FeaturesAutism: Associated Featuresmay occur, not required for diagnosismay occur, not required for diagnosis
• cognitive; deficits, strengths & weaknesses(50-70% intellectual impairment)
• unusual motor behaviours
• unusual sensory behaviours
• eating, sleeping, drinking
• attention; joint, shifting, focus
• mood; anxieties & fears
• medical conditions, seizures
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Early Signs of ASDEarly Signs of ASD
www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 6
Red Flags Red Flags immediate evaluation ifimmediate evaluation if
• no babbling by 12 months
• no gesturing by 12 months
• no single words by 16 months
• no 2-word phrases by 24 months (not just echolalic)
• any loss of any language or social skills at any age (30%)
Filipek et al, Amer. Acad. Neurology, 2000
www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 7
First Signs of Autism: BehaviourFirst Signs of Autism: BehaviourAt 12 months of age, may see unusualAt 12 months of age, may see unusual
•eye contact
•visual tracking
•disengagement of visual attention
•orienting to name
•imitation
•social smiling
•reactivity, social interest & affect
•sensory behaviorsZwaigenbaum, Bryson, Rogers, Rogerts, Brian & Szatmari, 2005
www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 8
First Signs of Autism: OtherFirst Signs of Autism: Other
Temperament: • 6 months, marked passivity & low activity level
• 12 months, extreme distress, fixating on particular objects, & rarely in a positive mood
Delayed expressive & receptive languageZwaigenbaum, Bryson, Rogers, Rogerts, Brian & Szatmari, 2005
Challenging behaviours may be the firstsign of high functioning autism
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www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 9
Early Diagnosis of AutismEarly Diagnosis of Autism
Why?
• early intervention � better prognosis
• so parents know
• connect to autism community
• support for families
www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 10
Ontario Parents’ ExperiencesOntario Parents’ ExperiencesA. Spadafora, M.A., 2005A. Spadafora, M.A., 2005
• 78 parents of 80 children with PDDs
• median birth year of 2000 (1968-2001)
• average age of diagnosis ~ 51 months51 months
(early intervention best before 42 months)(early intervention best before 42 months)
• age at first concern ~ 19 months (1–48 mo.); approx. 34 months before diagnosis!
www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 11
Early IdentificationEarly Identification
What we are doing
already is
NOT good enough
for
EARLY identification
& intervention!
www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 12
Causes of AutismCauses of Autism
• neurological disorder
• 4.6 boys to every girl
• genetic susceptibility
• environmental triggers?
• not related to parenting or learning
• not related to MMR vaccine or preservatives in vaccines
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More Children with Autism?More Children with Autism?
� 67 per 10,000 children (CDC, 2007)
• 1 in every 150 children• 1 in every 100 boys
� more children identified now??? – better identification?
- better public awareness- wider definition
- misdiagnoses?•increased prevalence, incidence?
www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 14
Families and Families and their Children’s ASD Diagnoses?their Children’s ASD Diagnoses?
denial?
anger?
bargaining?
depression?
acceptance?
www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 15
Acceptance SpiralAcceptance Spiral
It’s a process - it takes time!www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 16
Families: Research Shows Families: Research Shows Social SupportSocial Support
� helps parents of children with autism
� helps siblings of children with autism
AND
� helps children with autism make more progress
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AutismAutismbrings strong families closer
can drive distant families apart
www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 18
InterventionIntervention
www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 19
Basic Supports for All ChildrenBasic Supports for All Children
Supportive Environment
� basic needs: food, shelter, medical care, nurturance
� access to preferred toys, activities, interests & friends
� opportunities for success at the child’s level
www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 20
Basic Supports for All ChildrenBasic Supports for All Children
Supportive Caregivers
� parents and teachers need to be supported too!
� staff & parent relationships
� professionals; attitude is more than half the battle.
� don’t take things personally, avoid power struggles
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Autism Spectrum Disorders (ASD)Autism Spectrum Disorders (ASD)
Children with ASD learn differently.
They need different supports to help them learn & maintain behavioural control.
www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 22
General Helpful Supports for General Helpful Supports for Children with Autism/PDDChildren with Autism/PDD
1. Make things predictable
2. Reduce language
3. Use visual supports
4. Broaden preoccupations
5. Reduce anxiety
www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 23
1. Make Things Predictable1. Make Things Predictable
• develop routines so the child can predict what will happen next e.g. work, homework, bedtime and chores
• teach the child to use a schedule(picture, word, object), calendar
• prepare in advance for transitions & unexpected events, e.g. when playtime is over
• clear expectations
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2. Reduce Language2. Reduce Language
• use clear simple language, even if the person talks a lot
• avoid slang, metaphorical language, sarcasm, rhetorical questions, etc
• develop cue phrases.; talk less when he is excited or upset
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3. Use Visual Supports3. Use Visual Supports
• use pictures, videos, drawings, & manipulatives
• visually organize materials clearly, e.g. baskets, colour coding, tape on floor
• visual strategies e.g. Triangle of Choices
• written language is visual for people who can read
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4. Broaden Preoccupations4. Broaden Preoccupations
• use intense narrow, intereststo teach & motivate
• getting rid of preoccupationsrarely works in the short term
• schedule specific times for his interests e.g. dinosaur time, Dracula time
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5. Reduce Anxiety5. Reduce Anxiety
• use above strategies (make things predictable, reduce language, make things visual)
• allow the person time -- to process, to cope, to be alone
• try relaxation training, vigorous rhythmic exercise, medication
www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 28
Intervention ComponentsIntervention Components
• earliest age (as soon as autism is suspected)
• active engagement in intensive, 5 full-days, min. 25 hrs/wk, full-year, 1 on 1
• teach social, communication, cognitive development, & play skills
• systematic, individualized
• generalization
• parent involvement National Research Council, 2001
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Community Resources for ASDCommunity Resources for ASD
www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 30
Community Resources listCommunity Resources list
4 page list of Windsor resources for children with autism
�good resource to give to parents
www.summitcentre.org
�click on “Local Autism Services”
www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 31
The Summit Centre for The Summit Centre for Preschool Children with AutismPreschool Children with Autism
affiliated with U of W!
www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 32
UNITY: 3 Month Intensive UNITY: 3 Month Intensive ABA Parent TrainingABA Parent Training
atThe Summit Centre for Preschool Children
with Autism
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PurposePurpose
�� to provide highto provide high--quality intensive quality intensive Applied Behaviour Analysis (ABA)Applied Behaviour Analysis (ABA)training to selected parents training to selected parents of children with autismof children with autism
�� to enable parents to provide ABA home to enable parents to provide ABA home programming for their childrenprogramming for their children
based on the model of the HOPE Center, based on the model of the HOPE Center, Beaumont Hospital, Berkley, MIBeaumont Hospital, Berkley, MI
www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 34
All About AutismAll About AutismIntroductory workshops
• for parents of children with a diagnosis or suspicion of autism
• 3rd Wed. of month (except July & Aug)• different speakers & topics
Sponsored by: � Dedicated Parents, � Autism Society Ontario Windsor/Essex Chapter, � Autism Services Inc., � Children First, � Children’s Rehabilitation Centre, � Ontario Early Years Centres, � Talk to Me (Essex Preschool Speech & Language) � The Summit Centre for Preschool Children with Autism, � Thames Valley Children’s Centre The Autism Program South West Region
www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 35
Autism Resource LibraryAutism Resource Library
Autism Services Incorporated
• books, videos, DVD’s on autism
• will loan via school courier
• online catalog of what is available!
www.autismservicesinc.com
www.summitcentre.org © Marcia Gragg, PhD, CPsych, Feb. 8, 2008 p. 36
“Even the smallest footsteps can cross great distances.”“Even the smallest footsteps can cross great distances.”