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Transcript of The Learning Clinic. The Learning Clinic The Learning Clinic The Learning Clinic A sperger S yndrome...
The Learning Clinic
The Learning ClinicAsper
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TheLearningClinic
The Learning ClinicAsper
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AAsperger sperger
SSyndromeyndrome A PA Planlan forforTTransitionransition to to
IIndependencendependence
The Learning ClinicAsper
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Presented by:
Raymond W. DuCharme, Ph. D.
Kathleen A. McGrady, Psy. D.
CT CollegeCT CollegeJanuary 16, 2004January 16, 2004
The Learning Clinic
The Learning Clinic
Pervasive Development Disorder
Category of Diagnosis that includes Autism, Rett’s Disorder, Childhood Disintegrative Disorder, Asperger Syndrome, and PDD NOS. Historically, other diagnostic labels in this category have included Childhood Schizophrenia and Autistic Psychopathy.
The Learning ClinicAsper
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WWho is the ho is the
AAspergersperger
IIndividual?ndividual?
The Learning Clinic
The Learning Clinic
Asperger Syndrome CriteriaDSM-IV ICD-10
Qualitative impairment in social interaction X XRestricted repetitive and stereotyped patterns of behavior, interests, and activities
X X
No general language delay X XNo delay in cognitive development X XNormal general intelligence (most) XMarkedly clumsy (common) XNo delay in development of: age appropriate self-help skills adaptive behavior (excluding social interaction) curiosity about environment
X
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Asperger Syndrome Criteria
Pragmatic language skill deficits not part of DSM-IV or ICD-10 criteria but should be included for differential diagnosis.
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Other Developmental Issues
Deviation from normal development
Do not “Outgrow” Developmental Deficits
Stress Impairs Performance
Co-Morbid Diagnosis Impairs Overall Functioning
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Cognitive Functioning
Med
icati
on
s
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Psychological Symptoms
Ag
e /
Tim
e
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Clinical Symptoms and Learning Disabilities
Gra
de
The Learning Clinic
Asperger SyndromePervasive Developmental
DelayC O G N I T I O N
Memory
Higher Order Process Analysis, Synthesis, and Evaluation
Organization
Flexibility
The Learning Clinic
Asperger SyndromePervasive Developmental
DelayC O G N I T I O N
Wide Band of Knowledge
Problem Solving
Verbal-Performance IQ
Attention Shift
Rule - Governed Behavior
The Learning Clinic
Asperger SyndromePervasive Developmental
Delay
L A N G U A G E
Pragmatics
Syntax
Meaning: Connotative Denotative
The Learning Clinic
Asperger SyndromePervasive Developmental
Delay
L A N G U A G E
Processing Speed
Expression
Duration
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Asperger SyndromePervasive Developmental
Delay
S P E E C H
Prosody
Pedantic
Elocution
Volume
The Learning Clinic
Asperger SyndromePervasive Developmental
Delay
M O T O R
Fine Control
Gross Control
Coordination
Regulation
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Asperger SyndromePervasive Developmental
DelayS E N S O R Y P R E C E P T I O N
Visual Integration
Kinesthetic
Tactile Accuity
Gestalt
Integration of other Senses
The Learning Clinic
Asperger SyndromePervasive Developmental
Delay S O C I A L
Cue Identification
Responsive to others
Isolate
Rude
Aggressive
The Learning Clinic
Asperger SyndromePervasive Developmental
Delay S O C I A L
Boundary Acceptance
Maintain Social Roles(e.g., student, son, daughter, friend)
Self - Regulate
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WWhat are the hat are the
PPrioritiesriorities of the of the
AAsperger sperger
SSyndrome yndrome
SStudent?tudent?The Learning Clinic
The Learning Clinic
Priorities of the Asperger Student
1. Independence How to find and use resources
and self-advocate
2. Work Experience Paid employment and volunteer
work
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Priorities of the Asperger Student
3A. Shared Living versus Living Alone
Advantages and disadvantages of each
3B. Resources
How to find resources, e.g., doctors,therapists, etc.
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Priorities of the Asperger Student
4A. Social Activities
How to find resources for fun activities?
How to make friends and find others with common interests?
How to deal with the tendency to isolate?
The Learning Clinic
Priorities of the Asperger Student
4B. Medication
How do you know when you need medication?
Who do you go to for help?
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Priorities of the Asperger Student
5. College Experience
What it takes to be successful in college
6. Problem-Solving
How to partner with others to solve problems
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Priorities of the Asperger Student
6. Problem-Solving / Continued
Expressing issues openly
Independent problem-solving versus teaming
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How Can We Assess Readiness for Independence?
The Learning Clinic Pragmatic Skills Survey
The Learning Clinic Transition & Independent Living Skills Assessment
The Learning Clinic
Which Asperger Symptoms Compete with Independence?
Degree of Anosognosia
Ag
e
Over time, symptoms become egosyntonic
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What Does a Transition Program Include?
Independent Living
1. Housing
Housing Acquisition & Leases
Home Management
The Learning Clinic
What Does a Transition Program Include?
Independent Living
2. Nutrition
Meal Planning & Preparation
Dining
Clean-up & Food Storage
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What Does a Transition Program Include?
Independent Living
3. Money Management
Budgeting & Taxes
Banking & Credit
Consuming
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What Does a Transition Program Include?
Independent Living
4. Transportation
Type of Transportation & Costs
Independent Travel
Obtaining Driver’s License
Vehicle Maintenance
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What Does a Transition Program Include?
Independent Living
5. Leisure
Exercise Routine
Community Activities
Personal Hobbies
Community Groups
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What Does a Transition Program Include?
Independent Living
6. Legal Awareness
Responsibilities of Adulthood
Contracts
Constitutional Rights
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What Does a Transition Program Include?
Independent Living
6. Legal Awareness / Continued
Misdemeanor versus Felony
Resources for Legal Obligations
Sexual Harassment
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What Does a Transition Program Include?
Independent Living
7. Health
First Aid
Self-Administer Prescription Medications
Personal Hygiene
Stress-Control Strategies
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What Does a Transition Program Include?
Independent Living
8. Time Management
Realistic Goals
Time of Day Most / Least Productive
Priorities - Establish and Organize
Appointment Book or Calendar
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What Does a Transition Program Include?
Independent Living
8. Time Management / Continued
Step - Wise “Bite Size” Goals
Self - Reward
Identify Basic Needs
Schedule Time to Meet Basic Needs
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What Does a Transition Program Include?
Independent Living
9. Personal Safety at Home
Smoke Alarm - Check Operation Monthly
Fire Drill Procedures & Fire Extinguisher
Post Emergency Numbers
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What Does a Transition Program Include?
Independent Living
9. Personal Safety at Home / Continued
Basic First Aid
First Aid Supplies
Hazardous Materials
Lock Doors in the Home
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What Does a Transition Program Include?
Independent Living
10. Personal Safety in the Community
Walking in the Community at Night
Public Transportation
Dating
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What Does a Transition Program Include?
Independent Living
11. Personal Safety during Dating Relationships Sexual Abstinence Social Gender Boundaries STD’s Methods of Contraception “Safe” Sex Practice
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What Does a Transition Program Include?
Independent Living
12. Personal Presentation
Appropriate Clothing for Different Settings
Clothing: Needs versus Wants
Budgeting and Shopping for Clothes
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What Does a Transition Program Include?
Independent Living
12. Personal Presentation / Continued
Cleaning Different Types of Clothing
Female: Appropriate Use of Make-up / Hair Care
The Learning Clinic
What Does a Transition Program Include?
Independent Living
12. Personal Presentation / Continued
Male: Proper Grooming / Hair & Shaving
Body Language: Personal versusProfessional
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What Does a Transition Program Include?
Community Resources
Access Community Health Resources
Completion of Medical Forms
911 / Local Emergency Numbers
Health Insurance & Its Use
Community Services: Library, Legal Aid, Adult Education, Leisure
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What Does a Transition Program Include?
Community Service / Volunteer Opportunities
Community Service Opportunities
Value of Volunteering
Ten Hours / Month - Minimum per Quarter
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What Does a Transition Program Include?
Vocational Readiness, Training &Post-Secondary Education
Career PlanningAreas of InterestAptitudeTraining
Career PlanAction Plan
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What Does a Transition Program Include?
Employment Importance of Paid Employment
Job Shadowing, Internship, Volunteer Work
Search for Employment
Resumé
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What Does a Transition Program Include?
Employment / Continued Job Applications
Job Interview
Computer Skills for the Workplace
Wage Deductions
Maintaining Employment
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What Does a Transition Program Include?
Employment / Continued Changing Jobs
Termination of Employment
Job Safety Gear
Work Procedures
Maintaining Employment
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What Does a Transition Program Include?
Employment / Continued Workman’s Compensation
Procedures
Sexual Harassment in the Workplace
The Learning Clinic
What Does a Transition Program Include?
Post Secondary Education Career Track and Opportunities for
Employment
Education and Training Needed for Chosen Career
Colleges & Technical Schools with Available Programs
The Learning Clinic
What Does a Transition Program Include?
Post Secondary Education / Continued Cost & Ways to Pay for Tuition
Financial Aid Paperwork
Scholarships
Complete College Applications
Analyze Acceptance & Available Money
The Learning Clinic
What Does a Transition Program Include?
Post Secondary Education / Continued Borrowing Money for College Training
Plan Timeline & What Will Be Needed for School
Support Service for Post-Secondary Education
The Learning Clinic
What Does a Transition Program Include? Healthy Relationships
Quality of Healthy Relationships
Personality Traits (Self & Others) Necessary for Healthy Relationships
Emotional & Mental Well-being Within a Relationship
Boundaries & Intimacy
The Learning Clinic
What Does a Transition Program Include?
Healthy Relationships / Continued Relationship “Games”
Abusive Dangerous Relationships
How to Choose Healthy Partners for Relationships
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HHow ow DDo o SStudents tudents
AAssess ssess
and and CComment on omment on
TTheir heir
EExperience?xperience?The Learning Clinic
The Learning ClinicAsper
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AAssess ssess BBenefit by enefit by
CComparing omparing
PPerformance with erformance with AAll ll
SStudents of tudents of
CComparable omparable IQIQ and and
SSkill kill LLevel.evel.
The Learning Clinic
The Learning Clinic
Education: Asperger Student Classroom Behavior
1. Attending Behavior
Discern Task Expectations
Focus Attention on Relevant Stimuli
Shift Attention to Relevant Stimuli
Ignore Irrelevant Material
Perform Multi-Task Operations
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Education: Asperger Student Classroom Behavior
2. Responding Behavior
Verbal Skills Pragmatic Language Skills Writing Ability Executive Function Ability Perseverance STM for Denotative Items
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Education: Asperger Student Classroom Behavior
3. Reinforcement Behavior
Provide Contingent Positive Social Reinforcement
Assert Negative Reinforcement in an Appropriate Way
Receive Positive Reinforcement Ability to Respond to Positive
Reinforcement
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Education: Asperger Student Classroom Behavior
4. Initiating Behavior
Self - Initiate Classroom Routines
Use CAI Prompts
Start Task According to Direction
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Education: Asperger Student Classroom Behavior
5. Comply / Demonstrate Rule - Governed Behavior
Accept Correction from Instructor
Accept Correction in Public Setting
Self - Correct Assignments to Pre - determined Standards
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Education: Asperger Student Classroom Behavior
6. Completing Behavior
Perform Tasks to Standards
Return Completed Product to Supervisor
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Education: Asperger Student Classroom Behavior
7. Transitioning Behavior
Initiate Independent Steps between Tasks
Use Prompts / Cues to Signal Move from One Task to Another
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Education: Asperger Student Classroom Behavior
8. Cooperating Behavior
Taking Turns
Waiting
Avoid Arguing
Sharing
Making Requests Before Acting
The Learning Clinic
Education: Asperger Student Classroom Behavior
9. Adapting Behavior
Adjust to Different Routines in Different Classrooms
Adjust to Alteration in Routine
Follow New Routine Required by a Situation
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Education: Asperger Student Classroom Behavior
10. Cooperate with Medication Administration
11. Complete Homework
12. Attend School
Discern Task Expectations
Focus Attention on Relevant Stimuli
Shift Attention on Relevant Stimuli
Ignore Irrelevant Material
Perform Multi-Task Operations
The Learning Clinic
Competing Clinical Behaviors
Perseveration
Obsessive Thought
Rigid Cognitive Style
Inability to Shift from “Personal View” to Data - Based Decision
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Competing Clinical Behaviors
Confabulation
Affirming False Information
“Stealing”
Sexually Inappropriate Actions and Statements
/ Continued
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Competing Clinical Behaviors
Violation of Boundaries
Cognitive Disorientation and Distortion
/ Continued
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Optimal Classroom Behaviors
Closed Classroom Applied Task - Oriented Setting
Standards are Limited, Precise and Based on Asperger Student’s Level of Ability to Self - Regulate
Class Size Under 10 - Over 3
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Optimal Classroom Behaviors
Cues and Prompts are Provided
a. Daily Plan / Organizerb. Assigned Work Stationc. CAI Task Presentation
Clear System of Discipline Consistently Applied Setting Wide
/ Continued
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Optimal Classroom Behaviors
Classroom Mix Controlled
Interpersonal Style of Teacher: Direct, Non-Judgmental, Organized
Task Analysis Reflects:
a. Backward Chaining b. Performance Standardsc. Over - Learning Options
/ Continued
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Optimal Classroom Behaviors
Control Risk
Minimize Transitions
/ Continued
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What Is on the Horizon for Asperger Students?
Early Diagnosis
Pediatric Training
Teacher Training
Psycho - Education Treatment
Cognitive Behavioral Therapy
The Learning Clinic
What Is on the Horizon for Asperger Students?
Technology
Distant Coaching (remote video monitoring)
Computer Checklists and Prompting
Computer Assisted Instruction (CAI)
The Learning Clinic
What Is on the Horizon for Asperger Students?
Technology / Continued
Kurtzweil 3000
Dragon Naturally Speaking
The Learning ClinicLCLCT
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TheLearningClinic
. . . because every child can succeed!
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