Getting to Know Your StudentsPresenter: Teresa May

CBRSD Autism Specialist

A developmental disability significantly affecting verbal and nonverbal

communication and social interaction. Source: A Guide to Federal and State Education Requirements in Massachusetts, 2000

What is Autism Spectrum Disorder?

• ASD is a neurological condition that affects a person’s ability to effectively communicate and interact with others.

• It is a Pervasive Developmental Disorder that effects boys four times more often than girls.

• It is a “spectrum disorder” that affects individuals differently and to varying degrees

Profound (severe) Autism Moderate Mild (High Functioning) Asperger Syndrome

Pervasive Developmental Disorder

Autism Continuum

Measured I.Q.

Severe Gifted

Social- Emotional Interaction

Aloof Passive Active but Odd

Communication

Non-verbal Verbal

Motor Skills

Awkward Agile

Fine Motor

Uncoordinated Coordinated Sensory

Hypo Hyper

Asperger Syndrome (AS)• First described by Hans

Asperger in 1944 (Mildest and highest functioning end of ASD)

• Abnormalities noted in 3 broad aspects of development Social interaction and emotional relatedness Unusual patterns of narrow interests Behavioral and stylistic characteristics involving repetitive /perseverative features

Asperger Syndrome (con’t)

• Students more likely found in general education classrooms and often undiagnosed or misdiagnosed as ADD, ED, LD, or just odd

• Genetic factors more prevalent in AS. Often family history of autism, most often on the father’s side

Characteristics:

• Higher cognitive abilities (average to superior)

• Lucid language by 4 years• Present with considerable

pragmatic language difficulties

• Speech often stilted and repetitive; conversations revolve around rote, factual topics

Additional Characteristics

• Often engage in rituals

• Worry excessively when they do not know what to expect

Core Areas of Deficit

Core Areas of Deficit

• Speech and Language Deficits Non-VerbalEcholalic/sterotypical languageHyper-Verbal

• Social Skill DeficitsRange from isolative to indiscriminately social

• Limited/Repetitive Behavioral RepertoireSelf StimulationRigidityPerseverativeInflexibility

Communication Deficits• Severe delay or complete absence of Severe delay or complete absence of

speechspeech

• Immediate or delayed echolaliaImmediate or delayed echolalia

• Poor auditory processingPoor auditory processing

• Odd voice quality/volumeOdd voice quality/volume

• Understanding of language is Understanding of language is literal/concrete literal/concrete

(e.g., “listen up.” “That’s cool.” (e.g., “listen up.” “That’s cool.” ““Knock it off.”)Knock it off.”)

• May repeat sounds/questions/phrases May repeat sounds/questions/phrases

Strategies to address Communication needs

• Language occurs throughout day and is taught by everyone

• Use augmentative communication to stimulate verbal language (e.g. PECS)

• Use visual cues to facilitate understanding of abstract concepts (e.g. pictures, drawings, written words)

• BE CONCRETE

Communication Strategies (con’t)• Teach for generalization

by teaching in variety of settings, using different materials (e.g., color red: apple, stop sign, shirt, crayon)

• Auditory processing deficits: allow extra time for student to respond

Deficits in Pragmatic Language

• Turn-taking skills (within play and conversation)

• Gestalt processing (seeing the big picture)

• Perspective-taking• Problem solving• Organization

Additional Issues with Pragmatics

• Social Expectations• Proximity, eye contact, intonation• Conversational skills - Talking too much

- Interrupting - Changing topics without transition

(From Gail Hallenberg, M.S.,CCC-SLP)

Strategies to Improve Pragmatic Language

• Teach rules of communication

• Teach conversational skills step by step, using visual aides and representations

• Role playing• Start with easier tasks and

add complexity as the student gains skills and confidence

• Work on different contexts and generalization

• Repetition/practice• Always explain “why”

-- Helps students see the perspective of others (From Gail Hallenberg, M.S., CCC-SLP)

Strategies to Improve Pragmatic Language

Social Skill DeficitsSocial Skill Deficits

• Infants/children irritable Infants/children irritable and hard to comfortand hard to comfort

• IsolativeIsolative

• Poor/no eye contact; odd Poor/no eye contact; odd eye gazeeye gaze

• Inappropriate giggling or Inappropriate giggling or laughinglaughing

• No understanding of No understanding of “friendship”“friendship”

Social Challenges for Students with AS

1. Self observation/ evaluation of impact on others

2. Perspective taking; empathy

3. Applying problem solving skills

4. Dealing with change/novel stimuli

5. Body awareness/personal space

Additional Social Challenges

6. Coping with change/not getting your own way

7. Understanding subtle/ complex verbal and nonverbal communication

8. Processing and understanding emotion

9. Mastering the increasing complexity of games and rules

10. Learning to enjoy social contact

Strategies for Improving Social Skills

• Shape desired behaviors• Teach and practice appropriate social skills in natural

environments• Establish a “friendship system” for community

integration• Have neurotypical peers or adults prompt/cue

appropriate social skills• Capitalize on child’s strengths in integrated settings

Addressing Social Skills in the School

• Social Stories• Model desired social

skill• Social skill scripting• Social skills

discussion• Direct teaching of

desired social skill

Application to Natural Settings• Opportunities to apply new skills in a natural peer

context • Start with more structured situations and then try with

less structures; provide enough support to ensure success

• Coaching should still be given before and after, as needed

• Should be practiced across all settings– School clubs, teams, activity groups– Recess, P.E., lunch

– Mainstreaming classroom

Academic ChallengesAcademic Challenges

• Children adapt poorly Children adapt poorly to others and changes to others and changes in routinesin routines

• Do not use toys for Do not use toys for intended purpose (e.g., intended purpose (e.g., spins, lines up, flips, spins, lines up, flips, etcetc.)

Academic Challenges (con’t)Academic Challenges (con’t) Uneven development of skills:Uneven development of skills:

- Decodes words but- Decodes words but unable to comprehendunable to comprehend meaningmeaning - Good computation- Good computation skills, but unable to applyskills, but unable to apply

- Excellent visual - Excellent visual matching skillsmatching skills

- Gross/fine motor skills- Gross/fine motor skills range from superiorrange from superior to very poorto very poor

Academic Challenges• Verbal abilities higher

than performance skills• Lack higher level

abstract thinking and comprehension skills

• Impressive vocabularies give false impression that they understand (may be parroting what read or hear)

Academic Challenges (con’t)

• Excellent rote memory skills, but mechanical in nature

• Exhibit poor problem solving skills

• Literal and concrete thinkers

Strategies that Address Academic Strategies that Address Academic ChallengesChallenges

• Avoid surprisesAvoid surprises• Visual Schedules assist Visual Schedules assist

with daily routines and with daily routines and transitionstransitions

• Provide predictable Provide predictable structured, safe, structured, safe, environmentsenvironments

• Use priming techniquesUse priming techniques• Visual supportsVisual supports

Visual SupportsVisual Supports Today’s ScheduleToday’s Schedule1.1. Breakfast Breakfast 2.2. Speech – Ms. JaneSpeech – Ms. Jane3.3. OCR – Ms. NelsonOCR – Ms. Nelson4.4. Written LanguageWritten Language5.5. RecessRecess6.6. MathMath7.7. Social StudiesSocial Studies8.8. LunchLunch9.9. Reading Reading

ComprehensionComprehension10.10. Art or MusicArt or Music11.11. Homework ReviewHomework Review12.12. DismissalDismissal

Strategies that address Academic Challenges

• Break tasks into smaller parts

• Teach how to use toys/games appropriately

• Stress “functional use” of academic skills

• Fade cueing

Educational Strategies for Academic Challenges

Individualized academic programming designed to offer consistent success

Make learning rewarding, not anxiety provoking

Redirect away from following their own impulses

Insure student’s understanding of presented material via his/her demonstration of it

Academic Strategies (con’t)

Big job: Clean your desk

Little chunks: 1. Put pencils in pencil box 2. Close covers of all books 3. Throw away all wrinkled/

torn papers 4. Put important papers in a

folder 5. Put books in a neat stack

• Break reading comprehension into smaller parts and analyze 1 section at a time

• Expectations must be set for amount and quality of work produced. Start small and increase as skills develop

• Earning time toward doing what interests them is often a good motivator to do what is expected.

• Sensitivity to environmental conditions

• Hyper or hypo sensitivity to auditory, visual, smell/taste, tactile/kinesthetic

Sensory Deficits

Response to Sensory InputResponse to Sensory Input

• Under/over reaction to sound

• Eye contact avoidance• Focus on details of

objects• Avoids specific

foods/odors/textures, etc.

Strategies to AddressSensory Differences

• Remove environmental conditions, if reasonable (e.g., odors)

• Desensitize in small steps (consulting with O.T.)

• Implement sensory diet, as prescribed by O.T.

Behavior SupportBehavior Support

FirstFirst Then Then

Strategies

• Simplify abstract concepts. Use visuals as much as possible

• Teach the difference between general knowledge and personal ideas to help with writing skills

Emotional Vulnerability

• Often don’t have the emotional resources to cope with the demands of the classroom (esp. from 3rd grade on)

• Easily distressed due to inability to be flexible and lack of organizational skills

• Intolerant of making mistakes, low self-esteem

• Prone to depression• Rage and tantrum reactions

common response to stress and frustration

Educational Strategies: Emotional Vulnerability

• Provide high level of consistency to prevent outbursts

• Teach students strategies to cope with their stress:

Make list of concrete steps to follow when they become upset (e.g., 3 deep breaths, count fingers of left hand 3 times, ask to take a break outside of classroom, write steps on card, etc.)

• Be alert to changes in behavior that signal depression: More disorganized, inattentive, isolative, crying/suicidal remarks, increased levels of stress, etc.

Troubleshooting Problem Situations

• Approach problem situations with an open mind, and reserve (behavioral) judgments!

• Analyze problem situations, taking into account knowledge of both the student and his/her disability

• Develop an action plan based upon the student’s needs

• Be proactive in the application of supports

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BEHAVIORBasic Overall Guidelines

• All behavior is a form of communication• Investigate WHY its occurring

– Inability to communicate• Confusion/fear caused by change, sensory stimuli• Pain caused by sensory stimuli, illness, accident• Frustration/anger due to limited communication/social

skills– Get something desired (food, toy, attention)– End disliked activity– Meet sensory need (increase or decrease input)– Opportunity to make a comment– Habitual not having alternative

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All behavior communicates.

What may appear to be an act of willful noncompliance, may be, in actuality, the student’s idiosyncratic attempt to send a message that s/he is unable to get across in any other more conventional way. Moreover, since it is the caregiver’s judgments that determine how the student will be perceived, what the caregiver does not know can, and often does, jeopardize the student’s learning.

Behavior• If you try to force negative

behaviors to stop without understanding WHY then– The behavior will increase in

occurrence and intensity – Another negative behavior will

emerge to replace

• Replace with appropriate behavior based on needs of child– Focus on instruction rather than

discipline– Provide alternate acceptable behavior

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Behavior• Coordinate all personnel – consistency is

essential• Reinforce appropriate behavior frequently

– Use meaningful reinforcements

• During crisis– Move to quiet calm space– Provide familiar people, places, objects– Allow calming, repetitive, stereotyped activities

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Behavior

If child loses it– Engage pre-planned intervention– Keep voice calm, actions simple and visible– Assure class student is OK– Get closure when calm (sequence paper, books,

charts, clean up/apologize, transition)

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Difficulties encountered • Organization requires an

understanding of what one wants to do and a plan for implementation. These requirements are sufficiently complex, interrelated, and abstract to present formidable obstacles for students with autism.

• Developing systematic habits and work routines, checklists, visual schedules, and visual instructions concretely showing autistic students what has been completed, what remains to be done, and how to proceed.

Difficulties encountered • Distractibility takes many

forms in the classroom: reacting to outside car noises, visually following movements in the classroom, or studying the teacher’s pencil on the desk instead of completing the required work.

• Identifying what is distracting. it might be visual stimuli, it might be auditory. environmental modifications can be made to the physical make-up of a student’s work area, the presentation of work-related tasks, or many other possibilities.

Difficulties encountered • Sequencing is another area of difficulty. These students

often cannot remember the precise order of tasks because they focus concretely on specific details and do not always see relationships between them.

• Consistent work routines and visual instructions compensate for these difficulties. Visual instructions can highlight sequences of events and remind autistic students of the proper order to follow. The visual picture remains present and concrete, helping the student to follow the desired sequence. The establishment of systematic work habits is also helpful; a student who always works from left to right can have work presented in the correct sequence.

Difficulties encountered

• Difficulties with generalization. Students with autism frequently cannot apply what they have learned in one situation to similar settings. Appropriate generalization requires an understanding of the central principles in learned sequences and the subtle ways in which they are applicable to other situations. Focusing on specific details, students with autism frequently miss these central principles and their applications.

Some things to try• Use simple, concrete language. Less is better!• Key words and phrases that work include:

“The rule is…”“Make a good choice.”“If…..then…..”

Some things to try

Visuals• The importance of visuals cannot be

underestimated . As Temple Grandin, who has Asperger’s Syndrome, explains in Thinking in Pictures (Vintage, 1996): ‘Words are like a second language to me’.

• Use visuals for schedules, directions, introducing new activities and more.

Examples of Visual Supports

First/Then schedule

Visual Rules for desk

Some things to try

Show, Don’t Tell• difficulty sequencing tasks means that the

instruction ‘Look at the article and fill in both sections of the answer sheet’ may as well be given in Klingon. Instead of telling, show your pupil what to do and guide them through the start of the activity.

Some things to tryRewards• give out points for

appropriate (not just “good”) behavior and effort at completing tasks. The points can be recorded on a chart. When each student gains five points they get a small reward. (prizes can be free choice time)

Effective StrategiesLess is More

• Use plain language, check that the student is clear about what he/she needs to do

• Develop visual schedules, rules, instruction• Keep the routine the same. Let the student

know in advance if there will be a change and go through the change with them to reduce anxiety

• Handle group work in a sensitive way. Student must be clear about his/her role in the group

• Use detailed and clear instructions. Communicate important information in visual form

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General Interventions• Utilize step by step approach• Employ visuals whenever possible• Avoid power struggles• Be aware of sensory needs (need for

movement)• Move at an appropriate pace• Write and provide “instruction manuals”• Structure transitions• Provide behavioral supports across areas

(social, language, behavior)60

General Interventions• Utilize the child’s strengths/interests• Improve self-awareness and self-esteem• Teach student about strengths, weaknesses,

and disability awareness• Teach their classmates• Provide buddy and mentoring• Create an accepting classroom environment• Watch as opposed to listen to them• Don’t be deceived by verbal skills

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Modifications• Physical arrangements• Remove/minimize stimuli• Modify requirements

– Reduce length, amount, steps, complexity– Move to new space early (buddy system)– Take a Break (react to first signs of stress. Escalation

is usually rapid)quiet areawalkcalming/sensory experiences

Time to observe from distancenew activitiesinteractions with new objects

Don’t push – gradually move closer…fully include62

When you tell me,I forget

When you show me, I remember

When you involve me,

I understand

Fragile – Handle With Care

• Even though there are many things about me that are unique, in the ways that really matter I am just like other children.

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• I learn best from people I trust, and I learn to trust when I sense that people like me. Please try to see the world through my eyes, for I can’t see it through yours.

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• And please know that even though it may not seem so, I really am trying to adapt to a world that my neurological challenges prevent me from understanding without your help

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• . If you keep these things clearly in mind, you will be less apt to label me a behavior problem, and more likely to teach me the things I need to know so that I can function with greater understanding and competence in a world that is often inhospitable to my needs.

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RESOURCES and INFORMATION

• http://www.mrsmaysautismclassroom.com

• http://www.autism-help.org/

• http://www.autism-society.org/

• http://www.autismspeaks.org/

RESOURCES and INFORMATION• Stephen Shore, My life with Autism

http://www.autism.com/individuals/guidlifeon.htm• Teacchhttp://www.teacch.com/• Temple Grandinhttp://www.templegrandin.com/• Tony Atwoodhttp://www.tonyattwood.com.au/• Resources for Educatorshttp://www.angelfire.com/pa5/as/asteachersites.html• Donna Williams – Artist with autismhttp://www.donnawilliams.net/ 69