Autism Spectrum Disorders: Educational Issues and

Interventions

Judith Miller, Ph.D.Department of Psychiatry

University of Utah

Objectives for today

Discuss educational issues related to milder forms of ASD

Discuss social interventions and support Discuss educational accommodations to

consider

I. Educational Issues

Linking Educational and Clinical Issues around ASD

Definition of the disorder

Clinical assessment uses DSM-IV criteria to make a diagnosis

Educational assessment uses the State Office of Education’s Autism Definition to make an educational classification

Reliability of DSM-IV clinical diagnosis

Autism, Asperger Disorder, and PDDNOS share the same triad of impairments, and differ primarily in severity, not quality

Distinctions between forms of ASD (autism, HFA, AS, PDDNOS) not clear, and not reliable

ASD v. non-ASD is reliable If the diagnoses cannot be reliably distinguished from

each other by “autism experts,” validity of the proposed differences is called into question

ASD v. non ASD may be a more helpful distinction

ASD Terms that can be used interchangably

Autism, Autistic Disorder High functioning autism (i.e., a diagnosis of

autism made in a verbal individual with normal IQ)

Asperger Disorder PDDNOS Autism spectrum disorder “autistic features”

Autism as an Educational Classification

Feds provide a definition of Autism (and Communication Disorder, Developmental Delay, Specific Learning Disabilities, etc.)

Each state creates its own eligibility criteria– Utah adopted criteria that map almost exactly to

DSM-IV– Neither Utah nor Federal definition require a specific

IQ profile or age of onset

Use of the “Autism” Classification

Should be considered for any student with an autism spectrum disorder (e.g., autism, high-functioning autism, Asperger Disorder, PDDNOS)

Should be used if the features of the ASD are the primary disability

Other categories should be considered if:– There are other comorbid disorders impacting education– Team (including parents) decides that an understanding of the

student’s difficulties is best met with a different classification

Benefits of using the Autism classification

Accurately depicts the primary disability Alerts school professionals to the social and

communicative difficulties Reminds professionals of the need for social

and communicative supports and interventions Reminds teachers and staff that difficult

behavior may not be “willful opposition”

II. Educational Interventions

Social Interventions and Other Educational Interventions

Why include social interventions?

Social difficulties impact educational success– Lead to behavior problems– Limit educational opportunities

Social difficulties are included in the educational classification of autism

Social difficulties may restrict the child’s ability to function in the “real world” more than academic abilities

School is the learning ground for community settings

Possible reasons for social difficulties (Wagner, 1998)

The child doesn’t pick up social cues from the environment

The child doesn’t know how to respond to his environment appropriately

The child doesn’t practice the skill enough to use it naturally

The child can’t control his emotions enough to think about an appropriate response

Ways social deficits manifest

Inappropriate statements or yelling Aggression/destruction Echolalia or jargon Inappropriate touching Avoidance of activities Long periods of unengagement

Wait: Isn’t this was Social Skills Training Groups are for?

Yes! Social skills training groups target specific social skills like nonverbal communication, appropriate social behavior, etc.

BUT: Without coaching and reinforcement throughout the day, the skills don’t generalize.

Social skills need to be practiced

Teachers, parents, and staff need to know how to praise and reinforce good social skills when they occur spontaneously– “Wow! You looked right at Timmy’s eyes when you

asked him to play with you” Adults need to know current goals so they can

prompt for them across all settings– “Look at me so I know you are asking me a

question.”

Inappropriate behavior is an opportunity to teach

Teachers who view inappropriate behavior as a teaching moment will aid the child, and help the teacher be more effective– Redirection of inappropriate initations

Interrupting inappropriate initiation, describing or modeling the desired response, and having the student practice in the moment

– Praising appropriate interactions Critical for skill acquisition!!

Social Skills Assessments

Walker-McConnell (Singular Publishing Group; 800-521-8545)

Social Skills Rating System (AGS publishers) Vineland Socialization domain

Determining social goals

Should aim for age-appropriate goals Use a developmental perspective

– Proximity to peers– Watching peers– Greetings– Gross motor imitation– Using materials in a similar manner (parallel play)– Using the same materials

Next-level social goals

Turn taking Appropriate assertion Imitating use of objects

(toys, dressup) Asking for things from a peer Initiating conversations (“Let’s play”) Social comments (“That’s cool”) Responding to questions by peers

Higher level social goals

Take pride in appearance Relate well to the opposite sex Keep promises Listen when others are speaking Appropriate assertion Accepting feedback from teachers/peers Knowing when/how to report a problem to an adult Knowing when to allow the adult to handle disciplinary

matters

Ways to encourage social interaction in the classroom

Seat child with autism next to peers Small group activities Social games Students are encouraged to help each other

before seeking teacher assistance Teacher creates a positive and cooperative

atmosphere Sensitivity training

Seating arrangement ideas

Seat the student with ASD away from high levels of distraction and traffic

Seat the student near peers with good language and social skills

Peers may then be available to help keep the student on task, or to help provide notes

Consider pros and cons of seating next to the teacher (e.g., seating next to peers provides the opportunity to practice peer interaction skills)

Make sure they are not sitting next to a bully!

Small Group Activities

The student can work with 1-2 other students where each does a part of the project

The student with ASD should provide a legitimate and reasonable contribution (not just observe, and not be taken advantage of)

Activities might include some social component (e.g., group members have to go to each other for help, or have to present their individual findings to the group, etc.)

Ideal if grading procedures work to facilitate seeing the student with ASD as a legitimate benefit (e.g., his expertise in the area will enhance the project)

Social games

Can be modifications of any game Should include social goals, such as:

– Listening skills– Watching peers– Cooperation– Gross motor skills– Turn-taking

Lunch Bunch

Small lunch group that focuses on a particular social skill

Includes a majority of typical peers Can include a social game after students finish

eating

Encouraging the students to help each other

Provides a safe way for students with ASD to ask neighbor for help with:– Finding their place in a book– Looking to see what materials their neighbor has out

for this activity– Copying the neighbor’s notes– Neighbors may ask the student with ASD for help

too– Neighbors can help each other stay on task

Peer tutoring

Peers are hand picked to help an individual with autism during class time.

The peer might help with note-taking, helping the student stay on task, redirect inappropriate behavior.

Can be set up class wide to be more natural

Student with ASD having a special role

Great for facilitating a positive view of the student with ASD IF:

– The special role is legitimate– The special role provides some kind of service to the other

students E.g., the student with ASD gives a “science fact” or weather

report each morning, or is able to provide tutoring or some other assistance to peers

– The role encourages or requires some social interaction E.g., the student with ASD passes papers back and gives

compliments

Sensitivity Training

To have peers become more understanding of what the student with autism is going through

To foster tolerance of differences To foster a spirit of helpfulness

Talk with the student’s parents first. Some parents do not want their child “singled out” as being different. Some will want the “peer training” to be conducted without the child present

In general, students in older grades benefit from more specific information about autism than in younger grades

Talk to the group about differences

All individuals are different (hair color, eye glasses, reading skill, athletic ability, math skill, and social ability/making friends).

All individuals are the same in many ways (all communicate in some fashion, desire for friendship, belonging)

Differences make the world interesting

Talk to the group about issues specific to autism

Specific communication difficulties Social difficulties Unusual behaviors Remind students that none of these difficulties

are “contagious”

Generate a discussion of solutions

What could you do if you saw Johnny alone during recess?

What could you do if he was talking loudly during story time?

What could you say if he hugged you too hard? What could you say if he began to get

frustrated about something minor?

Generating solutions (older grades)

What could you do if you saw Alex sitting alone during lunch or at a football game?

What could you do if you brush by Sam and he accuses you of hitting him on purpose?

What could you do if Eric asks you an odd question as a way to say hello?

What strengths do you see in John? How could you help John fit in better in terms of

dressing and style?

Classroom Social Skills Training

Use a particular curriculum– Walker Social Skills (Pro-Ed)– Skillstreaming (Research Press)

Have specific weekly goals and activities Reinforce the skills during practice activities

and also when they occur naturally!

Class-Wide Peer Reinforcement

Have a system for recognizing and reinforcing helpfulness and cooperation– “Marble Jar”: When teacher sees a helpful act, a

marble goes into the jar; when the jar is full the class has a party

Teacher has to witness the act, not have it reported by a student

Good social skills, helpfulness, following directions can all be included

Peer Buddies

“Friends club”: Students volunteer to hang out with student with autism.

– Put their name in a hat, it is drawn each day or week. – Peer invites the student to join in, and gently redirects

inappropriate behavior

Helps protect the student from teasing and increase social contact

Need to reinforce peers’ efforts, and periodically discuss what’s working and what’s not!

Modified peer buddies for older students

Peers are hand picked (best if they have strong social skills and are well-liked)

Taught about ASD (with parent permission) or about the individual’s strengths and weaknesses

Encouraged to include the student in activities Given support and encouragement for their efforts, and

some specific strategies to try

Recess Social Skills Coaching

Adult provides support for social interaction during recess– Prompts for skills currently targeted in social skills

training program– Provides praise for appropriate attempts– Facilitates budding peer interactions

Adult knows when to reduce prompts and facilitation

Use of a dayplanner

Dayplanners are helpful skills for future independence

Some students love them and use them well Others have to be specifically taught how to

use them

Dayplanner elements

Should include daily schedule, with room for assignment descriptions

Place to check off when assignments are done, and when they are turned in

Should include a spot for teacher or parent comment Can serve as home note if done well Best if one dayplanner used for the day, rather than

different strategies for each class

Case example: Andrew 6th grade student Would become extremely upset at seemingly random

times of day Teacher printed out daily schedule and posted it on

corner of desk Saw behavior problems decrease dramatically When there was a change in the day, Andrew could

see it on the schedule and tolerate it without difficulty Teacher was able to made last-minute changes to

the schedule Helped Andrew be more adaptable to school days

Visual Instructions (TEACCH philosophy; adapted by Fullerton et al., 1996)

Tells how much work there is to do Tells where to begin, and what to do in what

order Tells the student what the finished product will

look like Tells when the student is finished Tells what happens next

Example of Visual Instructions(from Fullerton, et al., 1996)

Group Work in Health Class

1. Write a 3 page paper with 3 other kids in class.

2. Ms. Smith will tell you whom you will work with.

3. Your group will:1. Decide what your paper will be about.

2. Meet for 30 minutes each day this week from 10:15 to 10:45.

3. Write the paper on Friday and turn it in to the basket on my desk.

4. Check your goal card each day before you start.

Visual Instructions at Home

Can be helpful for learning self-care and independence skills– Household chores– Directions for favorite snack– Directions for packing for a trip, etc.

Common Regular Education Interventions to consider:

Shorten assignments (may not need repetitive practice) Reduce assignment length Provide time guideline for homework and grade on what was

completed (can adjust if it becomes clear the student is not learning the work)

Allow oral examinations Decrease amount of written work Provide a scribe/note taker Reduce amounts of board work and text copying

Provide visuals of important conceptsEncourage students to ask clarifying questionsMake eye contact when giving directionsProvide models of assignments (even written) when appropriateHave student restate instructionsTeach student to use cues and learning aidsProvide simple, concrete instructions

Teach self-checking strategiesCheck for meaning/comprehensionProvide peer tutorsTeach strategies for solving math word problemsProvide opportunities for cooperative learning and interactionRelate assignments to child’s interests as much as possibleTeach student to self-monitor and evaluate his own workUse precision commandsCreate behavior contracts or a class behavior management strategy

When all else fails….

Other regular education interventions might be helpful as well

But when all else fails, try to:– Make things visual– Make things meaningful to the student

Other important strategies

“Down time”: a chance for the student to excuse himself to relax alone. This is an excellent preventive strategy.

Davis model (secondary ed): Students begin and end each day with the same teacher, who helps with organizational skills and social skills training

Further information

Inclusive Programming for Elementary Students with Autism (Wagner, S. 1998; Future Horizons publishers)

Inclusive Programming for Middle School Students with Autism/Asperger’s Syndrome (Wagner, S. 2002; Future Horizons publishers)

Social Communication website (www.depts.washington.edu/soccomm)

Western Regional Resource Center (http://interact.uoregon.edu/wrrc/wrrc.html)

– Go to “site map” and find Autism/Asperger Disorder