AAC and ASD: Engineering AAC and ASD: Engineering Perspective-Taking and Perspective-Taking and Emotional RegulationEmotional Regulation

Marcia Weber-Olsen, Ph.D., CCC-SPMarcia Weber-Olsen, Ph.D., CCC-SPMonterey County SELPAMonterey County SELPAVerjene Kalashian, M.A., Verjene Kalashian, M.A.,

CCC-SPCCC-SPSan Lorenzo Valley USDSan Lorenzo Valley USD

THE BIG PICTURE…our vision for the future

Engaging Learning Environments that promote

communicative, social, and cognitive growth

for learners with Social Learning Disabilities Strong receptive base to support comprehension

Behavior management to support student engagement

Frequent expressive AAC use to support social interactive communication

Strong language and literacy training to support learning

Agenda Social Cognitive Learning (SCL) Deficits

Perspective-taking and ‘mind blindness’ in SCLD

Different ‘pathways’ to SCLDs

Developmental prerequisites for perspective-taking

Social Communication, Executive functioning and Emotional Regulation Challenges in students with SCLDs

AAC as a framework to support perspective-taking, emotional regulation and social-communication

Agenda- continuedEngineering AAC supports for:

Social Communication Social Scripting & Partner Focused Questions Small Talk Sharing the Day/Visual Bridges (Hodgson)

Perspective-Taking Social Stories Comic Strip Conversations Video Social Review

Emotional Regulation Identifying/Recognizing Emotions Grading of emotions Cognitive Behavior Therapy: Behavior guides, Calming

Strategies Contingency Maps

Comprehension drives language sense-making

Perspective-taking drives our thoughts about others’ thoughts, beliefs, knowledge, intentions & desires

‘Mindblindness’: Deficits in mentalizing about others (Baron-Cohen, 1995)

Language comprehension & perspective-taking deficits ….at the root of social learning difficulties (Mirenda & Beukelman,2000)

What Do We Mean By….”Perspective Taking”?

• Perceptual perspective: ability to visualize what others can ‘see’ or ‘hear’

• Conceptual perspective: ability to know what others are thinking and keep track of what others know

PERSPECTIVE-TAKING: a range of complex social scenarios

Source: Carol Gray.

“Theory of the Mind” ….a system for inferring and predicting a full range of mental states from another’s behavior” - Baron-Cohen, 1995

• ToM : a social executive function: “Understanding one’s own and others’ emotions, thoughts,

beliefs, prior experiences, motives, and intentions …and inferring plausible causal factors for these states” (Rubin & Laurent,2001)

• Inner language & executive functions assist perspective-taking

• Without ToM: the world is an “unpredictable place”

“Mindblindness”: deficits in mentalizing

about others (Baron-Cohen,1995)

Difficulty establishing shared knowledge for learner to process ongoing social interaction, or account for what others know

Difficulty understanding and predicting others’ intentions, actions or intended meanings…

Inability to understand misunderstandings

Difficulty anticipating what other’s think of one’s actions

Difficulty understanding deception, or being deceptive

Empathy & Perspective-taking

Difficulty reading other’s emotional states; comprehending other’s feelings

Insensitivity to others’ feelings

Pragmatic symptoms and Perspective-Taking

Poor ability to share topics: obsessive, circumscribed interests, “sticky topics”: problems linking to new topics (R. Paul, 2008)

Poor ability to infer what others already know & what they need to know in running conversation (pre-suppositional knowledge)

Different ‘Pathways’ to

SCLDs

Students with social-learning difficulties:

High Functioning Autism

Asperger Syndrome

PDD-Not Otherwise Specified: Atypical ‘Autism’

Autism

Asperger Syndrome

AUTISM SPECTRUM DISORDERS

Pervasive Developmental Disorder-NOS

Source: Wetherby & Prizant, 2000

High functioning

Behavior & Social-Cognitive Characteristics in Autism Spectrum

Disorders

• Inflexible learning style Do not accommodate well to change or novelty

Strongly desire routine in their environment; respond best with ‘predictability’ and structure (Rubin & Lennon, 2004)

• Sensory processing and behavioral ‘modulation’ difficulties (Wetherby & Prizant, 2001)

• Unique perspective-taking: difficulty predicting or correctly inferring what others “feel” or “think”

Genuine inability to understand others’ beliefs and emotions (Baron-Cohen,’95)

May expect others to know their thoughts, experiences, opinions

Other groups ‘at risk’ for Social-Cognitive Learning

challenges Attention Deficit Disorder: both hyperactive and inattentive types

Traumatically Brain Injured

Emotionally Disabled Schizotypal affective disorder Bipolar disorder

Genetic syndromes: Fragile X Syndrome: ~ 33% of children with this genetically inherited condition also have a co-morbid ASD and associated social-cognitive deficits (Hagerman, U.C.Davis M.I.N.D. Institute)

The ‘quirky kid’

Students with Social Cognitive Learning Challenges

Desire social contact, but have limited social & pragmatic skills to establish and maintain friendships

May appear indifferent to peer pressure

Unaware of “unwritten” social rules (hidden curriculum)

May lack intuitive empathy; insensitivity to other’s feelings

Often victims of bullying by middle school because of pronounced social learning problems

Significantly ‘at risk’ for mood disorders (Anxiety, depression)

Sources: Twachtman-Cullen, 2000; Atwood, 2003)

Developmental Prerequisites: between 9-18 mos.

• Joint Attention social communicative behavior in which two people share attentional focus on an object or event

• Joint Attn: Child responds to another’s attentional “directive” or initiates shared attention with another

• Most massive deficits in autism are evident in shared referencing/joint attention (Curcio,1975)

Eye gaze: three-way gaze shifts

Pointing gestures

Other declarative gestures (showing, or ’showing off’;inviting interaction from others)

Joint or Shared Attention in Autism

• Initially ASD children use pointing/showing gestures to get what they want in an instrumental way, not to “share attention” with social partners

• Discrepancy in use of early pragmatic functions:

Requesting & Commenting functions (to share topics/ invite interaction) do not develop concurrently as in typically developing children - Wetherby et al., 1998

• Disrupted joint auditory attention: some ASD children speak too loudly, or too softly, or with little modulation (Frith, 1989)

Social Language features in Autism

Spectrum Disorders (ASDs)Pragmatics & social communication are core areas of deficit

• Conversational and pragmatic skills such as, Staying topic-focused, turn-taking in conversation; establishing and

following the conversational focus of their social partners; Reading non-verbal cues

• Social Communication Skills include: Pragmatic skills + Paralinguistics: prosody, gaze, gestures, proximity - R.

Paul, 2008

• AND….Social Behaviors include:

• Conventional gestures • Facial expression and body language• Avoiding socially unacceptable behaviors

Language Features in Asperger Syndrome

• Grammatical & syntactic expression is on par with age: often ‘fluent’, syntactically mature utterances

Speech may be lengthy; say too much- Intense and narrow restricted interests drive conversational topics Overly ‘formal’ (pedantic) vocabulary Caveat: “superficial verbal skills often mask cavernous weaknesses

in comprehension” (Twachtman-Cullen, 2000)

• Prosody shows high rates of impairment in ASDs

Atypical intonation: flat pitch contour, robotic

Poorly modulated volume: overly loud or too soft

Speech rate: ‘hyperverbal’

Difficulty with figurative language; humor and/or abstract verbal concepts

The Invisible Disability…qualitatively assessing social pragmatic

skills• SLP’s standardized assessments measure basic technical

language skills…do not capture if student shows communicative competence in these skills.

• For students with social pragmatic deficits, the optimal assessment is a qualitative one– Observe student across environments and contexts– Compare social functioning to the level of their peers– Incorporate pragmatic language samples into the assessment

battery

• No assessment of a student with AS can be valid if it is completely based on standardized tools (this is also true for all child-based assessments to include psychological and educational)

Social Cognitive Assessment

• Emotional Intelligence Protocol. Source/author (VK) 2003, Thinking Publications

• The Social Thinking Dynamic Assessment Protocol- Garcia Winner, M. in Thinking about you thinking about me. 2nd edition.2007

Behavioral & Social-Cognitive Characteristics in ASDs

Difficulty with:

Emotional regulation: ability to self-regulate one’s arousal and emotional state, or seek assistance from others (mutual regulation) for availability and for social engagement (Rubin & Lennon, 2004)

• ER is another CORE developmental challenge in all students with ASDs

• Developmental progression from more basic physiological/biological need states (e.g., sucking thumb, averting gaze when stressed) to sophisticated behavioral strategies and the use of language & meta-cognition to self-regulate arousal levels

• ASD learners demonstrate ‘idiosyncratic’ motor ‘strategies’ used to self-regulate (to increase or decrease their arousal level) (e.g. flapping, toe walking; crashing into someone) that are misinterpreted as socially ‘deviant’ behavior

• Social partners often isolate themselves from such individuals

Supporting dysregulation in a Middle school student

Emotions & StressNeurotypicals

Mildly/moderately stressful situations activate frontal lobe functions; use cognitive rehearsal & language to verbally ‘mediate’/modulate their emotions

Autistic IndividualsGet “neurologically stuck” in an attempt to manage a rigid set of ‘expectations’ or to

avoid novel & ambiguous events (Corbett,2003)

Sensory or processing overload, anxiety/fear, increased novelty (change) or ambiguity elicits unregulated emotional reactivity (Levine & Wiener,1989)

Frontal lobe activity shuts down; amygdala activates & ignites a cerebral “fire storm”– Explosive ‘meltdowns’– Aggressive and/or ‘panic’ behaviors- flight/fight response– Escape behaviors– Withdrawal– Sensory shutting down (plugging ears, shutting eyes)

Significantly elevated stress circuits (limbic system-cortisol levels) compared to neurotypicals when stressed (Corbett,2004)

Structurally denser neurons in autistic brains: Medial temporal lobeAmygdala: almond-shaped structure

• aggression & emotion• interpretation of facial recognition and non-verbal social cues

Hippocampus: sea-horse shaped structurememory functions

Designing AAC Intervention Strategies

Range of Skills to become competent communicators- Light, J. & Bilger, C, 1998

• Linguistic Skills– Receptive and expressive skills– “Linguistic code”

• Operational Skills– Form signs or gestures correctly

• Social Skills– Skills to initiate, maintain, develop, and terminate

interactions– Skills to develop positive relationships and interactions– Skills to express range of communication functions (e.g.,

comments,requests, protests,etc.)– Skills to develop perspective taking– Prerequisite: turn-taking skill

• Strategic Skills– Compensatory strategies

Augmented OutputMay either supplement speech or act as a

primary communication mode

GESTURESNatural GesturesSign SystemsSign Language

GRAPHICSTraditional Orthography

Photographs

Line Drawings

Augmented InputCan play an important role in producing and/or comprehending speech

Visual Language Systems… successfully used for students with autism, etc. to visually augment language input and output

Core to all intervention strategies…

…present a combination of visual and verbal cueing

Middle School SDC Program

AAC Visual Supports Enhance Receptive and Expressive Communication

• Prompt joint attention

• Enhance attention to, and understanding of social messages and behavior

• Establish conversational referents

• Promote memory recall

• Increase comprehension of language concepts

• Facilitate social initiation and communicative intent

Johnston, S., Nelson, C., Evans, J., and Palasolo, K (2003).

Aided Language Stimulation

• A legitimate ‘second language’ involving a paradigm shift…visual language is a real language and must be available as an essential aspect of each life activity

• Infuses the environment with visual language to assist in the receptive and expressive processing for students with autism

Goosens et al., 1992 and Cafiero, 1998

Pool of Response Options…a scaffold that aids the student’s…

• Repeated exposure to input-comprehension• Initiation of communication• Expression• Retention/memory• Communicative functions beyond requesting• Expansion of syntax: words into complete

sentences• Segmentation: breaking sentences into

individual parts

How Many Symbols?

• ALS is appropriate for students with autism who can process many picture symbols compared to those who are at the one-to-three symbol level.

• Students with joint attention and able to point can handle up to 50 symbols on a language board.

• Students not yet able to establish joint attention can use 2 to 6 symbol language boards

• Because ALS is initially receptive language training, more symbols are used than student can verbalize or understand

• Students with autism who are speakers also benefit from ALS as a means to stimulate more complex receptive and expressive language skills. Words can be used in place of symbols for those with literacy skills.

Cafiero 1998

• Social Scripting:

• Vocabulary for turn taking• Sequence of a social script• Partner focused questions • “Small Talk” • Sharing the Day: Visual Bridges (Hodgon,1998)

Engineering AAC supports for:Social Communication

Vocabulary to Support Participation in Social Interactions

…social vocabulary can be used to take a turn in the conversation and participate more frequently.

…focus on turns that are quick to produce

…communicates to the partner that the AAC user is involved and interested in the conversation

Vocabulary to Facilitate Turn TakingYeah! Awesome Fat chance!

No way! Poor thing. Get a life!

Really? Okay. You’re kidding?

Cool. Wow! Hurray!

Gross! Gimme a break. Yes!

I doubt it. Whatever! Yea!

Says who? That’s great. Head nod.

Uh huh. Alright! Thumbs up sign.

Get out of here. Oh no! Thumbs down sign.

Neat! Yuck! Me, too.

Turn Taking

Turns include spoken messages, sign or gestures, messages on a communication board or speech-generating device.

Obligatory turns follow a partner’s question“What are you doing?”

Nonobligatory turns follow a partner’s comment or statement or they can be turns that extend or change a conversational topic “Cool! I have another idea”

Anatomy of a Sequenced Social Script

• Attention Getters“ Hi there!”“ There’s Nancy!”

• Starters“What’s up?”“ Did you see Lost last night?”

• Maintainers, Holders and Interjections…add interest to story and prompts listener to make a comment.

“It was awesome!”“I’ll give you a clue.”

• Turn Transfers…(partner focused questions)“What did you see?”“How about you?”

• Closing

PATHS to Starting a Conversation

• P: Prepare ahead: keep “fact files” with important facts about people you know– Birth date…family members…favorite food, color, school

subject…interests…reading computer games– Later on keep ‘invisible’ files

• A: Ask your self what you are going to say and how you are going to day it before you day it– Conversation starters

• T: Time is right

• H: “Hello”

• S: Signals - smile, gaze, body

Source: J. McAffee, 2002

Social Coaching…Small Talk

Determine the Content of the Introduction Message

• Attention-getting message“Excuse me.”

• Greeting(s)“Hi, “hello”

• The individual’s nameFull name for formal situationsNickname for informal situations

• The purpose of the interaction“I’d like to introduce myself.”“I’d like to place an order.”

Partner-Focused QuestionsThose questions an individual ask his or her

communication partners about their thoughts, feelings, and experiences“How are you?”“What’s up?” “What’s new?”“What did you do this weekend?”“What do you think?”“How about you?”“What’s wrong?”“How’d you do?”

Shows partners they are interested in themFosters social closeness and enhances interaction

How are you? What are you doing this weekend?

Where are you going on vacation?

What’s up? What are you doing? How was your vacation?

What do you want to do How are you doing? What’s the matter?

How was your weekend? How do you like? What are you doing tonight?

How was yours? What did you do last night? Do you have plans for the weekend?

How about you? What do you think? How was your birthday?

What do you think about? When is your vacation?

What’s wrong?

Social Scripts to Promote Social Interaction

• Scripts used for joke-telling, sharing life stories and general conversations

• Scripts help AAC users move beyond wants and needs

• Support students in learning to claim, start, and maintain turns in a conversation

• Pre-programmed turns on speech-generating devices (SGDs)

Sharing the day: Visual ‘bridges’

Hodgson,1998

Where you may never have “gone before” in therapy…

Perspective training & Social Skills Instruction

• Social Scripts Social Stories (C. Gray,1995)• Comic Strip Conversations (C. Gray, 1996)• Video Modeling

Emotional Regulation Training

Recognizing/labeling feelings Grading of Emotions Teaching calming & coping strategies Contingency Maps (Mirenda, 2005)

Designing Tools for Perspective-Taking and Social Success

3 Goals:

1. Improving the understanding and consideration others have of the unique perspective of the person with ASD

2. Providing accurate social information, including: Assistance in predicting, understanding and reading social situations

3 Supporting the individual in making more effective responses to social situations

Source: Carol Gray,1996

Social Stories…

…provide “scripted” events of social situations that challenge the student

…provide a positive statement of what the student can do

…are written from the student’s perspective 

What’s a ‘Social Story’?

• Social stories help the student understand why

• Social Stories answer questions that students don’t ask or don’t ask well

• Expected outcome: increase in participation in a novel routine when the student has reviewed the Social Story

• Also hoping for a decrease in resistance to change

3 purposes for Social Stories• Describe: a situation and appropriate behavior

• Explain “fictional” qualities & realistic interactions with people“When the principal wears a funny hat, it usually means there’s a

special event at school”

• Explain the environment:indicate location or environmental surroundings where events happen“At church, my family usually sits in the back row of pews…”“ At a restaurant, a waiter/waitress hands me a menu”

• Teach new routines and anticipated actions• Help student to translate a goal:

“I will try to stay calm when the fire alarm rings”“I can ask for a break when my work is finished”

(Ivey, Heflin, Juane, & Alberto , 2004)

I sit at my desk until my work is finished.

I know that I am finished because I have answered all of the questions on my page.

When I’m finished, I can take a break.

Social Stories… …are ‘perspective’ driven: try to correct

what the child is misperceiving, or give additional information the child needs to respond appropriately in a given situation

…teach social understanding over rote compliance (Gray, 2003)

Goal is to describe the target situation, not to direct the child’s behavior

• Show electronic & ALS social stories– “Playing Fair” - AT activity– “My Social Stories Book” (Gray & White, Aided Language

Supports)

• Can incorporate into lyrics of stories or songs

• Some students respond to stories written on a single page, while others respond to book style stories with one concept and a picture or icon on each page

Problem…• How do we get the student to “retrieve” the script on “the fl

y”?

• A visual support that travels with the student?

• A visual support that starts the “video-tape” rolling?

• Show Find a Friend Who…

• Give students models and scaffolds upon which to build their oral cognitive communication and writing.

• Thinking & Feeling Writing Prompts

 • A Social Story “on the fly”

• Goal: to assist students who struggle to understand the quick exchange of information in conversation

• “Instant replay” of the Who (was present), What (they were doing), Words (spoken), Thoughts/Beliefs (of those interacting)  

Comic Strip Conversations

Illustrate social situations & abstract or non-verbal conversational concepts (e.g., interruptions)

Visually “scaffold” dialogue exchanges (speech bubbles)

Convey emotional content/motivation through use of color coding

Target from the student’s perspective  

Comic Strip Conversations

Where you may never have “gone before” in therapy!

Perspective training & Emotional Regulation Instruction

• Social Stories (C. Gray,1995)• Comic Strip Conversations (C. Gray, 1996)• Video Modeling

Emotional Regulation Training

• Recognizing feelings• Grading of Emotions• Calming & coping strategies• Behavior Guides & Contingency Maps

Video Modeling(NIKOPOULOS & KEENAN, 2003)

Video modeling: utilizes medium of television/video to teach a variety of skills (Corbett, 2003)• Teaches ‘social ‘referencing’

• Attention: selectively focusing child’s behavior on relevant stimuli (tone of voice, proximity, loudness, verbal content, facial expression)

• Retention: maintaining learned social l through video review

• Use video clips from TV shows to exemplify interactions

• Rehearse with written scripts first

• Verbal rehearsal - example: asking a girl out on a date• Paraphrase rehearsal• Re-enact the scene with clinician• Re-enact the scene with peer

• Use VM and role-play to become aware of listener cues• Yawning, taking a breath’• Swirming in a chair• Looking toward door; looking at watch

Where you may never have “gone before” in therapy!

Perspective training & Emotional Regulation Instruction

• Social Stories (C. Gray,1995)• Comic Strip Conversations (C. Gray, 1996)• Video Review

Emotional Regulation Training

• Recognizing & labeling feelings• Grading of Emotions• Calming & coping strategies• Contingency Map (Pat Mirenda, 2005)

Emotional Regulation

Child must have emotional regulatory capacities to:

1. Avoid a state of “too high” or “too low” based on expectations of a social situation (Self-Regulation)

2. Seek assistance and/ or respond to others’ attempts to provide support when faced with stressful, overly stimulating, or distressful circumstances (Mutual Regulation)

3. Recover from being “pushed over the edge” into states of emotional dysregulation or “attentional shutdown” through self-regulation and/or mutual regulation strategies.

Source: E. Rubin. Addressing Social communication in Students with HFA and AS. Monterey SELPA. Feb. 2005

Ways to teach emotional regulation

• Teach a continuum of emotional vocabulary: “happy”, “content”, “excited”, “thrilled”… (“How Do You Feel?” posters, ‘Mood Swings’)

• ‘Grading’ of emotions: identify salient cues for a particular level of emotion (tone of voice, body language, facial expression, muscle tension, breathing)

• Teach ‘mutual regulation’ : Requesting assistance from others - seeking comfort/sympathy (Rubin & Lennon,2004)

• Regardless of language level, the student may be unable to adequately express himself in stressful/highly charged situations

Provide an ‘escape’ plan Walk and ‘no talk’ (Atwood,2004; McAffee, 2002) Provide distracting pleasurable activities( Atwood, 2004)

Grading of Emotions

Emotional Key Rings

Recognizing Feelings & Stress Activities

• “Happy and Sad”

• The Stress Thermometer (McAffee,2002) and Social Story: “When I have stress”

Software that Supports Concept Development

• IntelliTools Classroom Suite…suite of programs• IntelliTalk• IntelliPics Studio• IntelliMathics

• Concept development is supported with graphic, text, and/or animation

• Very useful for students with ASD in particular due to the programs visual and auditory supports

COGNITIVE BEHAVIOR THERAPY to Manage Emotional Regulation

Atwood, 2004

Affective Education Component

• Teach why we have emotions • Explore one emotion at a time, starting with

‘happiness’ & progressing to others: anxiety, anger, etc.

• Teach a continuum of emotional vocabulary: “happy”, “content”, “excited”, “thrilled”…

• Teach ‘Grading’ of emotions in response to stress-inducing situations

Record enjoyable activities: photo and communication scrapbooks

Sensory tools “Pleasures box” Sensory Calming areas: Special interest tools: solitude & a devoted interest

in a topic can be calming (example: interest in Japanese culture & tea ceremony)

Drama Autobiographies of adolescents/adults with

HFA/AS Mood diaries Medication

Additional Tools to Address ER

Atwood, 2004

Pleasures Box

• A form of cognitive distraction/redirection• Refocuses student on calming things• Sensory calming tools• Photographs; pet, family members, favorite toy,

favorite vacations or locations• Stories,music or calming sequences

REMEMBER TRANSITIONS!

The single most challenging part of every student’s and teacher’s day; they can‘t be avoided

WHY ARE TRANSITIONS SO DIFFICULT?

The student…

…doesn’t want to or is unable to stop a preferred activity/give up a reinforcer

…doesn’t like change

…doesn’t like losing ‘control’

…protests to avoid activities he perceives as ‘too hard’ or frustrating

Source: L. Hogdgon. Solving Behavior Problems in Autism.

Increasing flexibility at transitions…

Make transitions part of the daily routine; ask students to prep materials for the next day

Verbally announce natural endings (“only 2 problems left, then we will be done”)

Refer back to the visual schedule

Behavior self-monitoring guides

Modify the length of instructional periods...

Short instructional intervals

Intermittent breaks, or alternate ‘work’ and ‘break’ intervals

“Show” student the duration of an activity

Time Timer

www.Timetimer.com

Correct distorted conceptualizations of an event, situation, or person

Challenge false beliefs or assumptions: Example: being deliberately ‘hit’ by someone vs. considering the context: nice

guy who was running, tripped & accidentally bumped into me

Building an ‘Emotional Toolbox’ to repair & restructure feelings and beliefs Physical Tools for self regulation (tools to release emotional energy) Relaxation Tools for self-regulation Social Tools for mutual regulation: using other people as a means

to manage feelings Thinking Tools for self-regulation: self-talk, ‘reality checks’ using

logic/facts

Cognitive Restructuring Component to

Manage Emotional RegulationAtwood, 2004

Where you may never have “gone before” in therapy!

Perspective training & Emotional Regulation Instruction

• Social Stories (C. Gray,1995)• Comic Strip Conversations (C. Gray, 1996)• Video Self-Review

Emotional Regulation Training

• Recognizing & labeling feelings• Grading of Emotions• Calming & coping strategies• Contingency Maps (Mirenda, 2005)

Contingency Maps• Similar to visual schedules, only more detailed

and with a different purpose

• Goal: to provide information about the “current” problem and “desired” behavioral pathways related to problem behavior– Will help the individual understand why he or she should

engage in the behaviors associated with the “desired” pathway!

@ Pat Mirenda, PhD., 11/05

Contingency MapA contingency map depicts• The antecedent that typically triggers a problem behavior

• The problem behavior

• The consequences that will follow if it occurs• Ideally, the natural consequences; if not, artificial

• A functionally-related (desired) alternative behavior

• The consequences that will follow if it occurs• Again, ideally, the natural consequences

Antonia• Grade 2 student with autism, little speech• Included for half of the day; remainder spent in resource

room because of problem behavior

• Problem behaviors: head-butting, hitting, and pinching classmates and adults when she had to wait:

• For her turn during buddy reading• In line• For the computer to boot up, etc.• Waiting was also an enormous problem at home

@ Pat Mirenda, PhD., 11/05

Wait Signal• Antonia’s SLP taught her to wait, using a “wait

symbol” (a red circle that symbolized “wait”)

• SLP provided systematic instruction in a simulated “buddy reading” activity to teach A. the meaning of the red circle: “you will get what you want, but not quite yet…”

• “Wait” symbol was then used in real buddy reading by both A. and her classmates, along with other visual supports…

@ Pat Mirenda, PhD., 11/05

Contingency Map: Waiting in Line

@ Pat Mirenda, PhD., 11/05

Del• 6-year-old boy with autism, good verbal skills, high need

for predictability and order

• Prob Behavs: screaming, crying yelling, self-injurious behavior

• Triggers: paper-and-pencil tasks in grade 1 and PE class on Thursdays in the gym (unpredictable, chaotic)

• Function: escape from difficult activities

• Impact: Del was socially isolated from his classmates because they were afraid of him

@ Pat Mirenda, PhD., 11/05

Intervention• Paper-and-pencil task: teach Del to ask for a short

break, as needed

• PE class: teach Del to ask the teacher for permission to sit and watch the class instead of participating, as needed

• Verbal explanations given regarding the new, “desired” behaviors before each relevant activity

• No changes in Del’s behavior

@ Pat Mirenda, PhD., 11/05

Contingency Map

@ Pat Mirenda, PhD., 11/05

Contingency Map: PE

@ Pat Mirenda, PhD., 11/05

Result

• Immediate and dramatic reduction in Del’s problem behavior as he began to use the new, desired behaviors

• Lasted throughout grade 1 and into grade 2• Del received the most votes when the class

was asked to choose who they wanted to sit next to for a new seating plan

We have the tools to develop...

A deep tool chest of intervention

strategies

For more information

email vkalashian@slvusd.org

mwolsen@monterey.k12.ca.us

Resources to Get Started

• Atwood, T. 2004. Exploring Feelings: Cognitive Behavior Therapy to Manage ANXIETY. Arlington, TX: Future Horizons.

• Atwood, T. 2004. Exploring Feelings: cognitive Behavior Therapy to Manage ANGER. Arlington, TX: Future Horizons.

• Baker, J.E. 2003. Social Skills Training for Children and Adolescents with Asperger Syndrome and Social-communication problems. Shawnee Mission, KS: Autism-Asperger Publishing.

• Baker, J.E., 2001. The Social Skills Picture Book: Teaching play, emotions and communication to children with autism. Arlington, TX: Future Horizons.

• Boardmaker Plus; Mayer-Johnson, Inc.; Solana Beach, CA; www.mayer-johnson.com

• Britton Reese, P., and Challenner, N., 2002. Autism & PDD: Social Skills Lessons. Primary.Intermediate and Adolescent. Moline, IL: LinguiSystems, Inc.

More Resources...

• Brown, K., & Mirenda, P. (2006). Contingency mapping: A novel visual support strategy as an adjunct to functional equivalence training. Journal of Positive Behavior Interventions.

• Elder, P., Crain, S. & Goossens’, C. (1999). Engineering the preschool environment for interactive symbolic communication. Birmingham, AL: Southeast Augmentative Communication Conference

• Erickson, K. & Casey, K. (1998). Literacy, Augmentative Communication & Children with Autism and/or Pervasive Developmental Disorders. AAC in the Mountains Conference. Park City, UT.

• Fullerton, A., Stratton, J., Coyne, P. and Gray, C. 1996. Higher Functioning Adolescents and Young Adults with Autism. Austin, TX: Pro-Ed.

• Gray, C. 2003. The New Social Story Book Illustrated. Arlington, TX: Future Horizons, Inc.

• Gray, C. & White, L. 2002. My Social Stories Book. London: Jessica Kingsley & Publishers.

• Gray, C. 1994. Comic Strip Conversations. Arlington, TX: Future Horizons, Inc.

• Gray, C. 1995. Teaching children with autism to “read” social situations. In K.A. Quill (Ed.). Teaching Children with Autism: Strategies to Enhance Communication and Socialization. New York: Delmar Publishers.

• Hodgdon, L.: Visual Strategies for Improving Communication.; Solving Behavioral Problems in Autism. QuirkRoberts Publishing.

• Ivey, M.L., Heflin, Juane, I., and Alberto P, 2004. The use of social stories to promote independent behaviors in novel events for children with PDD-NOS. Focus On Autism and Other Developmental Disabilities, 19, 164-176.

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• Rubin, E. & Laurent, A. 2002. Feelings Book. Communication Crossroads. www.commxroads.com

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• Winner-Garcia, M. 2008. Thinking About YOU Thinking About ME. Volume 2. San Jose, CA: Center for Social Thinking. www.socialthinking.com

• Winner-Garcia, M. 200 _. Think Social! A Social Thinking Curriculum for School-Age Students. San Jose, CA: Center for Social Thinking. www.socialthinking.com

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Web resources

• www.adaptedlearning.com

• www.aheadwithautism.com

• www.asperger.net

• www.aspergersyndrome.com

• www.autism-society.org

• www.CommXRoads.com

• www.do2learn.com

• www.portacom.bc.ca

• www.disabilitysolution.org

• www.news-2-you.com

• www.sandbox-learning.com

• www.socialthinking.com

• www.thegraycenter.com

• www.usevisualstrategies.com