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AUTISM
August 23,2011 1
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
What is Autism?
Autism is a neurological disorder. The common characteristics are social interaction deficit,
communication deficit, and behavior problems. Autism is a spectrum disorder that affects individuals
differently and in varying degrees. The spectrum includes Autistic Disorder, Childhood
Disintegrative Disorder, Asperger Disorder, Rett’s Disorder, and Pervasive Developmental Disorder—Not Otherwise Specified
Every district has students identified with Autism Spectrum Disorder.
Autism Spectrum Disorders can be easily confused with ADD/ADHD, Obsessive Compulsive Disorder , Oppositional Defiant Disorder, Tourette’s Syndrome, Intellectual Disability
August 23,2011 2
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
Autism Spectrum Disorder (ASD)
“Classic” Autism
Asperger’s Disorder
PDD-NOSPervasive Developmental Disorder—Not Otherwise Specified
August 23,2011 3
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
Autism Facts
Autism affects 1 in every 110 individuals (2010) It occurs before the age of 3 It is 4X more common in boys than girls Autism is found in all cultures, races, and social structures around
the world. Parents notice a change in their child’s development as early as
12 months and characteristics become obvious by 2-6 years of age.
ASD is the fastest growing developmental disability in the US Only 56% of students with ASD complete high school. No known single cause for ASD. It is generally accepted that it is
caused by abnormalities in brain structure or function. Researchers are investigating a link between heredity, genetics, and medical problems. Some children are born with susceptibility to ASD, but researchers have not yet identified a single “trigger”.
August 23,2011 4
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
Five behaviors identified by NICHD that signal further evaluation(National Institute of Child Health and Human Development)
August 23,2011
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants 5
• Does not babble or coo by 12 months
• Does not gesture (point, wave, grasp) by 12 months
• Does not say single words by 16 months
• Does not say two-word phrases on his or her own by 24 months
• Has any loss of any language or social skill at any age
Medical Diagnosis vs. Educational Identification
Medical Diagnosis-physician diagnosis based on assessment of symptoms, diagnostic tests, and DSM-IV-TR (2000)
Educational Identification-made by a multi-disciplinary team comprised of various school professionals and parents to determine whether a student qualifies for special education services under Individual Disabilities Education Act (IDEA) (2009)
August 23,2011
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants 6
A new case of autism is diagnosed
almost every 20 minutes
August 23,2011 7
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
Characteristics
August 23,2011 8
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
Characteristics of Autism Spectrum Disorders (ASD)
Communication deficits Repetitive patterns of behavior, interests, and
activities Social interaction deficits
Social maturity of someone 1/3 to 2/3 of their age (Asperger’s)
Behavior difficulties Sensory processing issues Emotional vulnerability Cognitive delays Motor skill deficits Difficulty generalizing skills
August 23,2011 9
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
Communication
Lack of development of speech or use of gestures—receptive and expressive skill deficits
Inability to initialize or sustain a conversation
Repetitive use of language—echolalic speech
Preoccupation and focus in areas of interest
Preoccupation with parts of objects Monotone speech
August 23,2011 10
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
COMMUNICATION ACTIVITY
August 23,2011
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants 11
Social
Lack of eye contact Prefer to play alone Lack of social reciprocity or empathy Lack of imitating social play Routines are important Lack of facial expressions
August 23,2011 12
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
Sensory
Sensitive reactions—more intense or lack of intensity than peers
Lack caution when playing, impulsive to meet sensory input needs, excitability
May seem uninterested, oblivious, unwilling to participate
Hyperactive, easily upset, withdrawn Unable to complete tasks due to new stimuli
capturing attention Difficulty learning from experiences May appear stubborn or self-absorbed
August 23,2011 13
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
Behaviors Exhibited
Must finish an interest activity before going to the next
Poor organization skills Handwriting tends to be difficult Engage in activities beside and not with peers or no
turn taking (reciprocity) Do not understand humor Literal thinkers—common expressions and idioms are
understood literally Impulsivity Meltdowns—rages, aggressive or self-abusive
behaviors, tantrums Transition is difficult—routines or environments
August 23,2011 14
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
Transition Examples
Home to bus Locker to class Class to first assignment Getting and organizing materials Between groupings (individual to peer
groups) Class to lunch Waiting Ending the day Bus to home
August 23,2011
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants 15
Meltdowns vs. Temper Tantrums
Meltdowns Temper Tantrums
Does not look to see reactions of others.
Looks to see reaction of others.
Does not consider his/her own safety.
Takes precautions not to get hurt.
Winds down slowly. Uses social situation.
No one is in control. Ends when the situation is resolved.
A want has not been permitted. Has purpose/goal.
August 23,2011 16
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
Meltdowns and/or Rages
Causes: Attention from peers or adults Frustration Confusion Power/control Sensory stimulation Fear or relief of fear To obtain something—activity,
interaction, comfort, routine, object
Expression of internal stimulation—sick, hungry, tired, too hot
Unstructured time Change of routine/lack of
schedule
August 23,2011
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants 17
Why the behavior?
Stress Excitement Fatigue Overstimulation To gain
attention To escape/avoid
To meet sensory needs
Does not understand
Self-esteem fears Need for control Need for
“sameness”Deb Reha LCNCK Presented by Deb
Reha and Deb Tipton, AIT ConsultantsAugust 23,2011 18
SENSORY ACTIVITY
August 23,2011
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants 19
If the only tool you have in your toolbox is a hammer, then everything looks like a nail. (So if we do not see the autism, we are treating all students the same. Each child has individual needs. Let’s explore the other tools in our toolboxes.)
August 23,2011 20
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
Interventions
August 23,2011 21
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
Visual-Organizational Support
Helps transition within and between activities
Helps understand expectations Prepares student for a change Lessens anxiety Helps students comprehend verbal
language Teaches independence
August 23,2011
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants 22
Visuals/Organization Examples Schedules Color code Models of expected outcomes Graphic organizers Consistent Classroom rules Examples of how to head the paper Homework assignment area in the room Work stations Sticky notes for preparing or calming a
student Example of correct finished products 5 point scale
August 23,2011 23
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
Five Point Scale Example
August 23,2011
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants 24
Classroom Examples
Class work Shorten assignments
Odds/evens Circle the ones you want them to complete Top/bottom half Allow the student to circle and do X number of
problems Highlight important or relevant points Graphic organizers Stopping and starting point on assignment
August 23,2011 25
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
More ideas
Extended time to complete Model expectations with visuals of the
difference between an A paper and a C paper Fill in the blank notes for lectures Incorporate their interests in assignments Allow them choices that you are comfortable
with Limit homework to daily in class work, an
extra study time, no homework To ease handwriting, use a computer or scribe
August 23,2011 26
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
ACTIVITY
August 23,2011
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants 27
GIQ
8
Priming
Priming—preparing the student before the activity by telling, showing with a visual schedule, or using a social narrative. Right before the activity The day before The period before The beginning of class
August 23,2011 28
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
Social Narratives-Power Cards
Social narratives and power cards use a student’s specific interest to engage the student. A story is written and illustrated with lots of visual pictures of what is acceptable behavior.
Examples Preventing behaviors Teaching a new skills Showing a change in schedule (e.g., field trip)
August 23,2011
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants 29
Power Card
Back of power cardThe contestants on Survivor think everyone should have fun playing games. They also want you to remember three things when playing games with other people:
Games should be fun for everyone. If you win a game, you can: Smile, give high
fives, or say, "Alright!" If you lose a game, you can: Take a deep breath
and say, "Good job" to the opponent or say, "Maybe next time."
August 23,2011
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants 30
Hidden Curriculum Hidden curriculum is the unwritten social rules
and expectations of social behavior that most students just seem to learn without direct instruction.
Examples Raising your hand to go to the restroom When to use utensils and when not to when
eating Don’t say everything you think (telling teacher
she is fat or breath stinks) For kids with ASD, these skills often need to be
taught directly through visual supports, examples, and role playing.
August 23,2011
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants 31
Safe Place/Sensory Breaks
Allow a safe place or frequent sensory breaks They choose when they need a break Short breaks Walking, eating, fidgets, reinforcement of
goals/behaviors Be alert for high anxiety levels or need
for breaks
August 23,2011 32
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
VIDEO
August 23,2011
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants 33
Other Helpful Hints
Use language that is clear and concrete Ask questions of who, where, when, what, instead of
why or how Use limited sarcasm, idioms, and inferences Tell the student what to do, instead of what not to
do Give the student processing time (10-15 seconds) Give directions and new information in small
segments, teaching each step separately Give praise often Pair verbal with visuals (pictures or gestures) Consistent routines
August 23,2011 34
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
More Helpful Hints
Understand that behavior is a form of communication and that a change is needed on our part.
Encourage peer mentoring Build on strengths and interests Be aware of student’s sensory needs and
concerns in all settings Do things “with” instead of “for” the
student Have high expectations. We get what we
expect!August 23,2011
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants 35
Still More Helpful Hints
Consider the physical environment (lighting, noise, temperature, color, smell)
Treat the student with the same respect you treat your other students
Empower the student to be an active participant in all classroom and social activities
August 23,2011
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants 36
August 23,2011 37
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
Assistive Technology
August 23,2011 38
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
Low to Mid Tech
Graph paper for math Pencil grips Mechanical pencils Highlighters Visual timers Air pillow/cushion Color code/paper Delineate work area Picture
schedules/communica-tion notebooks
Comic strips
Stress relievers Darkened rooms Chew toys Headphones Power cards Strategy cards Puppets Code words Social Narratives Weighted blanket Menu of reinforcers Graphic organizers
August 23,2011 39
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
Nothing good in life ever happens
quickly!
August 23,2011 40
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
Websites to Explore
http://www.usd333.com/vnews/display.v/SEC/Special%20Education/LCNCK%7CAutism Go to usd333 website-special education-autism
AIM Modules– http://www.ocali.org/aim/- The Ohio Center for Autism and Low Incidence (OCALI). The AIM project is developing online modules on ASD including characteristics, diagnosis, interventions and supports, transition, and employment.
Autism Speaks- http://www.autismspeaks.org offers good information and links to helpful resources for parents and teachers.
August 23,2011 41
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
More…
iCAN – http://www.autismnetwork.org – The Interactive Collaborative Autism Network site is for anyone who lives with, teaches, or otherwise supports children and youth with autism spectrum disorders, including parents, teachers, and individuals with ASD.
Kansas Autism Spectrum Disorders - http://www.kansasasd.com/KSASD/Home.html -The Kansas Instructional Support Network (KISN) is one of the Kansas Statewide Technical Assistance Resource System (K-STARS) projects funded through a Title VI-B grant from the Kansas State Department of Education’s Student Support Services. Contains many informational links and technical assistance to districts.
http://autismspectrum.illinoisstate.edu/courses/non-credit.shtml A 54 non credit contact hour course in autism. Basic level autism team training workshop
August 23,2011 42
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
Resources LCNCK Autism Intervention Team
Deb Reha, Coordinator Anna Berger-Washington Elementary Anita Breen-Concordia High School Sharon Hartman—Clifton/Clyde Middle School Lorri Meyer—Concordia Elementary Lori Stahlman—SLP Deb Tipton—SLP Shawn Woolsey-Option/Opt2
LCNCK website
August 23,2011 43
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants
AUTISM
August 23,2011
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants 44
A.. AlwaysU..UniqueT.. TotallyI.. InterestingS.. SometimesM.. Mysterious
Bibliography
www.kansasasd.org National Institute of Child Health and
Human Development www.autism-society.org
August 23,2011
Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT
Consultants 45