Temple Grandin Autism and my sensory based world[1].pdf

7/29/2019 Temple Grandin Autism and my sensory based world[1].pdf

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Autism and My SensoryBased World 3rd Edition

Temple Grandin


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A good teacher is gently insistent

Early intervention essential

Minimum 20 hours weekly of

one-to-one teaching


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A child has to be pushed to keeplearning new skills

Pushing too hard causes sensoryoverload and no progress

Never have sudden surprises. Thiscauses fright and tantrums

Adults and teenagers must also bepushed to try new things and keeplearning


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Sensory processing disorder occurs

with many other disorders (co-morbid)

Autism spectrum

Dyslexia

Learning problems

ADHD

Asperger

Head injury

Oppositional defiant

Many others


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Sounds are better tolerated whenthe child initiates them.

Little Rainman by Karen Simmons

Child blocks ears because

certain sounds hurt


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Auditory Threshold NormalHearing auditory detail is impaired

Stretch out and enunciateconsonants

Hearing may be like a bad mobilephone connection

Occurs with many disorders

Hearing may fade in and outlike a poor mobile phone

connection

Echolalia increases as receptive

language becomes worse.J acqueline Roberts, 1997


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Attention shifting slownessoccurs with many disorders

Takes longer to shift back

and forth betweentwo different things


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Ami Klin

Viewer with Autism (Red Line)

Normal Comparison Viewer(Yellow Line)


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Oliver Sacks

Visual images break up

and fragment


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Signs of Visual Processing Problems

Finger flicking near eyes

Tilts head when looking at things

Hates escalators

Hates fluorescent lights andsees flicker

Difficulty catching a ball

Eye exams may be normal


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Words vibrate and jiggle on page


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Interventions for Visual Processing Problems

Incandescent lamp by desk

Block fluorescent lights with a hat

Laptop or tablet computer

Gray, tan, or pastel paper

Irlen lenses or pale colored glasses

Balancing games - sit on ball

Prismglasses - Developmental Optometrist


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Severe Sensory ProblemsExtreme effort required to screen out

background noise and visual distractionsNeeds frequent breaks to prevent sensoryoverload

Mono-channel

Body boundary problems

Often an auditory thinker


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Best Books to Understand

Severe Sensory Problems

How Can I Talk if my Lips Dont Move

by Tito Rajarish Muhopadhyay*

Carlys Voice by Arthur Fleischmannwith Carly Fleischmann*

* Nonverbal and types independently


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What Have Scientists Learned?

Sensory problems are real

Immature lower brain areas

Abnormal circuits betweendifferent brain regions

Sensory problems are variable

Many word based tasks are processedin visual areas of the brain

Frontal cortex is used less because it

has missing circuits Eric Courchesne, Nancy Minshew, MargaretBauman


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Heller, W., and Nitsch, J .B. 1997, Cognition and Emotion, 11:637-661.


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Structural MRI Connection

s


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HighDefinitionFiberTracksofTempleGrandin


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Temple Grandin Normal Age MatchedSubject

Axon Projection Field Much Less Organized


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Visual

Representation

Speech

Production


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Auditory

Walt Schneider, Univ. of Pittsburgh


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Miller et al., 1998 Neurology, 51:978-981


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Develop the Childs Strengths


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My mind works like

Google for Images



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Sensory thinkers sort specific

pictures, sounds, touches, andsmells into categories


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I realized my thinking

was different when Iasked other people to

think about churchsteeples


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Most people see intheir imagination a

generalized genericsteeple


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I see only specific pictures of

steeples I have observed.

They flash into my memory like aseries of still Googled pictures


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My childhood church

First category under steeples


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Local churches in Fort Collins

Secondary category under steeples

Famo s Steeples


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Famous Steeples

Mormon Temple, Washington, D.C.Third category under steeples


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Famous Steeples

Old North Church - BostonThird category under steeples

F St l


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Famous Steeples

Notre DameThird category under steeples


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Famous Steeples

Westminster Abbey


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Brain Scans

T. GrandinControl

Humphreys, Minshew, Behrmann, and Cibu, 2006


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Brain Scans

T. Grandin Control



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Abnormalities in Left

Hemisphere

University of Utah, 2010

D l T l t i th


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Develop Talents in the

Individuals Specialist Brain1. Photo Realistic Visual Thinking Poor at algebra

2. Pattern Thinker Music and Math Poor in reading

3. Verbal Facts Language Translation Poor at drawing

4. Auditory Thinker Visual perception fragmented

There can be mixtures of these thinking types

T C t i f


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Two Categories of

Mathematicians

Algebraistsa2 + b2 = c2

Geometers See this figure

Masha Gessen Perfect Rigor, 2009


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Robert Lang, 2006

H d A ti iti T ht


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Hands-on Activities Taught

Practical Problem Solving Skills


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All my thinking uses specificexamples to create concepts

It is bottom up thinking and nottop down thinking

I learned ALL concepts using

specific examples


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Play games with categorizing many objects to

learn concepts such as color, shape, bigger than,smaller than, clothing, food, etc.

Details are Attended to


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Details are Attended to

Instead of Whole Gestalts

Autism faster response time to small letters Attend to details of faces instead of the whole

Behrmann et al., Neuropsychologia 2005


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Is autistic learning just memorization? It ismemorization and scripting, but as more

information is memorized, it can be assembledinto more and more categories which will help

thinking to become more flexible.

Teach Number Concept


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Teach Number Concept

GeneralizationCount a variety of different kinds of objects

Addition and Subtraction - Teach with manyobjects

Fractions Teach by cutting up fruit and papercircles

Teach Word Concepts


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Teach Word Concepts

with Specific Examples

Walk down the stairs

A plane goes down and lands

Put a cup down

Lie down on the bed

Objects are More Interesting than Faces


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Objects are More Interesting than Faces

T. Grandin Control

Blue = objects Red = faces


Social Interaction Through


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Social Interaction Through

Shared Interests

School Clubs

Organizations such as Scouting

Hobbies

Careers

Classes that really interestan individual


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Categorize Behavior ProblemsIs it biological?

Sensory over sensitivity

Hidden painful medical problem

Is it behavioral?

Frustration because cannot communicate

Get attention Escape from a task

Sensory and Neurological Problems


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Sensory and Neurological Problems

That May Need Accommodations

Screams when the fire alarm rings

Tantrums in a supermarket

Cannot tolerate scratchy clothes

Poor handwriting

Tantrums or hyperactive under fluorescent lights

Difficulty multitasking

Difficulty with long verbal directions provide writtendirections

My 1950s upbringing taught me many important


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My 1950 s upbringing taught me many important

social and job skil ls. Everything was learned bycategorizing specific examples into these

concepts:

Turn taking in conversation and activities such asboard games

Being on time

Doing family activities I disliked

Doing things that pleased other people

Saying please and thank you

Social mistakes were instantly corrected by telling mewhat to do

Bad Behavior Was Not


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Bad Behavior Was Not

Tolerated When I was a Child

Being rude

Bad table manners

Manipulating a teacher by having a tantrum constantrules at both home and school

Poor grooming and sloppy clothes

Laughing at an overweight woman

Swearing


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Teach Social Skills in the Community

Shaking hands

Eye contact when meeting people

Ordering food in restaurants

Table manners

Shopping Talking to store staff

Kids doing projects and playing


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Kids doing projects and playing

games where the rules andduties are negotiated teaches

valuable social skills

Eccentric is acceptable; being


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Eccentric is acceptable; being

dirty and rude is not.

Do not try to de-geek the geek!

NASA Space Scientist Cries


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NASA Space Scientist Cries

When the Shuttle Was Cancelled

Its ok for Geeks to cry!


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Rule System

1. Really bad things2. Courtesy rules

3. Illegal, but not bad

4. Sins of the system

Hidden Painful Medical Problems in

N V b l I di id l Th t C


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Non-Verbal Individuals That Can

Cause SEVERE Behavior Problems

Acid Reflux heartburn (most common). Not

always obvious.

Constipation

Urinary tract infection

Yeast infection

Ear infectionBad tooth

H pylori (stomach, ulcer bug)


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The squeezemachine helped

reduce anxiety

and panic

attacks


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Fear is the main emotion

in Autism. My amygdala(fear center) is three

times larger.

University of Utah, 2010


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Using pressure to calm the nervous


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system during therapy

Sometimes speech is easier


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when the child is swinging

Sitting on a ball and wearing a weighted vest

helps concentration Use for 20 minutes


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helps concentration. Use for 20 minutes

then take off for 20 minutes.

It is important to desensitize touch


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p

sensitive autistic children so thatthey will enjoy affection. Feeling the

good feelings of being held helps todevelop feelings of kindness.


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Preparing for Employment

1. J obs for teenagers2. Mentors3. Visit work place

4. Trade journals5. Wall Street J ournal

Make portfolio - people respect talent6. Sell your skill, not yourself

I was a poor student but I learned lots of


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valuable work skills in high school. I didbuilding projects that other people appreciated

Before After

Jobs for Middle School


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and High School KidsWalking dogs

Maintaining computers

Making PowerPoint presentations

Selling artwork or crafts

Working on church or neighborhoodwebsite

Working in a farmers market


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People Were Impressed


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With My Drawings

My Design in


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Google SketchUp

Search for sketchup spectrum

Educational Resources


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Community Colleges

Technical Schools On-line Learning

University Courses


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Science WebsitesU.S. National Science Digital Library Project

Khanacademy.org

Udacity.com

Free courses Stanford and MIT

Physics Education Technology PhET

Open Course Ware Consortium

Wolfram Mathematica

Show Kids Interesting Things


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The Guys Have Fun with


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Stuffy the Mechanical Cowon the HBO Movie Site


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Avoid InterviewsFind the Back Door


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I was wearing my portfolio.People respect ability.

Jobs for Visual Thinkers


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Industrial design Computer network specialist

Graphic arts Drafting Auto mechanic Computer repair Handcrafts Convention AV technician Photographer Animal trainer Architect Veterinary technician

Jobs for Music and


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Math ThinkersMath teacher

Scientific researcherElectronics technician

Music teacherChemist

Computer programmerEngineer

PhysicistMusician/composerStatistician

Jobs for Verbal Thinkers


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Stocks and bonds analystJ ournalistTranslatorLibrarianCopy editorAccountant

Specialty RetailBookkeeper & record keeperBudget analyst

Special education teacherBook indexerSpeech therapist

Inventory controlspecialistLegal researcherStage actor

Bad Jobs for People with Autism


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Require lots of short term working memory

and fast processing information

My working memory is terrible

Cannot remember more than three steps

Cashier in a busy restaurant would be verydifficult

Jobs for People with Poor

V b l Skill N V b l


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Verbal Skills or Non-VerbalShelve Library Books

Factory Assembly Work

Fast Food Restaurant Work

Data Entry

Lawn and Garden Work

Recycling Plant/Warehouse

Stocking Shelves

Inventory Control

Handcrafts

Evaluation of Treatments


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Risk versus Benefit

Cost versus Benefit

Evidence of Effectiveness

SSRIS AntidepressantsW k ll ll f i t d i tt k


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Work really well for anxiety and panic attacks

Prozac (fluoxetine)

Zoloft (sertraline)

Celexa (citalopram)

Lexapro (escitalopram)

Paxil (paroxetine)

Atypical Anti-Psychotics

May have severe side effects


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May have severe side effects

Risperdal (rhisperdone)

Geodon (ziprasidone)

Zyprexa (olanzapine)

Abilify (aripiprazole)

Seroquel (quetiapine)

Low Dose Principle


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Some individuals on the autism spectrumneed only to of the normal starting

dose of drugs in these 3 classes:

SSRI Antidepressants

Tricyclic AntidepressantsAtypical Antipsychotics

Too much causes insomnia, agitation and irritability. Otherdrugs usually require normal doses. If used in smallchildren, micro doses 1/10 of mg of Rispordal.

Principles of Using Medication


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Try one thing at a time

A medication should have an obvious beneficialeffect

Withdraw a medication slowly, if a person hasbeen on it a long time

Be careful switching brands

Dontexpect 100% control of a symptom

Blood Pressure Medications ReduceA i t d A U d Sl Aid


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Blood Pressure Medications ReduceAnxiety and Are Used as Sleep Aids

Much Safer than Atypicals

Beta blocker propranololClonidine

Anti-Convulsant Drugs for

Aggression and Mood


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Aggression and MoodStabilization

Depakote

Lamitel (lamotrigine)Topamax (topiramate)

ADHD Drugs and Autism


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Stimulants tend to make classicalautism worse

Stimulants sometimes helpindividuals with mild Aspergers

Look Up All Drug


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Look Up All DrugInteractions

Prescription drugs

Non-prescription drugs

Herbal supplements

Special diets work for some individuals


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Vitamins and supplements B6 andMagnesium

Vigorous exercise for calming

Weighted blanket or vest for calming

Omega 3 supplements help the brain

Poor diet more depression

Traits in Close Relatives

F G ti f B k


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Four Generations of Bankers

MIT-Trained Engineer/Co-Inventor Auto Pilot

Anxiety

Depression

Visual Thinking Skills Artist, Home Decorators

Food Allergies

Intellectual Giftedness Writing English Literature

Asperger Traits

Ei t i


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Einstein

had many

autistictraits


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Autism.org

800 3 AUTISM


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800-3-AUTISM

grandin.com

Future Horizonshttp://www.fhautism.com/

Autism Asperger Publishing

Books by Temple Grandin


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Thinking in Pictures

Developing TalentsAnimals in Translation

Unwritten Social Rules

Emergence Labeled AutisticThe Way I See It, 2nd Edition

Animals Make Us Human

Documents

Temple Grandin Autism and my sensory based world[1].pdf