Transcript is for Asperger`s

“A” is for Asperger’s
(Autism Spectrum Disorder)
Understanding and Helping the
Student (previously diagnosed)
Asperger’s Disorder
AGENDA
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Basic Information-Characteristics
Thought Processes
Sensory Issues
Lens of Interpretation
Self-Regulation
Social Needs
Supports
GOALS FOR TODAY
• Understand the characteristics of
students with high functioning AU
• Gain ideas for helping students with
social skills
• Gain ideas for supporting students in
work and study skills
HISTORY OF ASPERGER’S
Asperger’s Syndrome (Disorder) was first described by
Hans Asperger, a Viennese physician, in 1944, when
he published a paper describing the behavior pattern of
several young boys, who, despite normal intelligence
and language development, displayed autistic-like
behaviors and marked deficiencies in social and
communication skills. It is a neurobiological disorder
that was added to the DSM IV in 1994, but has only
recently been recognized by professionals and
parents. Asperger’s is a Pervasive Developmental
Disorder, considered a part of the Autism spectrum. It
is mainly distinguished from Autistic Disorder because
there are no clinically significant delays in language.
DSM-5 Diagnosis
• Autism Spectrum Disorder
• Persistent deficits in social communication and
social interaction across multiple contexts, as
manifested by the following, currently or by history
» Deficits in social-emotional reciprocity
» Deficits in non-verbal communicative behaviors used
for social interaction
» Deficits in developing, maintaining, and
understanding relationships
DSM-5, Cont.
• Restricted, repetitive patterns of behavior,
interests, or activities, manifested by at least
2 of the following, currently or by history
» Stereotyped or repetitive motor movements, use of
objects, or speech
» Insistence on sameness, inflexible adherence to
routines, or ritualized patterns of verbal or nonverbal
behaviors
» Highly restricted, fixated interests that are abnormal
in intensity or focus
» Hyper- or hyporeactivity to sensory input or unusual
interest in sensory aspects of the environment
DSM-5, Cont.
• Symptoms must be present in the early
developmental period but may not fully manifest
until social demands exceed limited capacities, or
may be masked by learned behaviors later in life
• Symptoms cause clinically significant impairment
in social, occupational, or other important areas of
current functioning
• Not better explained by intellectual disabilities, or
global developmental delay
DSM-5, Cont.
• Severity must be specified based on social
communication and restricted, repetitive
behaviors:
• Level 3- Requiring very substantial support
• Level 2-Requiring substantial support
• Level 1- Requiring support
KEY FEATURES
Social Interaction
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Average to above average IQ
No verbal/performance split
Socially isolated
Tense with social demands
Difficulty reading social cues
Lack of friendship strategies
Immature and socially inappropriate
KEY FEATURES
Social Communication
• Language tends to be formal and pedantic or
stilted
• Voice may lack expression and may not read
vocal tones of others
• Difficulty using and interpreting non-verbal
communications
• Often understands things literally
• May fail to grasp implied meanings
• May tend to recite dialogue from movies, etc.
KEY FEATURES
Other Social and Motor Skills
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Often has an all-absorbing interest
Rigid-insists on certain routines, etc.
May be limited in ability to think and play creatively
Often has difficulty generalizing skills
Motoric clumsiness-awkward-may walk, run, and
move “funny”
• Organizational problems
• May find it hard to write or draw neatly
THOUGHT PROCESSES
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Think in concrete terms
Fails to understand metaphorical or abstract concepts
Takes figures of speech literally
Have difficulty in “thinking about thinking”-have a form of “mind
blindness”-and may have difficulty appreciating that others have
intentions, needs, desires,and beliefs that are different from
theirs
• Difficulty with predicting, reading intentions, understanding
emotions, explaining behaviors, reading and reacting to other’s
interests, understanding social interactions
• Susie, Johnny, and the tapping pencil
EXECUTIVE FUNCTION
• Executive functions are higher order thought
processes that allow us to plan, sequence,
initiate, and sustain our behavior towards some
goal, adjusting along the way by using feedback.
People with AU have difficulty with executive
function, especially with pre-planning, sustaining
effort, delaying action when necessary,
integrating information from various sources,
shifting attention from one task to another,
starting and stopping, and operating on multiple
levels.
SENSORY ISSUES
• One or more sensory systems are usually affected
such that ordinary sensations are felt as unbearably
intense
• The mere anticipation of a stimulus can lead to
anxiety or panic
• Most common-sound and touch
• Also can be taste, light intensity, colors and smells
• Approximately 40% of people with autism spectrum
disorders have some abnormality of sensory
sensitivity
BEHAVIOR
THE LENS OF INTERPRETATION
• All behavior serves a purpose
• It is functional or intended to be
• It is necessary to understand the function of the
behavior-from the viewpoint of the child
• The point of view of a student with AU will lead them
to interpret things differently from the “normal” point
of view
• In order to impact behaviors, we must look at things
through an Autistic lens and determine the function of
the behavior and find another way to meet that need
HOW TO HELP
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Identify the signs of overload
Identify situations that are problematic
Identify current strategies
Identify environmental factors and
modifications
• Teach students how to read sensations
and behaviors and how to manage
WHAT TO DO
Communication and environment
• Reduce distractions
• Give instructions in most efficient sensory
channel
• Provide auditory frames
• Provide visual frames
• Use graphic organizers
• Use “Low and Slow”
• Use cognitive portfolios (visual, stepwise
procedures) to remind students of strategies and
behaviors
• Use timers or visual cuing for changes in activity
WHAT TO DO
Activity level and arousal management
• Slow, rhythmic activities-deep breathing, walking,
music,pressure-ask the student what works
• Tolerate reasonable levels of movement
• Provide frequent motor breaks
• Engage everyone in motor breaks-wall push-ups,
stretching, deep breathing
• Walk and talk
• Allow student to stand while working or talking
• Teach allowable movement strategies
WHAT TO DO
Emotional and Social Support
• Teach 5 part approach-remember Low and Slow
• Help the student to interpret social situationsutilize rehearsals
• Use SOCCSS
• Use Social Autopsies
• Use Social Stories
• Use cognitive portfolios/social scripts
• Use Social Skills instruction-be blunt!
SOCIAL SUPPORTS
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SOCCSS
Social Scripts and Stories
Social Autopsies
Cue cards
Direct Social Skills Instruction
Social “clues”
Cue Cards
Conversations
Social-Emotional Cues
• Cues to calm down
SOCCSS
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Situation
Options
Consequences
Choices
Strategy
Simulation
SOCIAL SCRIPTS
• Helping the child structure the
behavior by working with the student
to design a script of what to do and
say in a specific situation.
• For example, a child and her teacher
may design a script for joining in
with a group who is playing at
recess.
Social Script-Ask a Friend to Play
• Script
SOCIAL STORIES
• A social story is a story that
describes social situations
specific to individuals and
situations. A social story is
written for a specific child
and a specific situation.
A SOCIAL STORY
My name is Jane. I go to Cook School. At lunch time,
everyone in my class goes to the lunchroom. We go through
a line and get a tray, then sit at tables to eat. I do not like the
lunchroom-it is noisy and crowded, and my ears hurt. My
teacher Mrs. Smith tells me that I have to eat there every
day. She helps me find ways to make it easier. First, Mrs.
Smith showed me that putting in my earplugs helps with the
noise. They are small and no one can see them. Every day,
I go to the restroom before lunch and put them in, then take
them out after lunch. She also lets me be the line leader or
the caboose. That helps me feel less crowded. The best
part is, lunch is short! I know by looking at my watch when it
will end, and I tell myself that I will be fine until then.
SOCIAL AUTOPSIES
• Debriefing a social error in order to
determine:
• The cause of the error
• The damage done by the error
• How to prevent the error from
happening again
SOCIAL SKILLS INSTRUCTION
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Conversational skills-exchanges
Cooperative Play Skills
Relationship Skills
Classroom Skills
Maximize by:
• Instruction and Interpretation
• Coaching-generalization
POSITIVE SUPPORTS
• Priming-previews activities where
student is likely to have troublevideo on priming- http://gizmodo.com/5980749/this-is-howyour-brain-works
• Home base-at end of day or after
stressful subjects
• Safe person/safe place
• Transitions-routines,
warnings,activities,signals, buddies
Visual Cuing in the Classroom
• Line up cue
Visual Cuing in the Classroom
• Visual Cuing in the Classroom
MODIFICATIONS
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Highlight texts
Sample problems worked out as guide
Directions individually
One direction at a time
Cue cards
Graphic organizers
Cognitive portfolios for steps
MORE SUPPORTS
• Provide information visually-written
directions, schedule
• Preferential seating-near compliant
peers, away from bullies, away from
high traffic
• Assistance with organization-picture
cues (take a picture of a clean desk,
organized locker, etc.)
Visual Schedules
• Morning Routine
Visual Schedules
• Portable schedule
Visual Schedule
• Classroom Schedule
Visual Schedule
• Full Day Home Routines
RESOURCES
• Asperger’s Syndrome: A Guide for Parents and
Professionals by Tony Attwood
• Asperger Syndrome and Adolescence by Teresa Bolick
• Asperger’s Syndrome and Difficult Moments by Myles and
Southwick
• Asperger Syndrome-Practical Strategies for the Classroom
by Leicester City Council and Leicester County Council
• Freaks, Geeks and Asperger Syndrome by Luke Jackson
• Power Cards by Elisa Gangnon
• Navigating the Social World by McAfee
• Pretending to be Normal by LeeAnn Holiday-Wiley
• The Incredible 5 Point Scale by Buron and Curtis
Resources
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www.fraser.org
www.autismspeaks.org
www.autismschedules.com
http://kidscandream.webs.com/page12.htm
(many ideas and social stories-not professional)