Transcript Autism Awareness: Early Signs & Interventions

Autism 101:
Basics, Strategies, &
Questions
Molly Henrickson
[email protected]
Autism Consultant
January 18, 2010
Schedule of the Hour
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What’s a spectrum?
Incidence
Causation
Signs/Characteristics
Strategies
Questions
Autism Spectrum
Disorders
Pervasive Developmental
Disorders
Asperger’s Syndrome
Autism
Pervasive Developmental
Disorder – Not
Otherwise Specified
Rett’s Syndrome
Childhood
Disintegrative
Disorder
What differentiates?
•Number of characteristics
•Age of onset
•Genetic factors
•Pattern of behaviors
•A certain diagnosis does not mean a “lesser” set of concerns, this
does not address severity of any behavior.
Spectrums of Ability
Language/
Communication
Perception/ Sensory
Regulation
Response to Stress
Social/Emotional
Intellectual Abilities/
Achievement
Rigidity/Inflexibility
Incidence
Incidence
• National Institute of
Child Health and Human
Services
– 1 in 1,000 “Classic” Autism
– 1 in 500 within spectrum,
including PDD-NOS
– 1 in 200 within autism
spectrum, including PDD-NOS
and Asperger’s Syndrome
• More common than
cystic fibrosis, multiple
sclerosis, and childhood
cancers
• Males 4:1 Females
Autism Spectrum Disorders
in Minnesota (Birth – 21 years)
Why the Increase?
• Olmsted County findings – Mayo Clinic –
Dr. Barbaresi
– Better awareness
– Better identification
– Broader definition
• Olmsted County
– 1980-1983 – 5.5 cases per 100,000 children
– 1995-1997 – 44.9 cases per 100,000 children
Causation
Theories of Causation
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“Refrigerator” Parents
Diet related - GF/CF diets
MMR Vaccines
Environmental factors
Neurological/Genetic
– Eye gaze studies
– Genetic – 5-10 genes involved
– Additive effects
Common Co-Morbid
Conditions
• Attention Deficit Disorder (ADD)
with or without hyperactivity
• Anxiety disorders
• Depression
• Bi-Polar Disorders
• Obsessive-Compulsive Disorders
• Tourette’s Syndrome
Characteristics or
Warning Signs
Autism: Hidden Epidemic
ASD students are not all
alike
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“Typical” ASD symptoms are present in everyone
at some time
“Typical” ASD symptoms are manifested in ways
specific to each individual
No exact recipe for approaches
Broad suggestions or strategies may help but
remember we cannot “cure” or “fix” kids with
ASD, but provide them with tools and strategies
to help them cope with the world.
Remember the Individual
• You know one student
with Autism, and you
know one student.
• Many of our students
have additional
diagnoses or needs
– Emotional and/or
behavioral needs
– Academic strengths
and/or weaknesses
– Medical conditions
Impairments in Social
Interaction
Difficulty making eye contact
Difficulty relating to others
Indifference to others
Extreme distress for no apparent
reason
Rule of Thumb:
“Social/Emotional”
age is 2/3 of
chronological age
Impairments in
Communication
Inappropriate
laughter or
giggling
Behaves as if
deaf OR
hypersensitive
Echolalia
(Immediate &
Delayed)
Indicates needs
by gestures, OR
does not use
gestures
Communication?
• “Do you want to play with blocks, or
links?”
– “I have a red door.”
• “What did you do last night?”
– “I went to bed at 8:15.”
• “That’s my favorite picture.”
– “I thought Super Frog was your
favorite.”
Restricted, Repetitive Behaviors
Inappropriate
attachment to certain
objects
Fascinated by spinning
objects or other selfstimulatory behaviors
Resists changes in
routine
Preoccupied by
obsessive games or
topics
Seemingly insensitive
to pain
Inconsistent
gross/fine motor
Prefers to be alone
Resists cuddling
(sometimes)
Common Misconceptions
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Savant skills
Eye contact
Physical contact
Nonverbal
Have a friend
Neurotypical Child
Development
• 4 months = warm and engaging to familiar
adults
• 9-12 months = joint attention
• 9 months = more complex babbling
• 12-14 months = first words
• 18 months = point, gesture, showing
• 18 months = begin some pretending
• 24 months = imaginative play
Red Flags
• No big smiles or other warm, joyful expression by
6 months
• No back and forth sharing of sounds, smiles, or
other facial expressions by 9 months or
thereafter
• No babbling by 12 months
• No back and forth gestures, such as pointing,
showing, reaching, or waving by 12 months
• No words by 16 months
• No two-word meaningful phrases (without
imitation or repeating) by 24 months
• ANY loss of speech or babbling or social skills at
ANY age
Very Early Signs – Social
Cognition (Neurology of
Socialization)
• Geraldine Dawson – First Birthday Videos
– More than 90% can predict at 1 year old for later ASD
diagnosis
• Eye contact, pointing, showing objects, turns to name
• Dawson – Face Recognition
– 6 month olds have different brain activity when looking at
mother’s face versus that of a stranger
– Brain activity not present in ASD even at 3-4 yrs
– ASD children did show a brain activity change when shown a
familiar toy
• Addicted to faces
• Can take an infant with you on an emotional “trip”
Strategies
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Visual Cues
Schedules
If/Then
First/Next
Social Stories
• Strategies can be
used with ALL
students.
Being Colorblind in a red/green world!
“Suppose you are colorblind, and cannot distinguish
between red and green. You are in a room with other
people, all of whom have normal vision. No one - not
even you - knows that you are colorblind. Everyone is
handed a list of instructions. They are printed in red
against a green background. Everyone except you
knows exactly what to do. They cannot understand why
you just sit there. The paper looks blank to you, and you
cannot understand how the others know what to do.
Think of how you would feel.”
What Can We Do?
• Include them in
activities
• Provide structure
• Teach to play (“Do
this”)
• Guide interactions
(“You can say ___”)
• Let know of
expectations (what
TO do)
Visual Cues
• Why needed?
– Processing speed is
often slower
– Language processing is
quite difficult
– Much of our language
is vague
– Decreases dependence
– easier to fade
• Why does it work?
– Visual, not auditory
– Static, doesn’t change
– Takes some social
interaction out
– Tell what to do, not
what not to do
– Can give expectations
3 Point Scale
3 Loud
Outside
Bikes
2 Talking
Lunch
Playing
1 Quiet
Naptime
Book time
Visual Cues
Volume Meter
Fidgets
Other Easy Visuals:
• Writing down daily
schedule
• Writing out visually
homework on board
• Starring changes in
the schedule with
different color
marker and
discussing them
with your class
• Giving an example
of what a map
should look likethen getting back
• Visually displaying
classroom
expectations
regardless if
inferred or not
along with district
Examples of Physical
Structure
Great Ideas to Share!
If/Then
• Helps to teach
consequence
• Can be positive or
negative
• Proactive strategy
Schedules
• Why needed?
– Unable to read social
cues
– Provides information
about expectations –
what is going to
happen
• Why does it work?
– Decreases anxiety
– Lets know who, what,
when, etc.
– Pre-warns of changes
– Often decreases
refusal & increase
motivation
First/Next
• Beginning schedule
• Teaches order and
expectations
• Helps to decrease
anxiety
General Rules – Dealing with
Upset Students
• Talk less
• Talk softer
• Use simpler
language
• Use visual cues
• Write a note back
and forth
• Comic Strip
conversation
• wait
Social Stories
• Why needed?
– Misunderstand social rules
and expectations
– Unable to read nonverbals
– Unsure of what to do in
different situations nerves
• Why it works?
– Points out key information
– Addresses the hidden
curriculum
– Decreases anxiety
– Visual
– Teaches social
understanding, not
compliance (not a list of
rules)
How to Use Social
Stories
• Can be done to prepare a student for an
upcoming event (decrease anxiety)
• Can be prepared to teach a new skill
• Can be read after a incident occurred that
was challenging for the student
Nose Picking
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Sometimes my nose itches or I
have boogies in my nose.
I will try not to pick my nose.
People don’t like it when I pick my
nose.
Picking my nose can spread germs
and make people sick.
I will try to remember to use a
Kleenex.
Teachers may remind me to use a
Kleenex.
If I don’t remember, I may need
to wash my hands.
Calendar Time
• At calendar, we sit down and talk about
the weather.
• The teacher points to the calendar.
• We talk about the weather.
• We talk about what we’re going to do
today.
• I need to talk in this group.
• It helps the teacher know that I’m
listening.
• This can make calendar more fun.
Autism: Being Friends
Questions?