Transcript Preparing Youth with ASD for Transition Presentation

Preparing Youth with ASD
for Adulthood
Phyllis Coyne
YTP Regional Training
NWRESD
November 1, 2011
About Autism Spectrum Disorder (ASD)
Pervasive neurodevelopmental disorder–
Neuro-anatomical and MRI studies reveal
differences in the brain.
1 : 110 (CDC, 2011)
70%: Average or above average
intelligence
Likely many causes – genes, medical
conditions, environmental factors
4 : 1 (boys : girls)
What Are the Current Defining
Characteristics of ASD?
Medical Diagnosis (DSM IV R): 3 characteristic
domains (social deficits, communication deficits and
restricted & repetitive patterns of behavior, interests
and activities)– clinician decides
Educational eligibility (OARs): 4 characteristic
domains (social interaction impairments,
communication impairments, restricted, repetitive &
stereotyped patterns of behavior, interests and
activities, unusual response to sensory information)–
educational team decides
Current 3 Main Types of ASD
Autistic Disorder (Kanner's or classic): delayed or lack
of development of verbal language; may have normal
intelligence (e.g., Rain Man or Temple Grandin)
Asperger's disorder: Normal development of verbal
language and normal intelligence
Pervasive Developmental Disorder- Not Otherwise
Specified (PDD-NOS). Don’t show all the
characteristics.
Proposed DSM V Revision for
Autism Spectrum Disorder
2 Characteristic Domains
1. Persistent deficits in social communication and social
interaction across contexts, not accounted for by general
developmental delays. Includes all 3 of the following:
a. Deficits in social-emotional reciprocity.
b. Deficits in nonverbal communicative behaviors used for
social interaction.
c. Deficits in developing and maintaining relationships,
appropriate to developmental level.
Proposed DSM V revisions continued
2. Restricted, repetitive patterns of behavior, interests, or activities.
Includes at least two of the following:
a. Stereotyped or repetitive speech, motor movements, or use of
objects.
b. Excessive adherence to routines, ritualized patterns of verbal or
nonverbal behavior, or excessive resistance to change.
c. Highly restricted, fixated interests that are abnormal in intensity
or focus.
d. Hyper-or hypo-reactivity to sensory input or unusual interest in
sensory aspects of environment.
Proposed DSM V revisions continued
Symptoms must be present in early childhood
(but may not become fully manifest until social
demands exceed limited capacities)
Symptoms together limit and impair everyday
functioning.
Proposed severity scale for two characteristic
domain to indicate level of support needed.
Challenges in Social Communication and
Social Interaction
a. Deficits in social-emotional reciprocity: ranges from
abnormal social approach and failure of normal back
and forth conversation through reduced sharing of
interests, emotions, and affect and response to total
lack of initiation of social interaction.
b. Deficits in nonverbal communicative behaviors used for
social interaction: ranges from poorly integrated verbal
and nonverbal communication through abnormalities
in eye contact and body-language, or deficits in
understanding and use of nonverbal communication,
to total lack of facial expression or gestures.
Social/Communication Challenges
continued
c. Deficits in developing and maintaining relationships,
appropriate to developmental level (beyond those with
caregivers): ranges from difficulties adjusting behavior
to suit different social contexts through difficulties in
sharing imaginative play and in making friends to an
apparent absence of interest in people.
Which is a balanced conversation?
Restricted, repetitive patterns of
behavior, interests, or activities
a.
Stereotyped or repetitive speech, motor
movements, or use of objects: simple motor
stereotypies, echolalia, repetitive use of objects, or
idiosyncratic phrases.
b. Excessive adherence to routines, ritualized patterns
of verbal or nonverbal behavior, or excessive
resistance to change: motoric rituals, insistence on
same route or food, repetitive questioning or
extreme distress at small changes.
Restricted/repetitive patterns continued
c. Highly restricted, fixated interests that are abnormal
in intensity or focus: strong attachment to or
preoccupation with unusual objects, excessively
circumscribed or perseverative interests.
d. Hyper-or hypo-reactivity to sensory input or unusual
interest in sensory aspects of environment: apparent
indifference to pain/heat/cold, adverse response to
specific sounds or textures, excessive smelling or
touching of objects, fascination with lights or
spinning objects.
Strengths of Youth with ASD
Systemizing-- analyze or build systems in order to understand
and predict; order things
Specific interests
Hyperattention to detail
Preference for sameness
Concentration
Strong memory for what seen & in area(s) of interest
Accuracy in visual perception
Unique talents and perspectives
Adolescence in ASD
• Great range in development: improve to deteriorate in
behavior, rigidity, and skills
• Majority similar and subtler pattern of persistent
problems in socialization, communication, interests,
sensory reactions, and organization
• 40% have psychiatric symptoms: increased mood
disorders, depression and anxiety
• Onset of seizures, especially for individuals with an
intellectual disability or marked developmental regression.
Why a Toolkit?
92% of adults with ASD not employed or engaged in
education/vocational training, and did not live independently
(Billstedt, Gillberg & Gillberg, 2005).
ODE/ARRA funding for materials for ASD & secondary
transition
Three most important topics for staff training and/or
resources for staff from 2010 survey:
1) How to prepare students with ASD for adulthood
2) How to provide effective transition services
3) How to provide instruction in non-academic areas
Content of Toolkit
Three main units:
Unit 1: Transition Planning and Services for
Youth with ASD
Unit 2: Supports for Transition Services and
Activities
Unit 3: The Expanded Core Curriculum for
Youth with ASD
8 Interrelated Units of ECC
Based in part on Recommendations from Oregon Commission on
ASD’s Education Revision & InteragencyTransition Subcommittees
Unit 3.1: Communication Skills
Unit 3.2: Social Skills
Unit 3.3: Executive Function/Organization Skills
Unit 3.4: Sensory Self-regulation
Unit 3.5: Self-Determination
Unit 3.6: Employment
Unit 3.7: Postsecondary Education
Unit 3.8: Independent Living and Community Participation
Where can I learn more about ECC?
• Columbia Regional Program’s ASD and Transition
webpage-http://www.crporegon.com/content/secondarytransition-project-asd
• Includes Preparing Youth with ASD for Adulthood: An
Educator’s Toolkit, Putting Feet on My Dreams Self
Determination Curriculum, Manual for Adolescents
with Asperger's Piloting Social Success (MAAPSS), Higher
Functioning Adolescents and Young Adults with Autism: A
Teacher’s Guide and more.
Let’s Look at Web page
Secondary Transition Project for ASD
How to Use Toolkit
Bookmark
http://www.crporegon.com/content/secondarytransition-project-asd
Read introduction
Get familiar with how units are organized
Go to and return to units as you need information
and tools
Explore Unit 3 at a minimum before Units 3.1 – 3.8.
Be prepared to work around broken links
What is in Most Units of Toolkit?
Free, accessible practical information & tools
Links to free guidebooks or comprehensive information on the topic of the
unit
Sample list for different grade levels
Assessment tools and/or links to
Lesson plans and/or links to “how to” tools
Links to websites with “how to” videos
List of practical books available on loan
List of online and/or local training
Glossary of terms
Let’s See What a Unit Looks Like
Sample Unit
Unit 3.6: Employment
What Are the Evidence Based Strategies
for Youth with ASD?
•
Response Interruption/Redirection
•
Self-Management
•
Social Narratives
•
Speech Generating Devices/VOCA
•
Structured Work Systems
Functional Communication
Training
•
Task Analysis
•
Naturalistic Intervention
•
Time Delay
•
Peer-Mediated Intervention
•
Video Modeling
•
Prompting
•
Visual Supports
•
Reinforcement
•
•
•
•
•
Antecedent-Based Interventions
(ABI)
Computer-Aided Instruction
Differential Reinforcement
Functional Behavior Assessment
Where can I learn more about EBP?
Effectiveness of strategies for teaching specific skills–
Appendix 3B: Evidence Based Practice in Preparing
Youth with ASD for
Adulthood http://www.crporegon.com/content/seco
ndary-transition-project-asd
How to implement-- National Professional
Development Center on ASD Evidence Based
Practices Briefs
http://autismpdc.fpg.unc.edu/content/briefs and
Autism Internet Modules
http://www.autisminternetmodules.org/
Unit 2: Supports for Success
Where can I learn more about Supports?
Unit 2: Supports in Preparing Youth with ASD for Adulthood
http://www.crporegon.com/content/secondarytransition-project-asd
Autism Web Course
http://cdd.unm.edu/swan/autism_course/modules/sens
ory/index.htm
Transition to Adulthood Guidelines for Individuals with
ASD
http://www.ocali.org/_archive/pdf_trans_guide/Trans_G
uide.pdf
Life Journey Through Autism: An Educator's Guide to
Asperger Syndrome
http://www.researchautism.org/resources/OAR_Guide_
From Jim Sinclair, Self Advocate
“Even if an autistic person has
the same goals as a nonautistic person he or she might
need to follow a different
procedure to get there…”
-
More Important Online Resources
Autism Spectrum Disorders and the Transition to
Adulthood
http://www.doe.virginia.gov/special_ed/disabilities/a
utism_transition_guide.pdf.
Adult Autism & Employment
http://www.dps.missouri.edu/Autism/Adult%20Auti
sm%20&%20Employment.pdf