Transcript ASD & Intellectual Disability - Coping in the

“Autism Spectrum Disorder,
Intellectual Disability : Coping in the
classroom”
Assoc Prof Robyn Young
School of Psychology
Flinders University
November 9, 2012
Areas of Impairment
Rigidity of
thought
Social Interaction
Restricted
interests
Social and
emotional
understanding
Resistance to
change
Sensory Processing
Verbal
Non verbal
Communication
ASDs
• Autism Spectrum Disorders (ASD) affect one in 160
Australians
• male to female ratio of 4:1.1
• A devastating, life-long and often debilitating
condition with no known cause or cure.
• Although it manifests in the first three years of life the
condition is life long
• Estimated lifetime cost for an individual with an ASD
is $3.5-$5 million
Autism Spectrum Disorder
More Severe
Childhood
Disintegrative
Disorder
Less Severe
Classic
Asperger
Autism
Syndrome
PDDNOS
Communication
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Understanding and using words
Understanding and using gestures and
body language
Interpreting facial expressions
Understanding idioms and sarcasm
Voice presentation may be unusual in
monotone, accent and volume
© Autism SA 2010
What do you mean?
Don’t put all your eggs
in one basket
Hit the books
© Autism SA 2010
Social Interaction
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Understanding personal
space
Initiating and maintaining
conversation
Strong sense of social
justice
Developing and maintaining
relationships
Working in and joining
groups
© Autism
Social Interaction
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Difficulty understanding the
unwritten social rules
Difficulty with sharing, taking
turns, waiting, asking for help,
listening and making mistakes
May like to spend some time on
their own
May be vulnerable to teasing
and bullying
© Autism
Theory of mind
It was an
accident.
Why
did you
push
me?
That was
done on
purpose!!
Kathy Hoopman –All cats have asperger syndrome
What does this mean??
• I Didn’t Say She Stole My Money
• I didn’t say she stole my money ( but
someone said it).
• I DIDN’T say she stole my money ( I
definitely did not).
• I didn’t SAY she stole my money ( but I
inferred it).
• I didn’t say SHE stole my money ( but
someone stole it).
Rigidity of Thought
• Difficulty with change e.g., change in
timetable, excursions, staff changes
• They like routine, structure and
predictability
• May have different priorities and interest
areas to you
© Autism SA
Sensory Processing
• Oversensitive or under sensitive to touch,
taste, smell, sight or sound (e.g. hands
over ears).
• May have difficulty with coordination
• May have difficulty concentrating and may
need movement or a quiet place during the
day
© Autism SA 2010
Students with ASD often display a high level of
anxiety due to sensory, communication, social
and emotional difficulties.
This may result in:
• Low self esteem
• Depression
• Meltdowns
© Autism SA 2010
Students with ASD may need
things to help them learn
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Break cards
Reward systems
Movement breaks
Visual supports
Timers
Fidgets
Chill out spots
© Autism SA 2010
Possible Phenotypes (Wing et al)
• Aloof
• Passive
• Active but odd.
Intervention Strategies
• Teach alternative perspectives and
solutions.
• Facilitate appropriate conflict resolution.
Encourage Friendship Skills
• Behavioral strategies of
observation and recording, task
analysis, cues, prompting, shaping
and rewards.
• Cognitive strategies to learn the
theory and script using Social
Stories.
Philosophy and Attitude
• Discovery not correction (advice
perceived as criticism)
• Appeal to reason and intelligence.
• Teach understanding not compliance.
• Share information.
Team Work Skills
Other strategies
• Teach them to watch other children as a
model of what to do.
• ‘Rent a friend.’
• Inclusion with neurotypical children as
they can modify their social play to
accommodate the child
Friendship Characteristics Associated With
Asperger’s Syndrome
• Intensity of the friendship(Possessive).
• Not ageist, sexist or cultural bias.
• Exhaustion. “It takes all my brain power
to be a friend”
Affective Education
• A project on a specific emotion.
• Start with happiness or pleasure.
• Create a scrap book that illustrates the
emotion.
• Diary with new experiences.
• Compare and contrast other children’s
scrap books.
Affective Education
• A thermometer, volume control, ruler,
gauge, rope on the floor or
speedometer to measure the degree of
intensity.
• Place photographs and words at the
appropriate point on the ‘thermometer.
• Increase precision and accuracy in
verbal expression.
Examples of activitiesHappiness
• What are the feelings and sensations when
you are happy?
• Compliments can make someone feel happy.
Choosing, giving and receiving compliments.
• Rope activity. Stand at the point that
represents the level of feeling. Examples: You
find and can keep $20, Your mother says that
she loves you.
Relaxation Tools. Decrease Heart
Rate
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Sleep.
Stress ball.
Pleasures book.
Deep pressure.
Jigsaw
Art
Simple operant conditioning
• A
B
C
• Discriminative Stimulus / Antecedent (A)
• Operant Response / Behaviour (B)
• Reinforcement / Punishment / Consequence (C)
Things to avoid
• Avoid giving eye-contact for disruptive
behaviour
– (this can be reinforcing).
• Avoid repeating instructions
– (every request must be responded to).
• Avoid overuse of the child’s name
– (this in itself is a request for eye-contact and a separate drill)
• Avoid over-prompting
– We are trying to make the child as independent as
possible
Criminals in waiting?
• ASD assumed to be a key causal factor underpinning
offending behaviour in many high profile (Howlin, 2004).
• Sexual and violent offences have typically dominated
• recent cases include the fulfillment of obsessions such
as computer hacking and arson (e.g., the cases of Ryan
Cleary, Gary McKinnon, William Cottrell).
• In some of these cases Asperger Syndrome (AS) has
been used as a defense against criminal conviction.
• Judge described ASD as an “affliction” which made him
incapable of “intent in aiding and abetting the
destruction” (Mikulan, 2009, September 10).
• Damaging claims in the press:
Teenage 'hacker' has Asperger's
syndrome
• Ryan Cleary, the teenager accused of a hacking attack
against the website of the UK's Serious Organised
Crime Agency has been diagnosed with Asperger's
syndrome since his arrest.
Does having ASD increase risk of
criminal involvement?
• claims individuals with ASD are up to 7 times more
likely to experience contact with the criminal justice
system (Curry, Posluszny, & Kraska, 1993)
• no convincing empirically based estimates relating to
prevalence rates of persons with ASD in the criminal
judicial system
• recent research suggesting NO increased likelihood
of criminal activity (e.g., Dein & Woodbury-Smith,
2010; Långström, Grann, Ruchkin, Sjöstedt, & Fazel,
2009; Mouridsen, Rich, Isager, & Nedergaard, 2008;
Myers, 2004; Woodbury-Smith, Clare, Holland, &
Kearns, 2006).
• The reality is that the majority of persons with ASD
do not engage in criminal behavior and are lawabiding citizens, often pedantic in their adherence to
the law (Murrie, Warren, Kristiansson, & Dietz, 2002;
Wing, 1997).
• prevalence may be inflated by the likelihood of
getting caught and convicted
• some characteristics of the disorder however, may
lead some individuals to an increased likelihood of
criminal activity
So why then do some individuals
with ASD get into trouble?
• unique from the perspective of criminal involvement
• may fail to appreciate the nature and impact of their
behavior.
• diagnostic features can render them more vulnerable
to involvement in antisocial behaviour
• becoming naïve targets, accomplices or victims of
crime.
• core-features of the disorder: (i) poor social
understanding or ToM, reflected by an inability to
appreciate the social implications of one’s behavior,
and (ii) rigidity of thought and obsessiveness.
Questions