Transcript Good Practice Conference

Good Practice Conference
“…collating, disseminating and encouraging
the adoption of good practice…”
Understanding ASD: the Way
to Effective Practice
Professor Rita Jordan OBE
Autism Centre for Education & Research
University of Birmingham
Good Practice Conference, Stirling 2009
Education & values
• 'Education' often taken as synonymous with forms of
therapeutic input directed at identified 'deficits' or difficulties
• People with ASD challenge view that goal of education should
be to make them ‘less autistic’ or to behave ‘normally’
• SEN not derived purely from a clinical condition
SEN of ASD
Jordan (2005)
• children with ASDs have needs that are:
– common (as children)
– individual (as individuals - assessed needs)
but also
– group (related to ASD)
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and it is only through awareness of group needs that individual needs can be
recognised and met
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all stakeholders (children, parents, teachers,aids, therapists, psychologists,
headteachers, local authorities) saw lack of understanding as key barrier to
inclusion (ACER, 2008)
What’s Special about ASD?
• need to learn explicitly what others acquire intuitively or
through social tutoring
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identity of self/ other
saliency of social signals
agency and intention
relevance and priority
social/cultural meaning
nature of communication
emotional consciousness
Difficulties & Differences
• executive functions
– ‘monotropic’ attention
– impulse control
– idiosyncratic perception
• imagination & reality testing
• empathy & emotional/ conscious understanding
• concept development
– problems abstracting
– rigidity of concept & schema boundaries
Strengths
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sustained attention to interests
no social distractions
usually visual information
careful attention to detail
no social heirarchy - no deceit - get job done
accurate detailed memories
‘fresh’ idiosyncratic art - visual/ poetry/ music
vulnerability brings out the best in others (often!)
Learning Style
• visual or procedural rather than verbal
• memory
– cued
– rote
• ‘social’ a dimension of difficulty
• emotions & cognition
– use interests for engagement
• often at sensory stage of meaning
– presentation --> reference
• repetition & consolidation
• explicit strategies for problem solving
• need to learn explicitly what others acquire intuitively
The ‘ASD’ lens
• individual needs determine learning and should
determine teaching
• individuality is even more the case in ASD
• yet a lack of mutual empathy means
– teachers have to use non-intuitive routes in teaching those
with ASD
– just as those with ASD have to use non intuitive routes in
their learning
Sensory challenges
• if assessed as challenge for child
– environmental / proximal adaptation
– inform Behaviour Support Plan
• if not assessed
– be alert to sensory issues and develop
understanding of environment to reduce
sensitivity - likely to be either ‘over’ or ‘under’
sensitive to different senses
Perceptual Challenges
• staff need to be aware for all so that there is:
– teaching for meaning (emphasise goals not parts
of tasks, reward effort not success)
– explicit rules & instructions (visual?)
– time for processing
– recognition of effect on learning & teaching
– checks on child’s perspective
Memory Challenges
• recognition that ‘savant’ skills may be
weakness
• processes for teaching or generalisation of
skills in functional environments
• methods to enable memory cues across
home/ school environments e.g. in homework
• teaching a range of memorisation strategies
Language & Communication
Challenges
• augmentative systems for those without speech
– at right ‘meaning’ level
• ’educational’ language
– assumes communication
– joint attention/ advance organisers/ gestures/ literality
• SALT support for communication programmes for all with
ASD
• structured teaching to reduce reliance on social &
linguistic mediation of learning
• programmes for expressive and receptive speech
– include communication gestures
Social & Emotional Challenges
• awareness of implications of lack of salience of social signals
– teaching attention to social signals
– use taught attentional signal as a signal
• teaching social meanings
– explicit teaching
– allowance in behaviour management
– enabling positive social experiences for practice
• teaching emotional awareness & control
– necessary understanding prior to ‘management’ or understanding of
facial expressions
Teaching for Purpose
• different approach needed to suit
– individual characteristics
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sociability
language
cognitive level
sensory issues
age
– goal
– practitioner comfort/ ability/ knowledge
Child factors: Sociability
• Wing’s classification
– withdrawn/ solitary -> passive/ responds -> ‘active but odd’ ->
eccentric & sensitive
• varies with conditions & with teaching
• level suggests optimum form of approach
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withdrawn - 1:1 directive & desensitisation
passive - interest & structured play experience
active but odd - social rules & experience (context)
eccentric - social skills in context e.g. buddy
Curriculum for ASD
• entitlement to culturally valued skills,
knowledge & understanding
• therapeutic needs from ASD difficulties
• additional explicit content for otherwise
‘intuitive’ knowledge
• long-term need for a ‘curriculum for life’
Later: Ecological Curriculum
• assess individual
• assess current and future environments &
occupations
• gaps in skills, appreciation, knowledge and
experience form curriculum goals
• teach in functional ways
• practise in functional contexts
Evidence
• no single approach
• evidence for:
– structure
– modern behavioural methods
– training parents in social interaction & communication techniques
• in all studies some do well and some do not
• in all studies children tend to learn only what are explicitly
taught
Important Distinction (Mesibov
2009)
• Evidence Supported
Treatment (EST)
– most common use
– starts with treatment
& asks if it works for a
particular (narrow)
group
• Evidence Based
Practice (EBP)
– what we should do
– starts with child and
asks how we can
achieve best outcome
Importance of Process
• sensitivity & flexibility of implementation at
least as important as particular programme
• rigid interpretation of manuals leads to poor
outcomes
• lack of understanding of ASD de-skills staff and
prevents effective individualisation
Definition of EBP
• the integration of the best available research and clinical
expertise within the context of patient characteristics, culture,
values and preferences.
(APA, 2006)
• practitioner expertise involves interpersonal skills and not just
single programme knowledge
Single vs Eclectic Curricula
Single
• enables staff expertise
• better monitoring &
easier evaluation
• builds staff & parent
confidence
• enables positive views
Eclectic
• can match to goal
• all needs can be
addressed
• needs compatibility
checks & child
perspective
• take strengths from
each
Conclusion
• normal intuitive learning requires cognitive effort
• normal levels of stimulation cause stress
• lack of control from
– poor self understanding
– poor social understanding
– poor communication
• understanding & individualisation is key to effective support &
education
• treating students equally does not mean treating them the
same but differently, to ensure equal access