Transcript autism spectrum disorders and behavior modification

Learn Your ABC’S:
Autism
Behavior
Communication
Liz Farmer, MA, Autism Consultant
Beth Waite, CCC/SLP-ATP
Assistive Technology Coordinator
Autism is a Neurobiological Disorder that
affects 3 primary areas
• COMMUNICATION
• SOCIAL
• BEHAVIORAL
COMMUNICATION AND LITERAL
THINKING
It’s raining
cats and dogs
Don’t make a
mountain out of a
mole hill!
You’re pulling
my leg.
Get busy! We have a
MILLION things to
do.
Good Luck and
Break a Leg!
I don’t
understand.
Zip your lip.
I’ve got my wires
crossed.
This muddies the water.
RECEPTIVE COMMUNICATION
Remember the 7 second rule
Hang up your coats
Put your backpacks away
Get out your morning work
There should be no talking
Stop for the pledge
Listen to the announcements
Wait! What is
after backpack?
HOW DO THESE PROBLEMS TRANSLATE TO SCHOOL
DIFFICULTIES?
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1. Problems following directions.
2. Problems understanding language.
3. Problems making inferences
4. Problems with multi-step tasks.
5. Problems sequencing.
Multi-Step Math Equations
Story Problems
Common Communication Deficits for ASD
•Receptive lang. delay typical for most kids on spectrum
•Pragmatic language and social skill deficits
•Nonverbal with minimal to no expressive language
•Must have co-existing significant deficits in behavior
or social emotional functioning or they shouldn’t be dx with ASD
Communication Modes for
Nonverbal/Minimally Verbal ASD
gestures/facial expressions (rare)
manual signs
objects
photos
picture symbols
written words
voice output devices
Make Language Visible
DAILY SCHEDULE
“Check your
schedule”
Now, I
get it!
NEEDED MODIFICATIONS
• Visual cues or schedules
• Augment instructions with gestures
• Give Short Concise Instructions
• Tell Kids What To Do vs. “not what to do”.
Visual Strategies are:
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Easily recognized
Easily understood
Universally understood
Visual Strategies include:
Body language
Objects
Pictures- Photographs-Logos
Printed format
Hierarchy of Visual Supports
Most concrete and easiest to understand
Objects, partial objects
Photographs cut to shape
Photographs
Line drawing symbols (Rebus, Boardmaker)
1. Realistically-colored
2. Black and white
Word choices
Phrases
Most abstract and difficult to understand
Remember when using
photos…
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Picture the critical
element (usually
an object vs.
activity)
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Eliminate
background
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Shoot close up to
target
Tools to Give Information
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Schedule and mini-schedule
Calendar
Choice boards
Menus
People locators
Saying no or “wait”
Transition and travel helpers
Conversation regulation
Barbara Bloomfield –
www.icontalk.com
From ICON to ICAN
www.patinsproject.com
First-Then Behavior Chart
PROBLEMS READING NON-VERBAL CUES
MEANS “MISSING THE OBVIOUS”
“uh hum”
We could
lose
recess
My teacher keeps
clearing his throat
We better
quiet down
Teacher’s
getting mad
What are they doing?
Watch
Video
He hit me!
They must be
laughing at
me
HOW DO THESE PROBLEMS TRANSLATE TO SCHOOL
DIFFICULTIES?
• 1. Trouble interacting with Peers (in the
classroom, hallway, cafeteria, recess, extra-curricular
activities)
• 2. Trouble following rules and understanding
“hidden” agenda
• 3. Become easy targets for others
• 4. Increases in anxiety due to
misinterpretations and lack of understanding
(*This often escalates to depression during middle/high school)
Social Skills Training Strategies
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Social Skills Groups
Pragmatic/Language
Peer Training
Social Stories
Video Modeling
Functions of Communication
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Greetings/Farewells
Requests/Protests
Comments
Initiation
Social Closeness
Topic setting
Maintaining
conversation
• Ask/answer questions
• Repair breakdowns
• Express ideas and
share feelings
• Acknowledge
comments
• Label and describe
• Direct others
• Telling jokes, secrets
Communication Characteristics often found in ASD
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Joint attention is usually absent
Interested in objects – not people
Communication repertoire may be limited
Imitation skills may be poor
Receptive vocabulary can be limited
Echolalia
Difficulty with abstract language
Social skills can be impaired
Behavior IS Communication
• We need to learn to read and predict
student behavior
• Adapt the circumstances to limit the
reason for the behavior
• Teach a substitute communication skill that
is more effective
• Focus on telling student “what” to do…
not “what not” to do
Emotions
• Difficulty understanding levels of intensity
• Difficulty expressing levels of intensity with
words and nonverbal clues
Stress
• Reactive approach to managing stress
• Under stress communication abilities may
become difficult to access
Learning Strategies
• Environmental modifications (quiet seating,
study carrel, etc.)
• Provide organizational tools (timers, planners,
checklists)
• Visual schedules/calendars
• Noise-canceling headphones to reduce
distraction
• Assistive Technology for writing/organizing
Pragmatic Language Skills
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Knowing “what” to say
Knowing “when” to say it
Knowing “where” to say it
Knowing “why” to say it
Knowing “how” to say it
*the “social” aspect of interacting with others*
More Visual Support for
Conversation
• Limit questions (student can turn in 2
tokens representing questions-then can’t
ask more).
• Limit amount of time student can talk
about topic using visual timer
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Substitute Communication Response Must:
• Be quick and easy for the student
• Be quickly reinforced by the comm.
partner
• Easily recognized by all working with
student
• AS POWERFUL AS THE NEGATIVE
BEHAVIOR
WARNING – initially the negative
behavior usually gets worse before
it gets better !
Social
Skills
Training
Why Do Social Groups?
• Identified deficits in the areas of personal
interactions with others.
• 1-1 training does not seem to generalize to
group settings.
• Kids can learn through direct modeling
experiences with others.
• Kids in social skill groups often begin
making friendships with each other!
Let’s Get Started
• ESTABLISH GROUP RULES AND A
PREDICTABLE ROUTINE
Components of Pragmatics
age appropriate topics
appropriate relationships
topic maintenance
making inferences
reciprocity
compromise
manners
sportsmanship
personal space
eye contact or faking it
accepting differences (filtering)
inflection
nonverbal cues
theory of mind
accurate perceptions
hidden social rules
•Voice Inflection
•Accurate perspective-taking
Audacity free audio editing software
http://audacity.sourceforge.net/
Theory of Mind
the ability to recognize other people’s
feelings, beliefs, intentions, and respond
accordingly.
This results in problems such as
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predicting how another might respond in a given situation
Inability to perceive intended meaning (tone of voice)
Insensitivity to other’s feelings
Inability to understand “unwritten social rules”
Social Skill Stories
My name is Max and this story is about me.
I like to play games with my friends.
Sometimes, I win.
Sometimes, someone else wins.
Make these with
Boardmaker,
Pixwriter, Google
images or anything!
Video prompting
Video self prompting
Video modeling
Video self modeling