Transcript Autism 101 - Part Two - The Strategies

Autism 101
Part 2 – The Strategies
Presented by:
Donelda Wygiera
School Psychologist
Chinook’s Edge School Division #73
Autism Spectrum Disorder
• Each Student with Autism is Unique
• Autism Spectrum Disorder (ASD) is a disorder
characterized, in varying degrees, by
difficulties in social interaction,
communication, and repetitive behaviours.
• Current Terminology (DSM5) is Autism
Spectrum Disorder only.
Supporting Learning in the Student
with Autism
Areas we will cover:
- Supporting Communication
- Improving Social Interaction and
Development
- Preventing Behaviour
- Supporting organizational skills
- Supporting sensory needs
To support our discussions, I will be sharing
quotes from the novel House Rules by Jodi
Picoult.
Supporting Communication
Communication encompasses a broad range of
challenges for individuals with autism, from
intake and processing of information, verbal
output, to reading and writing skills as well as
picking up on non-verbal cues and body
language.
We will look at Receptive and Expressive
communication.
Receptive Language
Supporting Communication –
Receptive Language
“Many students with ASD cannot understand
language as well as we think they can, based on
their other skills and responses”.
G. Mesibov and M. Howley
Supporting Communication –
Receptive Language
“I have never been a big fan of I Love Lucy. That
said, every time I see the episode when Lucy and
Ethel are working at the candy factory and get
behind on the packaging, it makes me laugh. ….
Having [this man] ask me these questions makes
me feel like Lucy at the candy factory. At first, I can
keep up … But then it begins to get more
complicated. The questions stack up like that
candy, and I am still trying to wrap the last one
when he sends the next one my way. All I want to
do is take his words and stuff them somewhere
where I don’t have to hear them anymore.”
pg. 130 House Rules Jodi Picoult
Supporting Communication –
Receptive Language
- Ensure student is attending before you deliver
instructions or ask a question. Identify a cue
“Okay class, this is important” and review this
with your student. Use the child’s name
before delivery if needed.
- Keep instructions short or give information in
chunks.
Supporting Communication –
Receptive Language
- Give positive directions to allow for
incomplete language processing. Minimize
the use of ‘don’t’ and ‘stop’.
- Allow ‘wait time’.
Supporting Communication –
Receptive Language
- Do not reprimand a student for “not listening or
responding” as it highlights his challenges and
may accidently reinforce some undesirable
behaviour.
- Model and shape correct responses to build
understanding.
Turn and Talk
Would modelling and shaping be useful at
Middle School or High School?
Supporting Communication –
Receptive Language
- Supplement verbal information with pictures,
visual schedules, gestures, visual examples,
written directions.
Examples can be paper versions or from various
Apps available for this purpose.
Visual Apps
Note that the Apps provided in this presentation are just a small sample and to
show examples of what is available. There are hundreds that can be explored to
determine which is best for the child you work with. See Marcie Purdue’s CESD
Assistive Technology site for great ideas at: http://atcesd.weebly.com/ or go to
CESD website and find it under Student Services quicklinks.
Expressive Language
Supporting Communication –
Expressive Language
“Language often falls behind other skills for people
with autism so their responses or ability to express
simple requests can be limited. Expressive
communication required a degree of initiation,
organization, and comprehension that is sometimes
beyond what these otherwise skilled youngsters
with autism can produce. This often results in
frustration on everyone’s part because they cannot
express many of their needs in ways that allow
others to meet those needs.”
Summarized from G. Mesibov and M. Howley
Supporting Communication –
Expressive Language
“If someone asks me what I’m doing for
the weekend … I stumble over how much
information is too much, and so instead of
giving a blow-by-blow description of my
future plans I’ll rely on someone else’s
words. Doing my best De Niro Taxi Driver
impression, I’ll say, “you talkin’ to me?”
Page 19 House Rules, Jodi Picoult
Supporting Communication –
Expressive Language
- Work to find a way to access the student’s
communication. Offer visual supports, cue
cards, multiple choice options, etc.
(For example – teaching the capital cities)
TURN AND TALK
Consider other typical evaluations you do in your
class that require expressive language. What are
some alternative ways a child could communicate
his learning?
Supporting Communication –
Expressive Language
- Use visual supports to prompt language or give
choices, such as a help card.
- Teach and use scripts (which could include words
and/or pictures) for communication.
Jacob’s social skill tutor, Jess, is working on ordering
food and has clearly used a script:
“A medium gluten-free pizza,” I say to the
...woman at the cash register …
Jess nudges me.
“Please,” I add.
pg. 64, House Rules, J. Picoult
Supporting Communication –
Expressive Language
- Teach your student to communicate “I don’t
know” to reduce anxiety with not being able
to answer a question.
- Add visual supports to the environment as
needed, such as cubby, ‘in’ box, ‘homework’
folder, etc.
- Teach/encourage student to use visual
supports already in the environment
(calendars, door signs, drawer labels, display
on cash register, body language, etc.)
Supporting Communication –
Expressive Language
For some children who have very little verbal
output or are very young, the use of an AAC,
communicate board, PEC system, sign language,
etc. may be required.
This is a screen shot of Touch Chat an
AAC (Augmentative and Alternative
Communication) app available for
ipads used to supplement or replace
speech or writing.
Supporting Communication –
Expressive Language
• Various Apps available as well such as Read &
Write for Google, Dragon, iSpeech, etc.
Supporting Communication –
Expressive Language
- It is important to consider if expressive
language is the culprit when you see some
behaviour.
Ex. When given options for snack, pretzels,
apples, or crackers, student always picks crackers
but then throws them on the floor.
Ex. When peers try to help with school work or
outdoor clothes, student hits at the children.
Supporting Communication –
Expressive Language
- Consider singing or using a sing-song
voice.
- Be cautious of pronoun confusion.
- Be aware of echolalia, immediate,
delayed, and functional echolalia.
- Teach self advocacy and negotiation skills
when appropriate.
Supporting Communication –
Expressive Language
- Address the language of emotions – the
communication of thoughts, feelings, end
emotional states through visual supports and
explicit teaching.
Ex. Finger painting = sensory aversion 
throwing things
Ex. No sand table = sad  head banging
Supporting Communication –
Expressive Language
Many students with ASD have a topic of interest
that they do talk about all the time. Often, this
can interfere with school work and social
interactions because it is all they want to talk
about.
When asked if he had completed his social skills ‘homework’ by his tutor,
Jacob reflects on how his attempt to ‘strike up a conversation with someone
his own age’ went:
I had been in the library at the bank of computers, and there was a kid sitting
next to me. Owen … For fun, I had been on a search engine researching
fracture pattern interpretation in the skull, and how you can differentiate
between blunt-force trauma and ballistic trauma using concentric fractures,
and that factoid seemed to be the perfect opening salvo for a conversation.
But I remembered Jess saying that not everyone is wowed by someone who’s
the human equivalent of a Snapple cap. So instead, I said this:
Me: Are you going to take the AP test in May?
Owen: I don’t know. I guess.
Me: (snickering): Well, I sure hope they don’t find semen!
Owen: What the hell?
Me: An AP test – acid phosphatase test – it’s used with a forensic
light source to test for presumptive seamen. It’s not as conclusive
as DNA, but then again, when you get a rapist who’s had a
vasectomy, there won’t be any sperm, and if an AP test and a 530nanometer trispot is all you’ve got –
Owen: Get the f___ away from me, freak.”
Pg. 65 , House Rules, J. Picoult
Supporting Communication –
Expressive Language
Staff can work to shape the student’s expectations
around favorite topics and minimize the impact of the
obsession.
- Provide scheduled opportunities to discuss the topic,
using a visual schedule.
- Establish boundaries (when is it okay to talk about Star
Wars and when is it not)
- Use a visual timer to help establish appropriate
duration
- Teach student to expand to other topics
- Positively reinforce the student for talking about other
subjects or the absence of the favourite topic.
Social Skills
Supporting Social Skills
“People with ASD do not have an intuitive grasp of
other’s motivations and behaviours. Social rules
are mysterious to them. These can result in
inappropriate behaviours designed to gain the
attention of other people, social withdrawal, or a
preference for being alone. The lack of social
relatedness can also make initiatives from other
people ineffective in motivating and directing
behaviour.”
Summarized from G. Mesibov and M. Howley
Supporting Social Skills
“By now, I have gotten used to kids telling me to
leave, to sit somewhere else. … I just don’t get the
social hints that other people do. So if I’m talking to
someone in class and he says, “Man, is it one
o’clock already?” I look at the clock and tell him
that yes, it is one o’clock already, when in reality he
is trying to find a polite way to get away from me. I
don’t understand why people never say what they
mean.” …. “For me, being in social situations –
whether that’s school, or Thanksgiving dinner, or
the line at the movies – is like moving to Lithuania
when you haven’t studied Lithuanian.”
Pg.19, House Rules, J. Picoult
Supporting Social Skills
Students with Autism Spectrum Disorder often
have the desire to interact with others, but do
not have the skills to engage appropriate or may
be overwhelmed by the process.
Supporting Social Skills
For some students, particularly young children,
supporting sensory issues is often the first place
to begin.
Only when a child can manage the noise and
unpredictability of a group of children will s/he
be able to interact at all.
Supporting Social Skills
Remember that social challenges can be
“bidirectional”. That is, they may be:
–deficits (a lack of social initiation) or
–excesses (too much social interaction
such as a one-sided conversation)
Supporting Social Skills
• As an adult working in the classroom, it is
important for you to extend a feeling of
welcome in the classroom, lunchroom, gym,
playground, etc.
• It will be beneficial for you to model for the
other students that they student with ASD is a
valued part of the group.
Supporting Social Skills
Key social skills to consider building:
• Reciprocity – the give and take of an
interaction.
• Foundational Social understanding – the
basics (e.g., smiling, using eye contact, turning
to a person who is talking to you, etc.)
Turn and Talk
How can you ensure DIRECT teaching of skills
can happen with your student?
Supporting Social Skills
• Make sure support is available during
unstructured times such as free play and
recess.
• Support the development of eye contact,
slowly and gently. Start with the body being
turned in the direction of the speaker.
Supporting Social Skills
• “It is hard for me to explain why it is so difficult
to look into people’s eyes. Imagine what it
would be like if someone sliced your chest with
a scalpel and rummaged around inside you,
squeezing your heart and lungs and kidneys.
That level of complete invasion is what it feels
like when I make eye contact. The reason I
choose not to look at people is that I don’t think
it’s polite to rifle through someone’s thoughts,
and the eyes might as well be glass windows,
they’re that transparent.”
Pg. 63, House Rules, J. Picoult
Supporting Social Skills
Specific strategies:
- Help with generalizations and flexible thinking as
they are often a challenge.
- Reinforce what the student does well socially.
- Model social interactions, turn taking and
reciprocity.
- Teach imitation, motor as well as verbal.
- Teach context clues and referencing those around
you.
Supporting Social Skills
Consider the importance of keeping a lookout for
unfortunate events of teasing by other students.
For high functioning students who are highly verbal
but have limited understanding of social nuances,
they can sometimes be the target of teasing. They
often do not “pick up” on non-verbal cues such as
tone of voice or hidden intentions of a request or
comment. They often go along with the teasing
because they do not identify that it has a negative
intent.
Supporting Social Skills
Specific strategies:
- Break social skills into small components parts
and teach these skills through supported
interactions.
- See examples of this from:
Social Rules for Kids: The top 100 Social Rules
Kids Need to Succeed by Susan Diamond
Supporting Social Skills
Specific strategies:
- Celebrate strengths and use these to your
advantage (e.g., sense of humour, love for
music, strong rote memory skills, good sense or
color, good visual perspective). Use these to
motivate interest in social interactions and give
the child a chance to be viewed as competent
and interesting to his/her peers.
Supporting Social Skills
Specific strategies:
- Consider pairing with a student who can
model strong social skills. Support the peers.
- Create small lunch groups. Consider providing
structured activities or topic boxes.
- Focus on social learning during times that are
not a great struggle for the child
- During group tasks, assign roles and review
responsibilities.
Supporting Social Skills
Specific strategies:
• Use video modelling to teach expected social
behaviour. There are many apps that can
assist with this.
Supporting Social Skills
Specific strategies:
- Teach empathy and reciprocity through
commentary and teaching:
-
awareness of feelings,
emotional states,
recognition of other’s facial expressions and
non-verbal cue
Remember to consider context
Supporting Social Skills
Specific strategies:
- Use social stories, social narratives, and social
cartooning as tools to help describe and define
social rules and expectations. Many apps
available.
Supporting Social Skills
Specific strategies:
- Provide direct teaching for the following:
- Listening and attending skills
- To recognize how and when s/he is doing too
much talking about him/herself or his/her
interests.
- Social boundaries (e.g., things you should not talk
about)
- How to recognize and maintain personal space
- Personal hygiene and changes in our bodies,
especially for older students.
Ideas for
Preventing Behaviour
Preventing Behaviour
• Recognize behaviour as a form of
communication. Work to understand the
communicative intent of the behavior and
teach the student a more expected way to
communicate.
• When behaviours occur, provide specific
feedback and ample praise and reinforcement
when your student uses more expected
behaviour or communication.
Preventing Behaviour
• Support transitions. These times are often
unstructured, unorganized and high stress for a
student with ASD.
• Communicate expectations regularly. For
example, use daily schedules, task schedules,
warn of changes to routines, prepare the student
for unexpected events such as fire drills,
substitutes, etc.
• Teach “Change” moments so a student can
manage when an event is so sudden preparation
is not possible
Preventing Behaviour
• Offer choices when appropriate. This provides
the student with some control, within reason.
Turn and Talk
What are some ways you can give a student
some choice? Are there ways of adding
additional support when providing choices?
Preventing Behaviour
• Provide a ‘home base’ or ‘calm place’ for the
student go use to feel safe. S/he can go there
to regroup, calm down, escape an
overwhelming situation or sensory overload.
Proactively teach this strategy and use visual
supports as reminders.
A high school high intelligent boy’s interpretation of
appropriate support:
“In school, part of my IEP is a cool-off pass – a COP. If I
need to, at any time, even during an exam, my teachers
will allow me to leave the classroom. Sometimes the
outside world gets a little too tight for me, and I need a
place to relax. I can come to the sensory break room, but
the truth is, I hardly ever do. The only kids who use the
sensory break room are special needs, and walking
through the door, I might as well just slap a big fat label
on myself that says I’m not normal.
So most of the time when I need a break, I wander
around the hallways.”
Pg. 113, House Rules, J. Picoult
Preventing Behaviour
• Teach self-monitoring strategies. This needs
to be done proactively when the student is
calm. Visual reminders will support.
• Consider providing breaks for “working hard”.
Be cautious of reinforcing good work and not
reinforcing outbursts accidently.
• Teach the student to request a break before
getting too frustrated or upset. Use a visual
cue for this, such as a card that shows “I need
a break first” or “I’m not ready yet”.
• Teach waiting strategies.
Preventing Behaviour
• Use a First, Then strategy. This helps a student
learn that there are some things you must do,
even if they are less preferred.
Preventing Behaviour
• Teach and provide a list of strategies for calming
when anxious, stressed, or angry. Make these
lists visual.
• Be aware and use a system that reinforces
desired behaviours seen (e.g., use of a
communication card)
• Learn and be aware of triggers and antecedents
that may result in frustration, overload, anxiety or
maladaptive behaviours. Make a list and ensure
all team members are aware of these possible
triggers.
Supporting
Organizational Skills
Supporting Organizational Skills
Due to struggles with executive functioning,
language skills, and social challenges, keeping
pace with the world around them can be
extremely challenging. If a student is having a
hard time processing sensory information, s/he
may be distracted from organizing thoughts and
work.
Supporting Organizational Skills
• Provide a schedule for daily activities. This
should be visual which might be photos,
symbols or written information depending on
the needs of the student.
Supporting Organizational Skills
• Some students will need more details than others
on their schedules.
• Create visual schedules for specific tasks and
routines.
• Create a ‘to do’ list and checklists for completing
tasks or assignments. Make these check lists
visual.
• Students will need to be taught to reference
his/her schedule and check off activities as they
are completed. This is essential for developing
independence.
Supporting Organizational Skills
• Colour code binders and folders by subject,
teacher, etc.
• Use labels to help organize materials, class
supplies, locations to do specific activities
(e.g., work area, lunch area, free time area,
etc.)
Supporting Organizational Skills
• Help manage time and deadlines using tools
like organizers, visual calendars, tablets, smart
phones, computers, visual timers, or watches
with alarms. Chuck tasks when necessary.
Supporting Organizational Skills
• Schedule a regular time to clean and organize
workspace. This can be done with the whole
class.
• Organize problem solving, teaching step-bystep strategies to organize thoughts for
problem solving, sequencing, etc. Direct
teaching will be beneficial.
Supporting Sensory
Needs
Supporting Sensory Needs
Sensory stimulation can be especially
distracting. People with ASD can overreact to
stimulation in the environment and have
difficulty modulating its impact. Behaviour
problems frequently result from their inability to
deal with sensory input.
Summarized from G. Mesibov and M. Howley
Supporting Sensory Needs
Sensory challenges can affect the student’s ability
to take in information, respond to requests,
participate in social situations, write, participate in
sports, and maintain a calm and ready to work
state.
Working to maintain a ‘modulated state’ is an
effective strategy for maximizing a student’s ability
to learn, maintain focus and reduce reactive
behaivour.
Supporting Sensory Needs
• Sensory issues can be in any of the sensory
areas:
– Visual (looking at things)
– Auditory (hearing things)
– Tactile (touching things)
– Taste (eating things)
– Smell (smelling things)
– Proprioceptive (Awareness of body and
movement)
The lawyer, Mr. Bond, is asking the judge for
accommodations for court:
“What a fair trial looks like for this defendant
may well be different from what it looks like for
others, that that’s the nature of America – we
make room for everyone, and that’s what we’re
going to do for Mr. Hunt.” He looks down at the
motion before him. “All right. I am going to
allow for the sensory breaks…. Anytime the
defendant feels the need to leave, he is to pass a
note to you, Mr. Bond”
Pg. 363, House Rules, J. Picoult
Talking about sensitivities to things like texture,
colour, sound and light.
“The items in this [sensory] room are the sensory
equivalent of the game Battleship. Instead of
calling out coordinates – B-4, D-7 – I call for another
physical sensation. Each time I feel the weight of a
blanket on my arm, or the pop of Bubble Wrap
under my body when I roll on it, it’s a direct hit.
And at the end of my sensory break, instead of
sinking my battle ship, I’ve just found a way to
locate myself in the grid of this world.”
Pg. 114, House Rules, J. Picoult
Supporting Sensory Needs
• Be aware of possible sensory issues and alter
the environment where possible (e.g., loud
noises, use low odor dry erase markers, seat
away from fish tank, etc.).
• Be aware of noises/sounds that might be
particularly difficult such as a gym teacher’s
whistle, the school bell to change classes, fire
alarm, hum of the florescent lights, etc.
Supporting Sensory Needs
• Highly decorated classroom can be visually
over-stimulating for some students with ASD.
Consider keeping the ‘lecture area’ as simple
as possible and hang work, posters, etc. at the
back of the room.
• Allow a student with ASD to transition before
others to eliminate dealing with noisy and
overwhelming hallways, boot rooms, etc.
Supporting Sensory Needs
• Consider providing an ‘out’ or ‘role’ for the
student with ASD to have during less
structured and noisy activities.
• Recognize that some sensory input can be
overwhelming while others can be calming.
An Occupational Therapist can assist in
understanding what activities should be used
at what times to ensure optimal learning
levels.
Much of this material was adapted from the
following resource found on the Autism Speaks
website
Family Services: School Community Tool Kit