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Diverse Learners CoP
Programming for Children with Asperger’s
Syndrome
Guest: Dot Lucci, M.Ed., C.A.G.S.
Director of Consultation and Training
Massachusetts General Hospital/
YouthCare
Facilitator: Donna Lupatkin
Date: December 3, 2007
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Agenda
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Welcome
Introduction
Characteristics Of Asperger’s Syndrome
Theory of Mind
Sensory Integration
Executive Functioning
Behavior
Central CoherenceTheory
Emotion Regulation
Learning Style
School wide programming
V Bulletin
Future Meetings and Assembly
Meet Dot
Dot has 30 years experience working with individuals with
Autism Spectrum Disorder. She is trained as a School
Psychologist with additional training in neuropsychology.
Dot is a national consultant and speaker and has
published numerous journal articles and a book chapter
in the Exceptional Brain. Currently she is Director of
Consultation and Training at Boston’s Massachusetts
General Hospital/YouthCare, on the Board of Directors of
the Asperger’s Association of New England and an
adjunct professor at Lesley University and Antioch
College.
Pervasive Developmental Disorder
(DSM-IV)
(AKA: Autism Spectrum Disorders- ASD)
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1 in 150 children are being born with an ASD
ASD - No 2 kids are alike
4:1 males/females - ASD
30 - 70% of ASD population are mentally retarded
May be nonverbal
May have co-morbid conditions
ASD knows no boundaries (SES, ethnicity etc.)
Life Long Disability
No Known Cause No Known Cure
Medications treat symptoms not ASD
A disorder that affects the brain but is not just brain-based
Pervasive Developmental Disorder (DSM-IV)
(Autism Spectrum Disorders)
Asperger’s Syndrome (AS)
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1:1 male/female ratio
Average to above average in IQ
Life Long Disability
No Known Cause No Known Cure
Medications treat symptoms not AS
AS appeared in DSM-IV in 1994
A disorder that affects the brain but is not just brainbased
• May have co-morbid conditions
• AS knows no boundaries (SES, ethnicity etc.)
Characteristics of Children with
AS
• Difficulties with Communication
– Superficial communication appears well developed strong
vocabulary & grammar but literalness, concrete interpretation,
poor abstraction, higher level language deficits…
• Difficulties with Behavior
– Rigid, concrete, routine bound, sensory issues, self-stims & odd
behaviors, poor adaptation to novelty…
• Difficulties with Socialization & Play
– Impairment in using and reading non-verbal & verbal behaviors
(gestures, affect, body language, intonation…)
– Impairment in higher level play skills
Characteristics of Children with
AS
• Lack ‘Theory of Mind’, intuitive road map
• Exhibits Sensory Integration issues
• Poor Executive Functioning skills (planning, inhibiting,
self-regulating, organization, productivity, …)
• Maladaptive Behavior = Communication
• Lack Central Coherence - Doesn’t “see the forest through
the trees”
• Poor Anxiety and Emotional Regulation
• Average - Above Average IQ doesn’t always translate into
daily social and academic functioning
Do These Characteristics Sound
Familiar?
• How these characteristics manifest in every child is
different.
• No Two Students with AS are alike
• Describe Some of your Students
Theory Of Mind (ToM)
• ToM - the ability to appreciate that other people have different
mental states: intentions, needs, desires, beliefs that may be
different that your own
• ToM - the understanding that other people have thoughts &
feelings and that these people can reflect on their
thoughts/feelings and can reflect on others people’s
thoughts/feelings and change their thinking and behavior
• ToM - involves: joint attention, representation, transitioning,
inferring, categorizing, abstraction, pretending, etc.
Theory Of Mind
Sensory Integration
SENSORY INTEGRATION is…
• There are 7 senses - 5 + 2, proprioception &
vestibular
• the ability of our senses to work together and
interconnect with other systems in the brain
• the ability to use information gathered from our
senses to organize our behavior and interact
successfully with the world
• the ability to filter out unimportant sensory
information and organize ourselves for
performing meaningful activity
Sensory Integration in Children
with AS
• Children with AS often have differences in the
way they receive, filter, modulate, and integrate
sensory information from their environments.
• Sometimes children’s behavior will be better
understood by thinking about their sensory
differences or anxiety level.
• Children may be over- and/or under-sensitive to
sensory input.
Executive Function in Children
with AS
• Children with AS often have deficits in Executive
Functioning . For example, they may:
– Not manage time effectively
– Get stuck on one topic or a detail
– Be inflexible
– Act impulsively
– Not plan well
– Be disorganized
– Not know what to attend to
– Not use previously learned knowledge
Behavior May Not Be What It
Appears To Be
• Behavior = Communication (requests, feelings,
negations, comments, self, sensory)
• Behaviors can appear willful, weird/odd, rude,
manipulative, annoying etc….
• Behaviors are usually connected to the environment, a
child’s internal state/emotions, the environment, sensory
input, developmental level, attention…
• AS is a neurological disorders -- it’s easier to change
what’s external to the child than to change the child
Central Coherence Theory &
AS
(Frith, 1989)
Individuals with AS
• have deficits in “getting the Big Picture” - not
understanding how the parts relate to the whole.
• have difficulty conceptualizing & integrating information
• tend not to relate information to a larger pattern of
behavior and thought.
Anxiety and Emotional
Regulation in Children with AS
Children with AS have difficulty with:
• Understanding & using a wide range of emotions
• Regulating emotions
• Linking behavior to emotions
• High rate of anxiety is a result of their wiring
• Responding appropriately to emotionally
charged situations
Anxiety and Emotional
Regulation in Children with AS
Children with AS:
• Often misinterpret the environment, and this can
increase anxiety
• Lose IQ points when anxious (we all do) leading
to decreased coping & problem solving abilities
• Challenges with anxiety are often misinterpreted
as behavioral – THINK ABOUT ANXIETY FIRST
Anxiety and Emotional
Regulation in Children with AS
Common stressors for children with AS:
• Being told “no,” reprimanded, criticized
• Being around other disruptive people
• Leaving a preferred activity
• Having to engage in a less preferred activity
• Change in the environment or routine
• Having to wait for preferred events
• Having a change in directions or a new task
• Fears
Typical Learning Styles of
Children with AS
• Verbal-Linguistic or Concrete-Sequential
• Likes: order, predictability, facts/details, exact directions
• Difficulties: incomplete or unorganized environments/
tasks, open-ended questions/tasks (no right/wrong,
favorite..), waiting, dealing with opposing view, acting
without specific instructions
• Learns Best: Structured & quiet environment/ tasks,
predictable routines, clear directions/consequences,
opportunities to apply learning in practical & meaningful
ways
• Things Makes Sense: step by step approach, here/now,
a schedule to follow, visuals coupled with verbals,
immediate feedback/guided practice
CHIME IN - Applying What
We’ve Learned
• What are the behaviors that you see that challenge you or your staff?
• Do you recognize how Sensory Integration, ToM, Central Coherence
or Executive Function deficits interfere with social and academic
learning?
• How have you dealt with them?
So What Do You Do With All That
Theory? Programming for the Student with AS
• Consider All the Referenced Areas
– ToM
– Sensory Integration
– Executive Functioning
– Behavior = Communication
– Central Coherence
– Anxiety & Emotional Regulation
– Learning Style
– And then some
Guiding Principle
Consistency, Structure, and Predictability
provide Simplicity and Stability which
enable the child with AS to Anticipate
Activities thus increasing his
Independence and Self-Esteem and
Quality of Life
Consider the Human
Environment
External - What
 Non-verbal Communication (affect, gestures, body language,
proximity, nuances…)
 Verbal Communication (prosody,tone, volume, rate, type,
humor…)
External - Who
 Type (1-1, dyad, small group…)
 Adults, peers, familiar/unfamiliar….
Internal - Who (Student characteristics/temperament…)
 Physical Health (hunger, thirst, hormones, emotions, sleep…)
Consider the Non-Human
Environment
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Environment (inside/outside, place)
Seating Options & Room Arrangement
Sensory Influences (color, visuals, smells, lighting,
manipulatives, temperature, air quality, music/sounds
Animals & Plants
Seasons & Weather
Tasks & Curriculum
Putting the Theory Into Practice
• Each Child is Unique - Know the Student with AS - treat
respectfully, accept quirkiness
• Children with AS are Consistently Inconsistent - Breathe!
• They don’t get why we do what we do (ToM) - Always
provide the Why
• Anxiety ---> fight/flight/fright --> Behavior
• Know that Behavior = Communication - it’s your job to
figure out what it means
• Emotions are connected to learning & memory->
participation
• Look outside the child (Human & Non-Human Environment)
to change the behavior
• Sensory Needs have to be addressed - create a sensory
diet
• Be flexible and creative when discipline is needed
Putting the Theory Into Practice
• They don’t see the forest through the tress - teach the big
picture
• Teach to their learning style, strengths & interests
• Use visual supports whenever possible
• Use specific AS teaching materials (social stories, comic
strip conversations, Incredible 5 point scale, power cards)
• Use videotaping
• Use structures, graphic organizers, other tools to
organize the academic & social world
• Teach audience control, Hidden Curriculum
• Teach self-awareness, self-management, self-advocacy,
relaxation & emotional regulation/self-calming
School Wide
Programming Considerations
• It Takes A Village to educate students with AS - Create a
Team (parents, staff, administrators, student (when
applicable), outside therapists..)
• Building Atmosphere - Directly Teach social curriculum
and create an Inclusive, Accepting Atmosphere among
staff & students - Students with AS are Quirky
• Teacher Attitude - Consistent yet Flexible, a sense of
Humor - able to laugh at self, ability to Think Outside the
Box, Patient/Caring, Willing to ask for Help and know
that you don’t know it all, Team Player, Organized
School Wide
Programming Considerations
• Professional Development - Knowledge about AS and the
related areas (ToM, SI, EF etc. ) is critical to success,
Time & commitment for students and staff
• 3 Cs - Consultation, Communication, Collaboration, A
willingness to seek outside consultation from an expert in
the field, home-school communication system
• Staffing - Trained Special Education Staff (special
educator, OT with SI knowledge, SLP, mental health
professionals (SW, Psy.), paraprofessional/assistant
• Scheduling Considerations - leave early/arrive late,
independent studies, classes to/not to take, length of
classes, PE, Cafeteria, Assemblies, Unstructured/
Structured times of the day (hallways, recess, etc.)
School Wide
Programming Considerations
• Administration - has to want these students, set the stage
for their participation & create an atmosphere for
inclusion & acceptance
• Other Considerations - discipline, grading, homework,
modifications to instructional requirements & outcomes
• Materials/Supplies - Purchase materials specific to
Students with AS to guide instruction, Create a reference
library of published & teacher-made materials
• Space - may need additional space for OT/SI needs,
behavioral needs, calming space
School Wide
Programming Considerations
• Social-Emotional Considerations - School Wide
emphasis on social/emotional guidelines, Safe person &
safe place for the student with AS,Specific instruction in
social-emotional skills & thinking, student-teacher
relationship, friendships, play, emotional regulation, etc.)
• Assign a Case Manager - Students with AS and their
parents are time consuming
• Access, Participation and Membership - Students with
AS can thrive emotionally, socially and academically in
supportive, caring, accepting environments with well
trained staff and students
Question & Answer Period
Pick My Brain Now or Contact Me Later
Dot Lucci, M.Ed., C.A.G.S.
Director of Consultation Services
Massachusetts General Hospital/YouthCare
47A River St. Suite A200
Wellesley, MA 02481
Ph. 781-489-6635
Fax 781-235-0285
Email [email protected]
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Future Conference Calls
• All of the calls will be on a Monday at 4:00 EST.
• January 14, 2008-Arlene Remz and colleagues
from Gateways in Boston-Topic TBA
• February 11, 2008- Hidden Sparks
professionals-Topic TBA
• March 10, 2008- Second Language
Development-Teaching Hebrew to the Diverse
Learner
• May 5, 2008-TBA
• June –date and topic TBA
We thank Hidden Sparks
for their generous support of
our CoP
Stay tuned for information
about the PEJE Assembly April
6-8, 2008
Looking forward to seeing
everyone on January 14,
2008-Arlene Remz and
colleagues from Gateways in
Boston-Topic TBA”