Download Supporting Students with Autism Spectrum Disorder

Supporting Students with Autism
Spectrum Disorder
Autism, Education & Behavior Consulting
Austin, Texas
2015
WHO ARE YOU?
Find Your Hobby Partners
Name
Experience you’ve had with
autism in your professional,
volunteer or personal lives
Learning Objectives
Participants will:
 Identify the areas of impairment associated with ASD
 Identify 3 learning characteristics of children with ASD
 Use the information about learning characteristics to identify
how the participant will work, interact and advocate for
students with ASD
TODAY’S AGENDA
 Autism Diagnosis
 Characteristics
 Strategies, Curriculum and Materials
 Family/Child in Crisis
 Additional Resources
It is sometimes said
that if you know one person with
autism,
you know one person with autism.
What is ASD?
Diagnostic and Statistical Manual of Mental Disorders
(5th ed.; DSM-5; American Psychiatric Association, 2013)
 Autism spectrum disorder (ASD) and autism are both general terms
for a group of complex disorders of brain development
 Neurodevelopmental Disorder
 A diagnosis of ASD now includes several conditions that used to be
diagnosed separately: autistic disorder, pervasive developmental
disorder not otherwise specified (PDD-NOS), and Asperger
syndrome.
THESE CONDITIONS ARE NOW ALL CALLED
AUTISM SPECTRUM DISORDER.

DIAGNOSIS
 No medical test
 Doctors look at the child’s behavior and development to
make a diagnosis
 ASD can sometimes be detected at 18 months or younger
 By age 2, a diagnosis by an experienced professional can be
considered very reliable
 Many do not receive a final diagnosis until much older
https://www.youtube.com/watch?v=qb_pX7n3ZRI
Early Signs @ 24 months
1.23 minutes
DIAGNOSIS
 The diagnosis of autism spectrum disorder is based on
analysis of
 Social communication & social interaction
 Restricted, repetitive patterns of behavior,
interests, or activities
 Severity of symptoms
DIAGNOSIS
A.Persistent deficits in social communication & social interaction
across contexts not accounted for by general developmental delays;
3/3 symptoms
A1
A2
A3
Deficits in social-emotional reciprocity
Deficits in nonverbal communicative behaviors used for social interaction
Deficits in developing, maintaining & understanding relationships
B. Deficits in restricted, repetitive patterns of behavior, interests, or
activities; 2/4 symptoms
B1
B2
B3
B4
Stereotyped or repetitive speech, motor movements or use of objects
Excessive adherence to routines, ritualized patterns of verbal or nonverbal
behavior, or excessive resistance to change
Highly restricted, fixated interests that are abnormal in intensity or focus
Hyper or hypo-reactivity to sensory input or unusual interest in sensory
aspects of the environment
See Dr. Laura Carpenter, Ph.D. 2/2013 Handout, “DSM-5 Autism Spectrum Disorder”
DIAGNOSIS
 Symptoms can be currently present or reported in past history
 In addition to the diagnosis, each person evaluated will also be
described in terms of
 any known genetic cause (e.g. Fragile X syndrome, Rett syndrome)
 level of language
 intellectual disability
 presence of medical conditions such as seizures, anxiety, depression
and/or gastrointestinal (GI) problems
DIAGNOSIS-DSM-5
NEW CATEGORY
Social Communication Disorder (SCD)
 Diagnosis for disabilities in social communication, without
the presence of repetitive behavior
More research and information is needed
 There are currently few guidelines for the treatment of SCD
 Utilize autism-specific interventions
WHO PROVIDES DIAGNOSIS?
 Developmental Pediatrician
 Neurologist
 Psychiatrist
 Team of Specialists (audiologist, speech & language therapist
occupational therapist)
 A Multi-Disciplinary Evaluation is important for diagnosing
autism and other challenges that often accompany autism,
such as delays in motor skills.
DID YOU KNOW…
The co-occurrence of one or more non-ASD developmental diagnoses is 83%.
The co-occurrence of one or more psychiatric diagnoses is 10%
PREVALENCE
Centers for Disease Control (CDC)
 In March 2014, the Centers for Disease Control and Prevention
issued their ADDM autism prevalence report
 Prevalence of autism: 1 in every 68 births in the United States –
nearly twice as great as the 2004 rate of 1 in 125
Almost 1 in 42 Boys
1 in 189 Girls
http://www.cdc.gov/ncbddd/autism/data.html
PREVALENCE
Autism Speaks, 2012
No longer a “low incidence disability”
More prevalent than children affected by
Diabetes
AIDS
Cancer
Cerebral Palsy
Cystic Fibrosis
Muscular Dystrophy
Down Syndrome
Almost half (46%) of children identified with ASD have average to above average intellectual ability.
Causes and Risk Factors
We do not know all of the causes of ASD.
We do know there may be many factors that make a
child more likely to have ASD.
Causes and Risk Factors
 RISK FACTOR 1
Genetic predisposition-Research has identified more than
100 autism risk genes.
 RISK FACTOR 2
Children who have a sibling with ASD are at a higher risk of also
having ASD. 5-10
 RISK FACTOR 3
ASD tends to occur more often in people who have certain
genetic or chromosomal conditions, such as fragile X
syndrome or tuberous sclerosis.11-14
Causes and Risk Factors
 RISK FACTOR 4
When taken during pregnancy, the prescription drugs
valproic acid (Depakote) and thalidomide have been linked
with a higher risk of ASD.15-16
 RISK FACTOR 5
There is some evidence that the critical period for developing
ASD occurs before, during, and immediately after birth. 17
 RISK FACTOR 6
Children born to older parents are at greater risk
Causes and Risk Factors
CDC currently working on one of the largest U.S. studies to
date, called Study to Explore Early Development (SEED).
SEED is looking at many possible risk factors for ASD,
including genetic, environmental, pregnancy, and behavioral
factors.
LONG TERM
 Researchers estimated the lifetime cost of caring for a child
with autism is as great as $2.4 million
 Spending on special education, housing during adulthood, &
indirect costs like lost productivity were the biggest
contributors to the million-dollar price tag
D.J. Svobodo
Artist, Motivational Speaker,
Author, Artist
Susan Boyle, Singer, Performer
Dan Akroyd, Actor, Producer, Writer
STRATEGY 1
Visual supports are a way of making
auditory information visual.
STRATEGY 2
Structured and consistent schedules,
agendas, & plans
STRATEGY 3
Prepare for
Transition
https://www.youtube.com/user/timetimer
Time: 2.03 minutes
Linear Clock or Wait Strip
A different, linear concept of a visual timer that features a
concrete visual representation of time, amount of steps to
be completed, number of minutes to work, math problems
to be completed using a series of dots as a visual guide.
Linear Clock
5
4
3
2
1
STRATEGY 4
Provide Breaks and a Home Base
 Create a Break Area
 Teach how to request a
Break
 Teach what to do in the
Break Area
Provide Breaks and a Home Base
 Supportive Space
 Non-punitive
 Scheduled/unscheduled
 Safe Break Area
 Overview of changes
in day/schedule
 Escape from stress of
current environment
STRATEGY 5
ALL students need SENSORY
SUPPORTS
https://vimeo.com/52193530
Time: 2.23 minutes
Sensory Supports Matrix
Student: _________
Time
Activity
Location
8:00 – 8:15
Opening/Calendar
Time
Classroom
Skill Development
Sensory Supports
Needed
Point to color of the week Koosh ball that is
“bounced” on his body
for reinforcer
Examples of sensory overload
12 signs of Sensory Overload
1. Loss of Balance/coordination
2. Skin flushes/goes pale
3. Child is verbalizing STOP!
4. Child refuses activities
5. Racing heartbeat
6. Hysteria/crying
7. Stomach Distress/nausea/vomiting, cramps
8. Sweating
9. Child becomes Angry/Agitated
10. Child begins repeating
11. Self-stimulatory behaviors occur
12. Child lashes out
34
STRATEGY 6
SUPPORTING SOCIAL INTERACTIONS
 Direct Instruction
 Social Narratives
 Cartooning
 Power Card Strategy
 Incredible 5-Point Scale
35
DIRECT INSTRUCTION
Levels of Learning
 Acquisition
 Fluency
 Generalization
 Maintenance
•
•
•
•
GENERALIZATION
Teach in a group and in
the real setting
Teach REAL skills
Practice DAILY
3X3X3
SOCIAL NARRATIVES/SOCIAL STORIES




Social Narratives are stories developed to provide learners
with insight into social situations.
Emphasizes the significant social cues of given social situations
The story provides the learner with examples of appropriate
social responses
Allows educators to pre-teach social situations and provide
learners with strategies to respond to those situations
The narrative must be individualized to the learner’s needs and
interests
http://www.kansasasd.com/socialnarratives.php
SOCIAL NARRATIVES
37
CARTOONING
Promotes social understanding
Use conversation and thought bubbles
Use comic strip format
Facilitates understanding of social situations
Arwood, E. & Brown, M. M. (1999) A guide to cartooning and flowcharting:
See the ideas. Portland, OR: Apricot
38
POWER CARD STRATEGY
 Power Card Strategy involves including special interests with
visual aids to teach and reinforce academic, behavioral and
social skills to individuals with Autism Spectrum Disorder.
https://www.youtube.com/watch?v=kKDQIC5Hv0U
Time: 1.46 minutes
The Incredible 5-Point
Scale
Autism Asperger
Publishing Company
https://www.socialthinking.com/
VIDEO
“5 Things Teachers Should Know About
Students With High-Functioning Autism
https://www.youtube.com/watch?v=txx8G6_FsaU
3.28 minutes
STRATEGY 7
Channel Their Strengths
Dr. Temple Grandin, Professor of Animal Sciences
James, Durbin, American Idol Finalist, Musician
David Byrne, Oscar Winner Musician
ACTIVITY
 Pair up or break into small groups
 Discuss 1 characteristic and a matching strategy that you will
use with a student
FAMILY STRESSORS
In the home
Outside the home
 Sleep issues
 Insurance limitations
 Behavioral/Communication
 Finding a doctor,




Issues
Marital differences
Medication issues
Homework issues
Sibling issues





hairdresser, dentist, etc.
Medication issues
Community isolation
No friends
Recreation leisure
limitations
Faith based issues
Services & Supports for High Functioning ASD
 No single or best treatment
 Parent training/Support
 CBT helpful for teens/adults in
 Group social skill development
learning social skills and selfcontrol of emotions, obsessions
and repetitive behaviors.
 Educational and social support
programs that focus on social
and adaptive skills utilizing a
step by step highly structured
activities. The instructor may
repeat important ideas or
instructions to help reinforce
more adaptive behaviors.




programs
SLP, OT, PT
Early interventions
Behavioral interventions
Medications such as selective
serotonin reuptake inhibitors
(SSRIs), antipsychotics and
stimulants to treat associated
problems such as anxiety,
depression and hyperactivity and
ADHD.
Autism Addendum is MANDATORY for
Students with ASD
•Review and update addendum at ANNUAL ARD
•Consider all 11 elements of the supplement
• We are NOT required to provide all of the services in
each of the 11 components
•We are required TO CONSIDER all 11 components
Components of the
Autism Addendum
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Extended educational programming
Daily schedule with minimal unstructured time
In-home/community training
Positive behavior support strategies
Transition planning
Parent/family training support
Staff to student ratio
Communication interventions
Social skills supports
Professional educator/staff support needed
Research based strategies
In-Home/Community Training and
Viable Alternatives
The ARD committee has considered information about
daily schedule reflecting
IN-HOME / COMMUNITY TRAINING or VIABLE
ALTERNATIVES
for acquisition of social / behavioral skills in new
contexts and determined:
In-Home/Community Training and
Viable Alternatives
 Purpose of in-home and community based training:
 Helps Ss reach acquisition of social/behavioral skills
 Promotes maintenance & generalization of skills across school,
home, community
 The district provides an in-home trainer
 Requires in-home training needs assessment
 Goals/objectives for in-home training are developed from
assessment
 TAC 89.1055(e)(3) “In-home/community-based training is an option
an ARD committee may choose for a student with autism in order for
the student to learn or reinforce social skills in a variety of settings.”
Parent/Family Training
The ARD committee has considered information
about PARENT / FAMILY TRAINING and
determined:
An ARD committee should address fading
strategies when parent training is discussed.
Parent/Family Training
 Parent/family training and support, provided by qualified personnel
with experience in Autism Spectrum Disorders (ASD)
 Provides a family with skills necessary for a child to succeed in the
home &/or community setting
 Includes information regarding resources (Ex. parent support groups,
workshops, videos, conferences, and materials designed to increase
parent knowledge of specific teaching/management techniques related
to the child's curriculum)
 Facilitates parental carryover of in-home training (Ex. strategies for
behavior management and developing structured home environments
and/or communication training so that parents are active participants
in promoting the continuity of interventions across all settings
COMMUNITY RESOURCES
• Austin Travis County Integral Care
• Growing Roots
• Spectrum Services
• Easter Seals Central Texas
• Any Baby Can
• Blue Sky Abilities
• Austin ISD FASST Team
http://www.integralcare.org/
http://growingrootsaustin.com/
http://www.spectrumsocial.net/
http://www.easterseals.com/centraltx/
http://www.anybabycan.org/
http://www.blueskyabilities.com/index.html
http://eparentsupport.org/page.php?2
• Texas Child Study Center
https://www.dellchildrens.net/services_and_programs/texas_child_study_center__mental_health_services/
• DARS Autism Program
http://www.dars.state.tx.us/autism/ContractorsProvidingServices.shtml
RESOURCES
 Autism Society of Central Texas
http://www.austinautismsociety.org/
 Autism Speaks
http://www.autismspeaks.org/
 Region 13 Autism Supports
http://www4.esc13.net/autism
 Autism Society of America
http://www.autism-society.org/
 Austin ISD Behavior Specialists Website
https://sites.google.com/site/aisdbehavior/home
Remember, that we are All teachers…
https://www.youtube.com/watch?v=JnylM
1hI2jc