Autism Spectrum Disorder

Rethinking the Glass House Rule

Living with ASDMetro Parent Conference

April 7, 2017

Complexity

• Perhaps student profiles and behaviors are becoming more complex

The Real Question • What is your professional and ethical

responsibility?

Understanding Asperger - Research

• Break in the brain• Cannot figure it out• Cognitive ability does not = social skill

development• Not holding back on social skills

Activity: Conversation without looking at the person’s eyes

Aspergers – Seeking guidance from someone who probably knows what to do is usually not a first or even a second thought. The student with Aspergers might be sitting next to someone who could obviously help but appears blinkered and determined to solve the problem by himself.Atwood, 2007

Fat lady in the grocery store

Student with Aspergers remarks in his usual tone of voice and volume, “That lady is fat and needs to go on a diet” The child’s opinion is that she should be grateful for the observation and advice, the likelihood that his mother will be embarrassed or the woman would be offended at such a rude comment is not part of the thinking process.

Atwood, 2007

“People expect cognition and social functioning to be equally developed. When kids with Asperger’s Syndrome experience difficulty they [public] wrongly assume it is deliberate misconduct.”(A. Klin and F. Volkmar, 1997)

Making Associations –Right or Wrong

Create rigid rule structures to make order in ambiguity

• Playing with toys for young children and the child molester

• “NO LEFT TURNS!”• Men go to bars and women are maids• “Jocks”, “People that don’t make good

decisions” and “friends”• Pass four red cars and it’s a good day• Blue gel pen = good assignment• Grocery Store Scenario• Exchanging Christmas presents

Cerebellum

Limbic System

Cerebrum

Amygdala

Progression of Etiological Theories

BRAIN research . . . Looking at brain differences

CorpusCollosum

Cerebellum • Balance & coordination

• Modulating sensory input

• Integrating motor & sensory information

• Smaller or sudden overgrowth that decreases

Purkinje Neurons

“Inability to rapidly or accurately

shift attention”

Limbic System

Amygdala-Brain’s Fear Center

• November 22, 2006: Study (Davidson, Univ. of Wisconsin) confirms reduced size of amygdala in most socially withdrawn individuals with ASD.– Starts hyperactive and enlarged– Shrinks over time (toxic adaptation) which

correlates with length of eye contact and general fear of, withdrawal from, people.

Amygdala, Cont.

• Small amygdala: significantly slower in identification of happy, angry, sad facial expressions.– Spent least amount of time looking at eyes relative

to other facial regions.• Smallest amygdala: 40% longer to recognize

emotional expressions.• Largest amygdala: looked at eyes 4 times

longer than smaller amydgalae.

Theory of Mind: Perspective Taking and Reciprocity

• “Mind reading” ability is located in the orbito-frontal cortex-superior temportal sulcus-amygdala area of the brain.

• Winning/losing concept difficult• Difficult to engage in manipulation• Difficult to understand concept of apology• Difficult to engage in lying

Theory of Mind

Cerebrum (Cerebral Cortex)Executive Functions examples:• Reasoning• Planning• Problem

solving• Judgment• Organization

• Studies have suggested at least 75% of children with Aspergers also have a profile indicative of ADHD.

• Difficulty with four aspects of attention:– Ability to sustain attention– Attention to relevant information– Shifting attention– Storing/encoding information

(episodic vs. semantic memory)

Attention

Attwood, 2007

Executive FunctioningResearch confirms that some children, but especially

adolescents and adults with AS, have impaired executive functioning.

Elementary:Difficulty with:• Inhibition (age 8)• working memory• using new strategies

Middle School and older:Additional difficulties with:• organization and planning• self-reflection and self-

monitoring (mental conversations)

• time management and prioritizing

• understanding abstract concepts

• weak central coherenceAttwood, 2007

Neurons• Mirror Neurons:

A study by UCLA neuroscientists (Dapretto et al)featuring functional MRI suggests that

mirror neurons help people understand the intentions of others –a key component to social interaction.

Faulty?Not cued into them?

• Cell-Adhesion Molecules: Help brain cells connect (Hakonarson, 2009, Center for Applied Genomics at Children’s Hospital of Philadelphia)

Nature Neuroscience, Hahamy et al

Resting-state brain studies are important because that is when patterns emerge spontaneously, allowing us to see how

various brain areas naturally connect and synchronize their activity

• From a young age, the average, typical person's brain networks get molded by shared experiences that could make synchronization patterns more similar to each other

• It is possible that in ASD, as interactions with the environment are disrupted, each one develops a more uniquely individualistic brain organization pattern

Yawning Study

Current results suggest that contagious yawning is impaired in ASD, which may relate to their impairment in empathy. It supports the claim that contagious yawning is based on the capacity for empathy.

Senju, et al, 2007

Cognitive Differences• Cognitive development

typically ranges from average to very superior IQ.

• Difficulties may include:– Difficulty shifting attention– Difficulty processing two

cognitive tasks simultaneously– Generalizing information– Retrieving information on

demand– Developing problem-specific

solutions– Difficulty with sense of time

SOLUTION SOLUTION

SOLUTION

PROBLEM

J.Janzen, Understanding the Nature of Autism

PROBLEM PROBLEM

PROBLEM

SOLUTION

J.Janzen, Understanding the Nature of Autism

Activity: Executive Functioning

O T T F F S S

Cognitive Inflexibility• Difficulty with change• Insistence on sameness• Rule-governed• Routines/rituals• Concrete thinking• Difficulty letting go of thought and ideas• Over-focus on details (weak central

coherence)

Cognitive Inflexibility• Difficulty with change• Insistence on sameness• Rule-governed• Routines/rituals• Concrete thinking• Difficulty letting go of thought and ideas• Over-focus on details (weak central

coherence)

Cognitive Strengths• Processing whole chunks of information

quickly• Good rote memory• Good long-term memory• Process visual information meaningfully• Understand and use context-free

information and rules

Learning Characteristics of ASDUneven skill development

Tends to resist change in learning environment

Difficulty generalizing skills/information

Difficulty with abstract concepts

Relies on cues and learned routines

May tend to function more reliably with consistency and structure within activities and environments

Learning Characteristics of ASDOrganizational issues

Focus on unimportant information

Difficulties processing multiple sensory input under certain conditions

Difficulty seeing the “big picture”

Over-selectivity

Good long-term and rote memory

Prefers sequences and routines

May demonstrate desirable persistence with a task if motivated

Tendency toward literalness – difficulty with multiple meaning words

Theory of Mind(ToM) means the ability to recognize andunderstand thoughts, beliefs, desires andintentions of other people in order tomake sense of their behaviour and predict what they are going to do. (Atwood, The Complete Guide to Aspergers Syndrome, 2007)

Experts on people

Experts on things

birth

Normal

ASD

Developmental Trajectories

Theory of Mind: Perspective Taking and Reciprocity

• “Mind reading” ability is located in the orbito-frontal cortex-superior temportal sulcus-amygdala area of the brain.

• Winning/losing concept difficult• Difficult to engage in manipulation• Difficult to understand concept of apology• Difficult to engage in lying

Sub Class Swearing Homework 1st Hour

Comm Art Room E 108 Hanthorne

Y N

Y N

2nd Hour Biology Erikson

Y N

Y N

3rd Hour World History

Y N

Y N

4th Hour Algebra

Y N

Y N

5th Hour English

Y N

Y N

6th Hour Media Assistant

Y N

Teacher Internal Script

StudentInternal Script

Social Contract

Younger Students with ASD

Strategy Must Fit Within the Autism Spectrum Disorder

Angry Birds Feeling Scale Elabortory Daily Chart

Schedule

Older Students with ASD

As the Student with ASD gets Older, Because of Previous Experiences, the Window of ASD GetsMore Narrow. Strategy Must Fit within the ASD.

MaturationThe ability to understand the value of deception and recognize when it might be expected occurs later in the development of the student with Aspergers, sometimes as late as early teens.

This can cause confusion to parents and teachers, as the previously honest, (perhaps to a fault) child recognizes that one can deceive people and avoid anticipated consequences. However the type of deception can be immature and the deceit easily identified by an adult. Atwood, 2007

Travis and Lying

Travis is 18 Years OldDrives and attends a typical high school

Driving to school his check engine light came on

Communicated in the best way he knew howDid not get any response

Got a response Is this Lying

Background Information

• Staff explained they could not believe what Travis said anymore He was constantly lying.

• Used white board invited Travis into the meeting

• Put the word liar on the white board• Travis said – “Everyone thinks I am a Liar”

• What was discovered by the facilitator and staff?

Travis’s Take on Things• “Telling the truth is not good enough for the

people”• Translation – I need help and the staff does

not help me• “The wrecker is better because my car blew

up”• Translation – Ms. Black responded to the

wrecker is coming because my car blew up but did not respond to my check engine light coming on

PROBLEM PROBLEM

PROBLEM

SOLUTION

J.Janzen, Understanding the Nature of Autism

Maturation• Lying and Asperger Syndrome• Due to the impaired or delayed ToM abilities,

the person with Aspergers may not realize that the other person is likely to be more offended by the lie than by any apparent misdemeanor

• He may consider that a lie can be a way of avoiding consequences or a quick solution to a social problem

• Maintaining self esteem should he have an arrogant self image whereby the making of mistakes is unthinkable. Atwood, 2007

Typical children, especially after the age of five years, are remarkably astute at perceiving and understanding social cues that indicate thoughts and feelings. (Michelle Garcia Winner, 11-08)• Parents nor educators teach these skills• Parent and educators only notice when these

skills are not present• The lack of these skills makes students and

adults uncomfortable• Zero productive social skills curriculum

developed

It is as though their mind prioritizes social cues above other information in their environment and they have a mental theory as to what the social cues mean and how to respond. (Michelle Garcia Winner, 11-08)• Minds of typically developing students work

differently• Lack of the prioritization of social skills• Lack of a mental theory • Eric example• Resulting response? How does this manifest

in a student you know?

This ability dominates the perception of typical people to such a degree that we become anthropomorphic and projecthuman social behaviour on animals andeven objects. (Michelle Garcia Winner, 11-08)

• Anthropomorphic - Attribution of human motivation, characteristics, or behavior to inanimate objects, animals, or natural phenomena.

• Factual or predictable information dominates the Asperger’s Population

S.A.T. Study – Aspergers• Significant differences• Typical

– Chasing, entrapping, and playing– Frightened, elated or frustrated

• Aspergers: Different terms to explain movement of shapes– Bouncing or oscillating vs. bravery or elation– Narratives – shorter with less elaborate plots– Fewer, more simplistic personality attributions– Focus on physical aspects of objects

Attribution Theory• Every day we must guess how people will

act, often from small shreds of evidence.• We do this through a form of social

cognition called attribution. • As we observe others, we make

inferences about them. We attribute people’s behavior to various causes.

• Whether we are right or wrong about the causes of their behavior, our conclusions affect how WE act.

Attribution• In 2005, in the aftermath of hurricane

Katrina, many celebrities went to New Orleans to help hurricane victims. As you watched these events, did you:

Attribute the celebrities’ actions to selfless concern for the suffering in New Orleans?

ORWere the celebrities motivated by a selfish desire to hog the limelight?

Attribution Theory

Two people enter a restaurant and order different meals. Nell tastes her food, then salts it. Bert salts his food before he tastes it. How would you explain their behavior?

Introduction to Psychology: Gateways to Mind and Behavior: Twelfth Edition, 2010 Cengage Learning, Inc.

Fundamental Attribution Error(It IS human nature!)

• Attribution Theory• Erroneous cognitive tendency• Over-value dispositional-based explanation for

behaviors of others• Under-value potentiality of situational

explanations for behavioral motives of others

We predominantly presume that the actions of others are indicative of the "kind" of person they are, rather than the

kind of situations that compel their behavior.

An attribution is an inference about why an event occurred. More generally, "attribution is a process that begins with social perception, progresses through a causal judgment and social inference, and ends with behavioral consequences."

(Crittenden 1983)

Professional Responsibility

Path A Path B

??

Attribution• Going to have prejudices/attribution errors • Lack of social skills – negates any viable

opportunities • Oddity about social characteristics• Physical appearance• Perceived cognitive ability• Are we going to be embarrassed?• Is she going to embarrass herself?• Make people uncomfortable

What made you change what you attribute her behavior to?

She Started SingingStrengths Outweighed Public

Perception

Susan Boyle: Behavior Didn’t Change

• Walks off stage without results• Doesn’t understand she won by reactions• Wake up call• Shut down the cynicism in the audience

• We are going to make attributions and attribution errors

Doesn’t Change Issues• Required Hospitalization• Continued Difficulty with Social Situations• Support Person – Britain’s Got Talent• Greater Societal Understanding –

Because of TalentWhat would have happened to her without

discovery of her talent?

Continued sneers and judgment of her lack of social understanding

Students with AspergersHave Strengths and Talents

How will we respond?

Will we give them a chance and overcome our own attribution errors?

Will we be judgmental and attribute their behaviors to their own control?

Option A Option B Option C

Keep doing what

you’re doing

Magic Fix

Put strategies in

place & support the student with lens of AS

Michigan Definition to Determine Eligibility for ASD

• Qualitative Impairments in Reciprocal Social Interactions: 2 of 4 areas

• Qualitative Impairments in Communication: 1 of 4 areas

• Restricted, Repetitive and Stereotyped Behaviors: 1 of 4 areas

What Do You Attribute the Student’s Focus and/or Intensity of Interest Area To?

• Pick Student: To what to you attribute focus and/or intensity of interest area?

• Worksheet

• Collin – Dinosaurs

Fundamental Attribution ErrorCollin - Outcomes

Path A Path BLikely outcomes for Collin if his behavior is attributed to Aspergers and the situational context??

Likely outcomes for Collin if my attribution is dispositional based??

Cut the projector screen and leaf on plant;Pulled down his pants to show peers his underwear

Fundamental Attribution ErrorCollin - Outcomes

Path A Path B

Showing DinosaurDinosaur Scissors

Sexual HarassmentProperty Destruction

Cut the projector screen and leaf on plant;Pulled down his pants to show peers his underwear

An attribution is an inference about why an event occurred. More generally, "attribution is a process that begins with social perception, progresses through a causal judgment and social inference, and ends with behavioral consequences"

(Crittenden 1983)

Focus and/or Intensity of Interest Area

The special interest has several functions:a. To overcome anxietyb. To provide pleasurec. To provide relaxationd. To ensure great predictability and

certainty in lifee. To help understand the physical worldf. To create an alternative worldg. To create a sense of identityh. To occupy time, facilitate conversation

and indicate intellectual ability (Atwood, 2007)

Not No Where and When

Intense Interests

• What About Us?– Do you ever feel like something is missing?– What do you do?– How do you handle it?

– Where is YOUR CELL PHONE right now?

Group Discussion

Intense Interests

This is hard!!!

Co-workers will say that you are giving into the Autism

Spectrum Disorder

Professional ResponsibilityStudent’s Focus and/or Intensity of Interest

Your Own Student

Path A Path B

? ?

NO

WHERE WHENAND

Option A Option B Option C

Keep doing what

you’re doing

Magic Fix

Put strategies in

place & support the student with lens of AS

Michigan Definition to Determine Eligibility for ASD

• Qualitative Impairments in Reciprocal Social Interactions: 2 of 4 areas

• Qualitative Impairments in Communication: 1 of 4 areas

• Restricted, Repetitive and Stereotyped Behaviors: 1 or 4 areas

What Do You Attribute the Student’s Communication Issues To?

• Pick Student: To what to you attribute communication difficulties?

• Worksheet

• Matthew – Doughnuts and Police

Fundamental Attribution ErrorMatthew - Outcomes

Path A Path BLikely outcomes for Matthew if his behavior is attributed to Aspergers and the situational context??

Likely outcomes for Matthew if my attribution is dispositional based??

Asked the Police Officer in an assembly if he likeddoughnuts

Fundamental Attribution ErrorMatthew - Outcomes

Path A Path B•Intense questioning about police officers and doughnuts•Questions all police officers if they like doughnuts based on urban legend•Lack of understanding

•Making Fun of Police Officers•Disrespectful in an Assembly•Physical Management•10 Days Suspension

Asked the Police Officer if he liked doughnuts

An attribution is an inference about why an event occurred. More generally, "attribution is a process that begins with social perception, progresses through a causal judgment and social inference, and ends with behavioral consequences"

(Crittenden 1983, p. 426).

Pragmatic Language (Social Communication)

• Pedantic, formal– In this economy – Calculate my percentage – When in a rare conflict

• Difficulty with relinquishing conversational turn--prompts

• Limited understanding of conversational partner (interest, cues, topic appropriateness)

• Tone of voice (often perceived as disrespectful)• Literal use of Language

– Blow Your Socks Off– Stinker– What’s Up

Whenever a Student with ASD is Struggling Stop Talking

Think Visual Strategies and Supports

Pragmatic Language (Social Communication)

• Pedantic, formal– In this economy – Calculate my percentage – When in a rare conflict

• Difficulty with relinquishing conversational turn--prompts

• Limited understanding of conversational partner (interest, cues, topic appropriateness)

• Tone of voice (often perceived as disrespectful)• Literal use of Language

– Blow Your Socks Off– Stinker– What’s Up

We have a young man in our middle school who has autism (we actually have many young people with autism....however this story just focuses on one specific young man) and has been rather challenging so far this year. Well, today he decided that he didn't want to participate in class.....after losing all his tokens he was taken to "time-away". Of course, this didn't go as planned and MK had to assist the parapro in moving him to his designated timeout area. Once he was safely escorted to his time-away...he served his "time", completed his compliance task and immediately bolted for the bathroom. Of course, all the individuals working with him at this time were female and thus could not enter the bathroom.....so I was called. I entered the bathroom to find him just standing there....really doing nothing. The moment I enter...he runs into one of the stalls and attempts to slam the door shut. I quickly grab the door and walk in. At this point....he backs himself into a corner and in his deepest most convincing pirate voice....says " "You'll never get anything out of me...you lousy no good scum-sucker". I start laughing...tell him that is a great line and ask him what class he needs to be in? He says "room 104" At this point, we walk out of the bathroom, I hand him over to his parapro and they head down the hall to room 104. When they arrive...they walk into Mrs. Redker's class as she is teaching sex ed. The young man hears the topic......takes one look at his para and yells "I'm not ready for this" and bolts out of the room!!! Hey..Mr. Caine, do you think this is a "pragmatic" issue? Gotta love our jobs! Hope each of you are having a great day!

Liam raised his hand and asked a question about what he was supposed to do. The task was identifying a vocabulary word that had a similar meaning to two stimulus words. Mrs. K helped him with one item, told him to do a “process of elimination,” and walked away.

Liam said, “I don’t know!” Mrs. K replied, “Well, you’ve got to go through the words. Just skip the ones you don’t know.”

Liam said, “I’ll skip the whole thing.” He began laughing to himself again.

Mrs. K. said, “Do you need Mrs. C to remind you about being appropriate?” Liam said, “No, I need Mrs. C to remind me about how to do this!”

Pragmatic Language (Social Communication)

• Pedantic, formal– In this economy – Calculate my percentage – When in a rare conflict

• Difficulty with relinquishing conversational turn--prompts

• Limited understanding of conversational partner (interest, cues, topic appropriateness)

• Tone of voice (often perceived as disrespectful)• Literal use of Language

– Blow Your Socks Off– Stinker– What’s Up

Ordering/ReOrderingSecretaries Name

• Baiba• Bunny• Bev• Blanche• June

• What is wrong with this place?• Get a normal name• At least they could all start with the same letter

Option A Option B Option C

Keep doing what

you’re doing

Magic Fix

Put strategies in

place & support the student with lens of AS

Professional ResponsibilityStudent’s Communication

Your Own Student

Path A Path B

? ?

Michigan Definition to Determine Eligibility for ASD

• Qualitative Impairments in Reciprocal Social Interactions: 2 of 4 areas

• Qualitative Impairments in Communication:1 of 4 areas

• Restricted, Repetitive and Stereotyped Behaviors: 1 or 4 areas

What Do You Attribute the Student’s Social Skill Differences To?

• Pick Student: To what to you attribute the social mistakes?

• Worksheet

• Jacob – Student attention

Fundamental Attribution ErrorJacob - Outcomes

Path A Path BLikely outcomes for Jacob if his behavior is attributed to Aspergers and the situational context??

Likely outcomes for Jacob if my attribution is dispositional based??

Tickled peers on the back of the neck

Fundamental Attribution ErrorJacob - Outcomes

Path A Path B•Desperately wanted to •Interact with Kids•Tickle Back of Necks•Trying to Fit In•Incompatible Response•Tried Even Harder

•Targeting Students•Aggressive Toward Peers•Change of Classroom•Feared by Others•Threat of 10 Days Suspension

Tickled peers on the back of the neck

Card QuestionsQuestion Answer

1 How many cars make up the chase for the race? 122 C.O.T.in 2007 stood for what? Car of Tomorrow3 C.O.T. in 2008 stands for what? Car of Today4 How many road races are run each year? 25 How many point races are in a season? 366 What's the biggest race of the year? Daytona7 What was Jr's old number? 88 What is Jr's new number? 889 What was Jr's old sponsor? Budwiser

10 What is Jr's new sponsor? AMP/Mt. Dew11 What team does Jr. race for now? Hendrick

12 Who are Jr's new teammates?24- Jeff Gordon; 48 Jimmy Johnson; 5 Casey Mears

13 Who drove the #5 car last year? Kyle Bush14 What team does Kyle Bush drive for this year? Joe Gibbs Racing15 What is Kyle Bush's new number? 1816 What kind of car does Jr. drive? Chevy Impala17 What new car manufacture started in cup series in O7? Toyota

18 What team did Jr start his career with? D.E.I./Dale Earnhart Inc19 What kind of tires does NASCAR use? Goodyear20 What kind of car did the Chevy teams use last year? Monte Carlo SS21 Who is Jeff Gordon's sponsor? Dupont22 who is Jimmy Johnson's sponsor? Lowe's