Autism Spectrum Disorders• Autism

• Characteristics

• Strategies

• Child in Crisis

• Curriculum and Materials

• Additional Resources and Information

What is autism?Criteria for diagnosis of autism?

1. qualitative impairment in social interaction

• impairment in the use of nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction

• failure to develop peer relationships appropriate to developmental level

• a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by lack of showing, brining, or pointing out objects of interest)

• lack of social or emotional reciprocity

2. qualitative impairment in communication

• delay in, or total lack of, the development of spoken language (without trying to compensate through alternative modes of communication such as gesture or mime)

What is autism?• in individual with adequate speech, marked impairment in the ability to

initiate or sustain a conversation with others

• lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level

• stereotyped and repetitive use of language or idiosyncratic language

3. restricted repetitive and stereotyped patterns of behavior, interests, and activities

• encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal in intensity or focus

• apparently inflexible adherence to specific, non-functional routines or rituals

• stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)

• persistent preoccupation with parts of objects

(American Psychiatric Association (2000), Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision)

AutismDifferences in the brain include:•Changes in the amaygdala – regulating emotional responses•Cerebellum – regulating movement, balance, coordination•Cerebral cortex(Autism 101: Through the Looking Glass)

Facts:•Rate of autism is 1 in 150•4:1 ratio of autism in boys to girls(http://www.autismspeaks.org)

Characteristics of AutismLEARNING CHARACTERISTICS OF AUTISM• concrete- difficulty thinking abstract (autistic children typically can’t pretend or imagine something that isn’t real or couldn’t really happen) • over selectivity- cue in or attend to irrelevant detail miss the main point of task/activity

• lack of generalization- learn in one place, can’t do in another

• same content/same context- learn skill in one environment/place change aspect of place, can’t do task

• distractibility- easy to tune into something else

• visual/spatial- learn by seeing and doing rather than hearing; difficulty processing language

• ritualistic- learn pattern one way, hard to change

• motivation- Different from peers or what others would want

Classroom StrategiesTalking to a child with autism:

•Attention: make sure you get the child’s attention before talking to them.

•Unnecessary Language: be short and to the point (For example, instead of saying, You need to come and sit in your seat like all the other children until it’s time to go outside,” point to the chair and say, “Sit please.”

•Do vs. Don’t: Tell the child what you want him/her to do instead of what not to do. Avoid using don’t because a child with autism may not understand or catch the reversed meaning of the statement beginning with don’t. (Crissey, 2005, p. 3)

Classroom Strategies

• Visual Schedules

• Visuals

• Social Stories

• 5 point scale

• Comic Strip Conversations/Cartooning

• Power Cards

Visual ScheduleProviding a daily schedule in a visual format will make the day predictable, ease transitions, and reduce stress.

• full day, may break the day into sections, or display only a part of the day at a time.

• may use photos, line drawings, picture symbols or words

(Crissey, 2005, p. 3).

Visual Schedule Spelling

Reading

Math

Bathroom

Activity

Lunch

Bathroom

Recess

ABT

CCC Lab

Visual Schedule

VisualsOther types of visual supports include:

• reminders of what to do, such as posted rules

• “to do” checklists,

• charts displaying consequences for inappropriate actions.

Visually displaying free time or other choices helps the child to understand the process of decision making.

Presenting a card is often easier for the child than asking for help. Using simple cue cards for the child to give to an adult or to place in a certain location may be helpful.

(Crissey, 2005, p. 4)

I need help I need a break

5 Point Scale•visual scale

•used to help students reduce abstract ideas such as emotions, feelings, or pain into simple numbers

•can also be used to address behaviors such as vocal volume, disrespect, etc.

•can be used to help student identify where they can use certain behaviors. (e.g. vocal volume level 5 is reserved for outside or in an extreme emergency when there is no one near by that can hear you)

Example

Michael is a 5th grader with autism. He is very soft spoken and often difficult to understand. He is frequently asked to repeat things because he is so difficult to understand. He is prompted constantly to “speak louder”, however, every time he is called on the teacher has to ask him to speak up again.

A 5 point scale was created for him to use to measure vocal volume and since it is been in place the teacher no longer says “speak up”. Instead she uses phrases such as, “Say it at a 3!” or “Keep it at a 2!” In addition, she will use a visual and point the volume level she wants Michael to use.

ExampleThe scale: What it looks like:

Yelling(sirens, shouting, screaming, fire alarm)

Loud(announcements over the intercom)

Conversation(friends talking, easy to hear but not too loud)

Whisper(have to be really close to hear, talk into ear)

No sound(peaceful)

Example

“Colton is in the 6th grade. He has problems getting along in school. He likes to be in control and gets upset if he perceives something is wrong. For example, if someone cuts in line he may feel compelled to punish that person by kicking or hitting them. Colton’s ability to control his behavior varies from day to day. Colton enjoys school despite having challenges with others who do not follow his way of thinking”

(Buron & Curtis, 2003, p. 26).

ExampleLooks

Like

Feels

Like

I Can

Try toKicking or hitting My head will

explodeCall my mom to go home

Screaming or hitting Nervous Go see Mr. Peterson

Quiet, rude talk Bad mood, grumpy Stay away from kids

Regular kid Good Enjoy it

Playing A million bucks Stay that way

Social StoriesSocial Stories present appropriate social behavior in the form of a book and include:

• relevant social cues that a child might miss if not directly taught

• specific behaviors/actions the child is to expect in a given situation

• details for the child to know what is expected of him

Social stories may be used to:

• address many different behaviors from fear, aggression, obsession, etc

• teach routines and changes in routines

• help teach students to understand their behaviors and the behaviors of others

• give step-by-step directions for completing a task

• tell how to respond to a given situation

Writing a Social Story

Social stories include the following information:

1. who, what, and where

2. Statement of desired responses

3. Reaction and feelings of others involved

• social stories need to be age and ability appropriate and use terms like “usually” or “sometimes” instead of “always”

• Social stories are typically written in present tense to describe events as the take place, but may be written to describe events that will take place in the future.

• Illustrations may be included depending on the need of the student.

Presenting Social Stories

•Present the social story in a quiet place that is free from distractions

•Reread social story just before targeted situation

•Review social story frequently until behavior diminishes

•Keep the social story accessible to the student so he/she can refer back to it as needed.

•Never refer to the social story or attempt using the social story when the child is in crisis/having a meltdown.

ExampleMy Grown-Up Voice

When I need help, I will raise my hand and wait for Ms. McKenney and Mr. Jones to call on me.

When Ms. McKenney calls on me, I will use my grown-up voice to ask for help. I will not whine or make noises.

If I don’t understand something, I will use my grown-up voice and ask for help.

I can say, “Excuse me Ms. McKenney, what did you say?”

Then Ms. McKenney might say, “What nice manners you have Bill, and thank you for using your grown-up voice. I will be happy to repeat what I said.”

When I make noises, my friends can not hear Ms. McKenney teaching. My noises hurt their ears.

When I was a baby, I would whine or make noises when I needed something, because I didn’t know how to talk. I am a big boy now and I know how to talk, so I can use my grown-up voice. I do not whine or make noises to get attention.

Ms. McKenney and Mr. Jones like it when I use my grown-up voice. My voice is so nice when I don’t whine. My teachers smile and say, “What a nice voice you have, Bill. We are so happy to hear your nice voice.”

When I whine or make noises it hurts others ears, but when I use my grown-up voice, it sounds nice to others.

Everyone is happy when I use my grown-up voice.

I like using my grown-up voice.

Comic Strip Conversations/Cartooning

Comic Strip Conversations (aka: Cartooning) are visual systems used to enhance the ability of children and youth with social-cognitive challenges to understand their environment, including the hidden curriculum.

Steps for creating/using comic strip conversations:

•Drawing: Begin by drawing the drawing the comic strip conversation. This can be done by you or the student. Either way, artistic ability is not required; stick figures work fine.

•Guide with questions: The adult guides the student’s drawing or what needs to be drawn by asking a series of questions:

•Where are you? •Who else is there?•What did you do?•What did others do

(Myles, Trautman, & Schelvan, 2004, p. 28-29)

•Insight: The adult shares his/her personal insights during the cartooning process when the natural opportunity occurs. (NOTE: student should have as much control as possible during the cartooning session and adults should strive to “achieve a balance between gathering insights into the student’s perspective, while sharing accurate social information.”

•Provide sequence or structure: Use comic strip boxes in which the student can draw the figures, particularly if the student has organizational problems. This way boxes can be numbered if the events are drawn out of sequence.

•Summarize the cartoon: This allows participants to discuss the comic strip in chronological order. The student should verbalize independently, as much as possible, with the adult only clarifying as needed. Summarization ensures that both the child and the adult have the same understanding of a given situation.

•Identify new solutions: The adult and student work together, again with the student performing as independently as possible, to identify new outcomes of the pictured event. The adult and student jointly analyze each item, discussing the advantages and disadvantages of each. The student retains the list, which becomes a plan for future situations.

(Myles, Trautman, & Schelvan, 2004, p. 28-29)

Example

Example

Social Stories/Comic Strip Conversations

Social stories and Comic Strip Conversations are techniques that were created by Carol Gray. For more information about these techniques and their creator visit: www.thegraycenter.org.

Power CardsThe power card strategy is a visual aid that incorporates the child’sspecial interest in teaching appropriate social interactions including:• routines• behavior expectations• the meaning of language• the hidden curriculum.

The Power Card Strategy consists of presenting on a single sheet or in booklet form a short scenario, written in the first person, describing howthe child’s hero solves a problem and a small card, the POWER CARD,which recaps how the child can use the same strategy to solve a

similarproblem himself.

(Gagnon, 2001, p. 19)

Components:

•A brief scenario using the student’s hero or special interest and the behavior or situation that is difficult for the child. The scenario is written at the individual’s comprehension level.

In the first paragraph, the hero or role model attempts a solution to the problem and experiences success. The second paragraph encourages the student to try out the new behavior, which is broken down into three to five manageable steps.

•The POWER CARD is the size of a trading card, bookmark, or business card. It contains a small picture of the special interest and the solutions to the problem behavior or situation broken down into three to five steps. The POWER CARD is provided to aid in generalization. It can be carried in a purse, wallet or pocket or it can be velcroed inside a book, notebook, or locker. It may also be placed on the corner of a student’s desk.

(Gagnon, 2001, p. 21)

Where Can the Power Card Strategy Be Used?

Power Cards are appropriate for behaviors/situations in which the student:

1. lacks understanding of what she/he is to do.

2. does not understand that he has choices.

3. has difficulty understanding that there is a cause-and-effect relationship between a specific behavior and its consequence.

4. has difficulty remembering what to do without a prompt.

5. does not understand the perspective of others.

6. knows what to do when calm but cannot follow a give routine under stress.

7. needs a visual reminder to recall the behavioral expectation for the situation.

8. has difficulty generalizing.

9. is difficult to motivate and may be motivated only by the special interest.

10.has difficulty accepting directions from an adult

(Gagnon, 2001, p. 21-22)

Power Cards are NOT appropriate with/when the student:

1. has sensory needs such as difficulty tolerating certain noises, smells, or tastes.

2. Is extremely challenged cognitively and appears not to understand spoken language at the sentence or paragraph level. (This doesn’t mean that the child has to be a reader.)

3. engages in the problem behavior only once.

4. The teacher or other adults do not have a positive relationship with the child. Remember, the Power Card strategy is not a punishment. It should not be perceived as negative in any way.

5. A child in crisis. When the child is in the rage stage, this technique will not work.

6. does not have a well-developed area of interest. In order to buy into the strategy, the child needs to want to follow the hero’s directions.

(Gagnon, 2001, p. 22)

ExampleStudent Description:

Aaron has been acting out in class and seeking attention from his peers by saying or blurting out inappropriate comments in class. He likes the attention he gets from his peers for doing this and he thinks he’s being accepted when his peers laugh at him for doing this.

Aaron’s special interest is Nascar and he especially likes Nascar driver, Jeff Gordon.

Power Card Story:

“Jeff Gordon and His Fans”

Jeff Gordon loves being a race car driver, but sometimes it is difficult for him to think before he speaks. At the end of a long day sometimes all he wants to do is make others laugh. Sometimes Jeff blurts things out when his boss is talking. But Jeff has learned to think before he speaks. Jeff has learned it is important not to talk when his boss is talking and not to say things to try and make others laugh

when his boss is trying to talk to his pit crew and teach them the latest NASCAR rules and regulations. Jeff has learned to stop and think about the comments he makes before speaking.

Just like Jeff, it is important for Aaron to think before he speaks. It would make Jeff proud to know that Aaron is like him and that he thinks before he speaks and doesn’t interrupt his teachers in class. It is important for Aaron to remember to do the following:

1. Think before he speaks. Say it in your head first before saying it out loud. If it’s not related to what the teacher is teaching then Aaron shouldn’t say out loud in class.

2. If Aaron can’t think of something to say about the teacher’s lesson, it’s better for him not to say anything at all.

3. Always follow the classroom rules and raise your hand before you speak.

1. Think before he speaks. Say it in your head first before saying it out loud. If it’s not related to what the teacher is teaching then Aaron shouldn’t say out loud in class.

2. If Aaron can’t think of something to say about the teacher’s lesson, it’s better for him not to say anything at all.

3. Always follow the classroom rules and raise your hand before you speak.

Calm in Crisis/How to Handle a Meltdown

Don’t:•Loud voices•Negative statements/threats (e.g. “You had your chance”, “You made your choice, now you need to leave class”)•Taking away preferred or comforting materials or activities•Physical redirection•Angry tone or body language•Punishments (e.g., “You just lost your sticker on your behavior chart)

Do:One of the most important skills a teacher can have is the ability to be clam and comforting in a crisis or “meltdown” situation. A comforting teacher may:•talk softly and share encouraging words•repeat a calming phrase•or simply keep one’s own body relaxed

(Kluth)

“The more you try to control the situation, the less control you will have!”

Things to Consider:It’s important to consider the following things:

•Fight or Flight

•Ask previous teachers and/or parents what typically occurs when the child has a meltdown (does he/she throw things, hit, kick, etc.)

•Find out if there are triggers or warning signs that a meltdown might occur and if so what are those triggers or warning signs

•Talk with teachers, parents, administrators, etc and discuss the best way to deescalate the situation

•Determine when you should call for additional support

Plan for what the other students should do (Drill and Practice):

Examples:Develop a code word for clearing the room. Discuss this with your class when the student is out of the room.

Develop a place they should go when they leave the room (e.g. classroom across the hall, library, etc).

Designate a student who will go to the office, get another teacher, etc. to notify someone

Make sure that everyone involved with the student is aware of the plan

Have a Plan

Curriculum and Materials• Super Skills: A Social Skills Group Program for Children with

Aspergers Syndrome, High Functioning Autism and Related Challenges By: Judith Coucouvanis (ISBN#: 1-931282-67-6)

• Navigating the Social World: A Curriculum for Individuals with Asperger’s Syndrome, High Functioning Autism and Related Disorders By: Jeanette McAfee, M.D. (ISNB#: 1-885477-82-1)

• Power Cards: Using Special Interests to Motivate Children and Youth with Asperger Syndrome and Autism By: Elisa Gagnon (ISBN#:1-931282-01-3)

• The Incredible 5-Point Scale: Assisting students with autism spectrum disorders in understanding social interactions and controlling their emotional responses By Kari Dunn Buron and Mitzi Curtis (ISBN#:1-931282-52-8)

• The Hidden Curriculum: Practical Solutions for Understanding Unstated Rules in Social Situations By: Brenda Smith Myles, Melissa L. Trautman, and Ronda L. Schelvan (ISBN#: 1-931282-60-9)

• Practical Solutions to Everyday Challenges for Children with Asperger Syndrome By: Haley Morgan Myles (ISBN#:1-931282-15-3)

Additional Resources

• www.scautism.org

• www.autismspeaks.org

• www.futurehorizons-autism.com

• www.teacch.com/welcome.html

• www.paulakluth.com

• www.tonyatwood.com.au

• www.thegraycenter.org/

References:Gagnon, E. (2001). Power Cards: Using Special Interests to Motivate Children and Youth with Asperger Syndrome and Autism. Kansas: Autism Asperger Publishing Co. pp. 19-22.

Buron, K.D. & Curtis, M. (2003). The Incredible 5-Point Scale. Kansas: Autism Asperger Publishing Co.

Crissey, P. (2005). I Have Autism: A Child’s First Look at Autism. Super Duper Publications

Myles, B.S., Trautman, M.L. & Schelvan, R.L. (2004). The Hidden Curriculum: Practical Solutions for Understanding Unstated Rules in Social Situations. Kansas: Autism Asperger Publishing Co.

Paula Kluth: Calm in Crisis. 6 October 2008. http://www.paulakluth.com/articles/calmincrisis.html

Autism Speaks: Be Informed. 24 October 2008.http://www.autismspeaks.org/whatisit/index.php?WT.svl=Top_Nav