Los Angeles Unified School District Division of Special Education

4. Autism Spectrum Disorder First described by Leo Kanner in 1943 Lifelong disorder: there is no cure at this time Can be present at birth, but typically appears prior to age 3 Affects 1 in 166 Four to five times more common in boys

5. Autism Worldwide Increase Possible Reasons: Medical and Educational community better informed Genetic evidence for predisposition in some families Compromised immune system and environmental factors Vaccines???

6. IMPORTANT FACTORS TO CONSIDER WHEN PROJECTING STUDENT OUTCOMES

7. Core Areas of Deficit Speech and Language Deficits Non-Verbal Echolalic/sterotypical language Hyper-Verbal Social Skill Deficits Range from isolative to indiscriminately social Limited/Repetitive Behavioral Repertoire Self Stimulation Rigidity Perseverative Inflexibility

8. The symptoms of autism fall on a continuum from mild to severe in many domains. Each individual is affected differently. It is common for a child to exhibit an extremely uneven profile. IQ: For example, a child with a low measured IQ may have above average word recognition or spelling skills. They may be able to read or spell the word �big� but unable to choose the big object. One child loves to read VCR manuals but would be unable to program a VCR or explain the directions. Another child may have a high measured IQ but be unable to function successfully in the social environment of the classroom without extensive assistance and modifications. Cognitive assessment of these students is complex and the measured IQ is typically an underestimate, particularly at younger ages. Social ranges from isolation to active but not typical. Communication ranges from nonverbal to quite chatty but lacks development of fluent reciprocal communication. Gross and fine motor skills are quite varied. Sensory impairments reflect actual sensory differences and are unique to each student. The symptoms of autism fall on a continuum from mild to severe in many domains. Each individual is affected differently. It is common for a child to exhibit an extremely uneven profile. IQ: For example, a child with a low measured IQ may have above average word recognition or spelling skills. They may be able to read or spell the word �big� but unable to choose the big object. One child loves to read VCR manuals but would be unable to program a VCR or explain the directions. Another child may have a high measured IQ but be unable to function successfully in the social environment of the classroom without extensive assistance and modifications. Cognitive assessment of these students is complex and the measured IQ is typically an underestimate, particularly at younger ages. Social ranges from isolation to active but not typical. Communication ranges from nonverbal to quite chatty but lacks development of fluent reciprocal communication. Gross and fine motor skills are quite varied. Sensory impairments reflect actual sensory differences and are unique to each student.

9. Communication Deficits Severe delay or complete absence of speech Immediate or delayed echolalia Poor auditory processing Odd voice quality/volume Understanding of language is literal/concrete (e.g., �listen up.� �It�s raining cats and dogs�) May repeat sounds/questions/phrases

10. Strategies to address Communication needs Language occurs throughout day and taught by everyone Use augmentative communication to stimulate verbal language (e.g. PECS) Use visual cues to facilitate understanding of abstract concepts (e.g. pictures, drawings, written words) BE CONCRETE

11. Communication Strategies (con�t) Teach for generalization by teaching in variety of settings, using different materials (e.g., color red: apple, stop sign, shirt, crayon) Auditory processing deficits: allow extra time for student to respond

12. Social Skill Deficits Infants/children irritable and hard to comfort Isolative Poor/no eye contact; odd eye gaze Inappropriate giggling or laughing No understanding of �friendship�

13. Strategies for Improving Social Skills Shape desired behaviors Teach and practice appropriate social skills in natural environments Establish a �friendship system� for community integration Have neurotypical peers or adults prompt/cue appropriate social skills Capitalize on child�s strengths in integrated settings

14. Academic Challenges Children adapt poorly to others and changes in routines Do not use toys for intended purpose (e.g., spins, lines up, flips, etc.)

15. Academic Challenges (con�t) Uneven development of skills: - Decodes words but unable to comprehend meaning - Good computation skills, but unable to apply - Excellent visual matching skills - Gross/fine motor skills range from superior to very poor

16. Strategies that Address Academic Challenges Avoid surprises Visual Schedules assist with daily routines and transitions Provide predictable structured, safe, environments Use priming techniques Visual supports

17. Visual Supports Today�s Schedule Breakfast Speech � Ms. Jane OCR � Ms. Nelson Written Language Recess Math Social Studies Lunch Reading Comprehension Art or Music Homework Review Dismissal

18. Strategies that address Academic Challenges Break tasks into smaller parts Teach how to use toys/games appropriately Stress �functional use� of academic skills Fade cueing

19. Sensitivity to environmental conditions Hyper or hypo sensitivity to auditory, visual, smell/taste, tactile/kinesthetic Sensory Deficits

20. Response to Sensory Input Under/over reaction to sound Eye contact avoidance Focus on details of objects Avoids specific foods/odors/textures, etc.

21. Strategies to AddressSensory Differences Remove environmental conditions, if reasonable (e.g., odors) Desensitize in small steps (consulting with O.T.) Implement sensory diet, as prescribed by O.T.

22.  Asperger Syndrome

23. Asperger Syndrome (AS) First described by Hans Asperger in 1944 (Mildest and highest functioning end of ASD) Abnormalities noted in 3 broad aspects of development ? Social interaction and emotional relatedness ? Unusual patterns of narrow interests ? Behavioral and stylistic characteristics involving repetitive/perseverative features

24. Asperger Syndrome (con�t) Students more likely found in general education classrooms and often undiagnosed or misdiagnosed as ADD, ED, LD, or just odd Genetic factors more prevalent in AS. Often family history of autism, most often on the father�s side

25. Characteristics: Higher cognitive abilities (average to superior) Lucid language by 4 years Present with considerable pragmatic language difficulties Speech often stilted and repetitive; conversations revolve around rote, factual topics

26. Additional Characteristics Often engage in rituals Worry excessively when they do not know what to expect

27. Deficits in Pragmatic Language Turn-taking skills (within play and conversation) Gestalt processing (seeing the big picture) Perspective-taking Problem solving Organization

28. Additional Issues with Pragmatics Social Expectations Proximity, eye contact, intonation Conversational skills - Talking too much - Interrupting - Changing topics without transition (From Gail Hallenberg, M.S.,CCC-SLP)

29. Strategies to Improve Pragmatic Language Teach rules of communication Teach conversational skills step by step, using visual aides and representations Role playing Start with easier tasks and add complexity as the student gains skills and confidence

30. Work on different contexts and generalization Repetition/practice Always explain �why� -- Helps students see the perspective of others (From Gail Hallenberg, M.S., CCC-SLP)

31. Academic Challenges Verbal abilities higher than performance skills Lack higher level abstract thinking and comprehension skills Impressive vocabularies give false impression that they understand (may be parroting what read or hear)

32. Academic Challenges (con�t) Excellent rote memory skills, but mechanical in nature Exhibit poor problem solving skills Literal and concrete thinkers

33. Educational Strategies for Academic Challenges Individualized academic programming designed to offer consistent success Make learning rewarding, not anxiety provoking Redirect away from following their own impulses Insure student�s understanding of presented material via his/her demonstration of it

34. Academic Strategies (con�t) Big job: Clean your desk Little chunks: 1. Put pencils in pencil box 2. Close covers of all books 3. Throw away all wrinkled/ torn papers 4. Put important papers in a folder 5. Put books in a neat stack Break reading comprehension into smaller parts and analyze 1 section at a time Expectations must be set for amount and quality of work produced. Start small and increase as skills develop Earning time toward doing what interests them is often a good motivator to do what is expected.

35. Behavior Support First Then

36. Strategies Simplify abstract concepts. Use visuals as much as possible Teach the difference between general knowledge and personal ideas to help with writing skills

37. Emotional Vulnerability Often don�t have the emotional resources to cope with the demands of the classroom (esp. from 3rd grade on) Easily distressed due to inability to be flexible and lack of organizational skills Intolerant of making mistakes, low self-esteem Prone to depression Rage and tantrum reactions common response to stress and frustration

38. Educational Strategies: Emotional Vulnerability Provide high level of consistency to prevent outbursts Teach students strategies to cope with their stress: Make list of concrete steps to follow when they become upset (e.g., 3 deep breaths, count fingers of left hand 3 times, ask to take a break outside of classroom, write steps on card, etc.) Be alert to changes in behavior that signal depression: More disorganized, inattentive, isolative, crying/suicidal remarks, increased levels of stress, etc.

39. Social Challenges for Students with AS Self observation/ evaluation of impact on others Perspective taking; empathy Applying problem solving skills Dealing with change/novel stimuli Body awareness/personal space

40. Additional Social Challenges Coping with change/not getting your own way Understanding subtle/ complex verbal and nonverbal communication Processing and understanding emotion Mastering the increasing complexity of games and rules Learning to enjoy social contact

41. Addressing Social Skills in the School Social Stories Model desired social skill Social skill scripting Social skills discussion Direct teaching of desired social skill

42. Application to Natural Settings Opportunities to apply new skills in a natural peer context Start with more structured situations and then try with less structures; provide enough support to ensure success Coaching should still be given before and after, as needed Should be practiced across all settings School clubs, teams, activity groups Recess, P.E., lunch Mainstreaming classroom