ASD, ADHD, and Effective Classroom Strategies

1. ASD, ADHD, and Effective Classroom Strategies Presented at All Souls Unitarian Universalist Church Lee Guerro, RN, MSN Candidate University of Phoenix November 13, 2016

2. AgendaASD, ADHD, and Classroom and Behavior Management Strategies • Introduction • Workshop Format • Parent’s Perspective • Approach to Teaching • Evidence-Based Practice (EBP)

3. AgendaASD, ADHD, and Classroom and Behavior Management Strategies • Discussion of Autism Spectrum Disorder (ASD) and Interventions • Discussion of Attention Deficit Hyperactivity Disorder (ADHD) and Interventions • Roundtable Sharing and Planning for Interventions • Evaluations

4. Steps We Will Take Together During the Workshop

5. ASD and ADHD and Effective Classroom Strategies

6. A Parent’s Perspective on Her Child With a Disability

7. Welcome to Holland • Planning a trip to Italy, then landing in Holland • New guidebooks and new language needed • Meeting a new group of people • Holland is as beautiful as Italy, in a different way.

8. Welcome to Holland • Parent may feel that others are insensitive to the problems and differences that she faces. • She feels regret and longing for lost possibilities • Important to be sensitive to parents feelings • Important to understand their special challenges

9. Approach to Teaching

10. The Theory of Human Caring for Teachers • Embrace altruistic values and practice loving kindness with self and others; • Instill trust and hope by being available to meet the needs of others; • Be sensitive to self and others by nurturing individual beliefs, personal growth, and practices; • (Wagner, 2010)

11. The Theory of Human Caring for Teachers • Be present to, and supportive of, the expression of positive and negative feelings; • Develop helping, trusting, and caring relationships; • Perform teaching and learning that addresses individual needs and learning styles. (Wagner, 2010)

12. The Theory of Human Caring for Teachers • Create a healing environment for physical and spiritual needs; • Use creative problem solving to meet the needs of others; • Assist with basic physical, emotional, and spiritual human needs; and, • Slow down and allow space for unexpected wonder. (Wagner, 2010)

13. Seven Principles of the Unitarian Universalist Association • The inherent worth and dignity of every person; • Justice, compassion, and equity in human relations; • Acceptance of one another and encouragement to spiritual growth in our congregations; • A free and responsible search for truth and meaning;

14. Seven Principles of the Unitarian Universalist Association • The right of conscience and use of the democratic process in our congregations and in society at large; • The goal of world community with peace, liberty, and justice for all; and, • Respect for the interdependent web of existence of which we are a part. (Unitarian Universalist Association, 2015)

15. Evidence-Based Practice

16. Evidence-Based Practice (EBP) • EBP has become a popular term in education • EBP has two separate and distinct meanings • EBP can be an approach to making educational decisions that is supported by research • EBP can mean that an instructional technique is supported by research

17. EBP and Parental Involvement • Interventions supported by research • Early intervention improves outcomes • Parent and educator evaluate effectiveness • Parents give relevant input to educators • Educator and parent ensure consistency

18. Autism Spectrum Disorder

19. Autism Spectrum Disorder (ASD) • ASD is a neurodevelopmental disorder • ASD impacts 4 to 5 times more boys than girls • ASD affects up to 1 in 68 children • There is no cure for ASD • Early intervention improves outcomes

20. Autism is a Spectrum • Number of and type of symptoms differs widely • Wide range of symptoms possible • Dysfunction in perceptual/sensory processing • Sensory hyposensitivity or hypersensitivity • Sensory processing disorder (SPD)

21. ASD: A Neurodevelopmental Disorder • Not caused by intellectual disability or developmental delay • Social communication and interaction deficits • Difficulty with verbal and nonverbal communication • Repetitive patterns in activities, interests, or behaviors

22. Biology of ASD • Genetic factors include up to 90% heritability • Differences in the structure of the brain • Significantly decreased metabolism in some areas of the brain • Differences in empathy circuit functioning

23. Risk Factors for ASD • A sibling with autism • A parent schizophrenia/other mental disorder • Male gender • Low birthweight • Maternal age over 40 • Paternal age between 40 and 49

24. Environmental/Dietary Factors • No link with measles, mumps, rubella vaccine • Limited evidence for influence of metals • Limited evidence for influence of chemicals • Possible link with Vitamin D deficiency

25. Interventions for Autism Spectrum Disorder

26. Preventive Interventions for the ASD Child • Preventive interventions are proactive • Priming provides a preview • Prompting elicits responses • Visual schedules increase predictability

27. Peer-Mediated Interventions • Typically developing peers as facilitators • Appropriate modeling of communication and social behaviors • Play buddies intervention for entire class • Peer modeling, peer interactions, and peer reinforcing

28. Social Stories • Social Stories are customizable • Addresses disturbances in social interaction, communication, behaviors, other impairments • Increases ability to read and understand social situations • Can be combined with sensory integration strategies to increase self-regulation

29. Sample Social Story: Asking Politely

30. Sample Social Story: Fire Drill

31. Visual Schedules

32. Visual Schedules

33. Attention Deficit Hyperactivity Disorder ADHD

34. ADHD: A Neurobiological Disorder • 7.8% to 9.5% from ages 4 to 17 affected • 13.2% of boys and 5.6% of girls affected • Symptoms must be present before age 12 • Symptoms must cause significant impairment • Symptoms must continue for at least six months

35. Causes of ADHD • Heritability rate of 76% • Prenatal exposure to toxins such as tobacco smoke, lead, and alcohol • Poor prenatal nutrition may be a factor • Low birthweight is a strong predictor

36. Dietary Factors • No evidence of poor diet (except prenatally) • Inconclusive studies on food colors and additives • Some individuals possibly sensitive to additives • Up to 33% of children may benefit from dietary restrictions of food coloring and additives

37. Neurobiology of ADHD • Chaotic environment of deprivation may be causative • ADHD affects frontal lobe executive functions • Planning and organizing, shifting tasks affected • Hyperactivity caused by lack of frontal lobe inhibition • Impulsivity results from lack of control of amygdala • Mind wanders due to internal distractions

38. Features of ADHD • Inattention: less attentive, more disruptive • Impulsivity: calls out, leaves seat unexpectedly • Hyperactivity: excessive motor activity • Aggression is a rare feature • High risk of academic problems

39. Inattention • Easily distracted from tasks • Intrusion of external stimuli • Losing things, forgetting things • Low reading comprehension • Excessive daydreaming

40. Impulsivity • Poor decision making • Blurting answers before end of question • Low tolerance for frustration • Short temper and impatience

41. Hyperactivity • Rapid speech • Lack of ability to sit still • Running around the house and other areas • Fidgeting and difficulty with sedentary activities

42. Interventions for Attention Deficit Hyperactivity Disorder

43. Concrete Skills Building for Daily Living • Assigned places for important items • Prioritizing importance of papers to avoid clutter and hoarding • Use of smartphones and planners to stay organized • Coaching for goal setting and accountability

44. Goal of Preventive Behavioral Interventions • Core deficit is delayed response to environment • Behavioral modifications to the environment • Prevention of disruptive and inattentive behaviors • Posting rules and schedules defines expectations

45. Preventive Behavior Interventions • Post class rules/schedules close to student • Tape rules/schedules to student’s desk • Praise students for following the classroom rules • Frequent praise when rules are followed

46. Preventive Behavioral InterventionsReduce Task Demands • Reduced length and content of assignments • Better fit with shorter attention spans • Choice-making interventions • Higher task engagement

47. Consequence-Based Strategies • Strategies applied after the event • Intended to alter frequency • Contingent positive reinforcement • Time out from positive reinforcement

48. So, How Does This Work At Church?

49. The Sunday School and Church Environment • Children are at church for one to two hours per week • Church and Sunday School are not as strictly structured as the school environment • Currently there are two teachers per classroom • Children with disabilities may need more

50. Parental Involvement is Critical to Success • Parents know the child’s unique characteristics • Parents know what interventions are being used at school and which ones work • Consistency across environments supports the best results for the child • Contact Judith with ongoing questions