Autism in the Regular Early Childhood Classroom

1. Autism in the Regular Early Childhood Classroom Presented by Laura Robison

2. What is Autism? • A complex developmental disability • Usually appears during the first three years of life • Result of a neurological disorder that affects the normal functioning of the brain • Impacts development in the areas of social interaction and communication skills. (Autism Society of America, 2008; Robledo & Ham-Kucharski, 2005)

3. What is Autism? (cont.) • A spectrum disorder • Affects each individual differently at varying degrees • One of five disorders that fall under classification of Pervasive Developmental Disorders (PDD) (Autism Society of America, 2008; Robledo & Ham-Kucharski, 2005)

4. Pervasive Developmental Disorders (PDD) • A category consisting of five neurological disorders characterized by severe and pervasive impairment in several areas of development (Autism Society of America, 2008)

5. Pervasive Developmental Disorders (PDD) (cont.) • Diagnosis, including autism or any other developmental disability, is usually based upon the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV) and is the main diagnostic reference used by mental health professionals in the U.S. (Autism Society of America, 2008)

6. PDD Consists of Five Neurological Disorders • Autistic Disorder • Asperger’s Disorder • Childhood Disintegrative Disorder (CDD) • Rett’s Disorder • PDD-Not Otherwise Specified (PDD-NOS) (Autism Society of America, 2008)

7. Prevalence of Autism • 1 in 150 births • 1.5 million Americans • On the rise, no one knows why • Growing at a rate of 10-17% per year • Four times more prevalent in boys than girls • One of the fastest growing developmental disorders in children (Autism Society of America, 2008)

8. Autism Prevalence vs. Total Prevalence of Other Disabilities (Hollenbeck, 2004)

9. Causes of Autism • No single known cause • Generally accepted as being caused by abnormalities in brain structure or function • Possible link between heredity, genetics, and medical problems • Vaccines-the research favors rejection of theory-more research is needed (Autism Society of America, 2008)

10. Causes of Autism (cont.) • Occurs more frequently in children with certain medical conditions: • Fragile X syndrome • Tuberous sclerosis • Congenital rubella syndrome • Untreated phenylketonuria (PKU) • Not associated with psychological factors (Autism Society of America, 2007)

11. Some Characteristics Associated with Autism • Insistence on sameness; resistance to change • Difficulty in expressing needs • Repeating words or phrases • Laughing (and/or crying) for no apparent reason • Prefer to be alone • Tantrums • Difficulty socializing with others (Autism Society of America, 2008)

12. Some Characteristics Associated with Autism (cont.) • Not wanting to cuddle or be cuddled • Little or no eye contact • Unresponsive to normal teaching methods • Sustained odd play • Spinning objects • Obsessive attachment to objects • Over- or under-sensitivity to pain (Autism Society of America, 2008)

13. Some Characteristics Associated with Autism (cont.) • No real fear of danger • Noticeable physical over- or under-activity • Uneven gross/fine motor skills • Unresponsive to verbal cues (Autism Society of America, 2008)

14. Diagnosis of Autism • No medical tests • Based on observation of communication, behavior, and developmental levels • Early diagnosis associated with dramatically better outcomes • Child’s doctor should conduct a developmental screening (Autism Society of America, 2008)

15. Five “Red Flags” That Indicate the Need for Further Evaluation • Does not babble or coo by 12 months • Does not gesture (point, wave, grasp) by 12 months • Does not say single words by 16 months • Does not say two-word phrases on his or her own by 24 months • Has any loss of any language or social skill at any age (National Institute of Child Health and Human Development, as cited by Autism Society of America, 2008)

16. American Academy of Pediatrics (AAP) Recommendations for Pediatricians • Universal screening by pediatricians consisting of formal ASD screening at 18 and 24 months • Intervention as soon as an ASD diagnosis is seriously considered (American Academy of Pediatrics, 2007)

17. American Academy of Pediatrics (AAP) Recommendations for Pediatricians • Intensive intervention at least 25 hours per week, 12 months per year • A low student-to-teacher ratio with sufficient one-on-one time • A program that includes parents (American Academy of Pediatrics, 2007)

18. Possible Professionals to Include on a Multidisciplinary Assessment or Treatment Team • Developmental pediatrician • Child psychiatrist • Clinical psychologist • Occupational therapist • Physical therapist • Speech/language therapist • Social Worker (Autism Society of America, 2007)

19. Treatment Approaches or Strategies • Applied Behavioral Analysis (ABA) • Developmental, Individual Relationship—Based Model (DIR/Floortime) • Treatment & Education of Autistic and Related Communication of Handicapped Children (TEACCH) • Picture Exchange Communication Systems (PECS) (Autism Society of America, 2008; Robledo & Ham-Kucharski, 2005)

20. Treatment Approaches or Strategies (cont.) • Sensory Integration • Social Stories • Pivotal Response Treatment • Facilitated Communication (FC) • Relationship Development Intervention (RDI) (Autism Society of America, 2008; Robledo & Ham-Kucharski, 2005)

21. Complementary Approaches • Hippotherapy • Martial Arts Therapy • Auditory Integration Therapy • Gluten-Free-Casein-Free Diet (Autism Society of America, 2008; Robledo & Ham-Kucharski, 2005)

22. Interventions and Strategies for Teachers Working with Students with Autism • Aim high, start small, and celebrate • Create and maintain high expectations • Break learning goals into small steps • Celebrate accomplishments (Anderson, 2006; as cited in Heward, 2006)

23. Interventions and Strategies for Teachers Working with Students with Autism (cont.) • Teach immediately useful skills first • What are your student’s needs? Can he/she make his needs known? • Does the student have the basic skills necessary to be included in the regular education classroom? • Can the student take care of his/her own personal needs? • Does the student know how to respond when other children ask him to play? (Anderson, 2006; as cited in Heward, 2006)

24. Interventions and Strategies for Teachers Working with Students with Autism (cont.) • Focus on teaching skills, not on decreasing behaviors • Create and use interventions that offer children alternative behaviors • Try to determine what function a negative behavior has for a student (Anderson, as cited in Heward, 2006)

25. Interventions and Strategies for Teachers Working with Students with Autism (cont.) • Make your praise effective • Pair your praise and approval with the frequent presentation of preferred items that the student likes • Provide praise and attention when the student is engaged in any appropriate activity that he/she enjoys (Anderson, as cited in Heward, 2006)

26. Interventions and Strategies for Teachers Working with Students with Autism (cont.) • Increase language use throughout the day • Embed frequent opportunities for students to use language skills • Teacher-directed lessons • Peer-assisted lessons • Less structured learning activities • Transitions • Take advantage of naturally occurring situations throughout the day • Require all students to respond and accept verbal approximations • Have Fun! (Anderson, as cited in Heward, 2006)

27. Interventions and Strategies for Teachers Working with Students with Autism (cont.) • Arrange environments to promote desired student behaviors • Embed instruction, prompts, and feedback into class routines • Modify class plans to meet student needs (Hundert, 2007)

28. Interventions and Strategies for Teachers Working with Students with Autism (cont.) • Always put the needs of students first • Work closely with families, include parents in decision-making, and be sensitive to family culture • Work closely with all service providers • Be flexible • Be positive and enthusiastic; it is contagious

29. Interventions and Strategies for Teachers Working with Students with Autism (cont.) • Don’t be afraid to try new things • Pair students with regular peers, rotate buddies • Challenge when possible, but pick your battles wisely • Celebrate whenever possible

30. References American Academy of Pediatricians. (2007). New AAP reports help pediatricians identify and manage autism earlier. Retrieved on February 22, 2008, from http://www.aap.org/advocacy/releases/oct07autism.htm Autism Society of America. (2008). The voice of autism. Retrieved February 22, 2008, from http://www.autism-society.org Heward, W. L. (2006). Exceptional children: An introduction to special education (8th ed.). Upper Saddle River, NJ: Pearson.

31. References (cont.) Hollenbeck, D.F. (2004). Public Schools Autism Prevalence Report Series, 1992-2003. Gibsonia, PA: FightingAutism. Retrieved on February 22, 2008, from http://www.fightingautism.org/idea/ Hundert, J. P. (2007). Classroom interventions for children with disabilities: Generalization to new intervention targets. Journal of Positive Behavior Intervention, 9 (3), 159-173. Robledo, S. J., & Ham-Kucharski, D. (2005). The autism book: Answers to your most pressing questions. New York: Penguin Group.

32. Other Resources University of North Carolina Department of Psychiatry. (2008). Division TEACCH: Treatment and education of autistic and related communication-handicapped children. Retrieved February 22, 2008, form http://www.teacch.com Yack, E., Aquilla, P., & Sutton, S. (2004). Building bridges through sensory integration: Therapy for children with autism and other pervasive developmental disorders (2nd ed.).Las Vegas, NV: Sensory Resources.