Children need people who not only care, but truly understand them …

1. Children need people who not only care, but truly understand them …

2. Characteristics of Autism • Brainstorming Activity

3. What is Autism? • A group of developmental disabilities • Autism • PDD NOS (Pervasive Developmental Disorder) • Asperger’s Syndrome • Rett Syndrome • Childhood Disintegrative Disorder • Affect a person’s ability to understand what they see, hear, and otherwise sense. • difficulty understanding verbal and nonverbal communication and learning appropriate ways of relating to other people, objects and events. • things may not feel, smell, taste, or sound the same to a person with autism. Sometimes certain smells, sounds, and tastes cause the person with autism to feel bad and they may become upset.

4. How Common is Autism? • Autism Spectrum Disorder (ASD) is the second most common developmental disability, following mental retardation.11 • Up to 1 of every 150 children born today will be diagnosed with ASD. 11 • 1.5 million Americans have ASD.11 • There are over 50,000 North Carolina families affected by ASD and the number grows each day.12 • There are at least 3,618 children in NC ages 5 and younger who have autism spectrum disorder.12 • Every day in North Carolina, two children will be diagnosed with autism spectrum disorder. That’s 60 children per month and over 700 per year. 12 • In the public school system, the student population with autism is increasing by 15.7% per year while the total student population is growing 1.5% per year. 12 • The total number of students with autism spectrum disorders in NC public schools has nearly tripled since 1999. 12

5. How is autism treated? • No cure for ASD. • Remember: No single method is effective in treating every individual with ASD, as every person is unique and has different needs and abilities. • It is important to match the strategies to the individual needs of the student.

6. The anatomical differences of the autistic brain: • Structural differences:2 • Undersized Corpus Callosum which is the area of the brain that connects the left and right hemispheres. Subsequently there is decreased bilateral coordination, motor planning, awareness of body in space. • Increased white matter (axons) in the brain, with too many local connections and not enough long distance connection axons. • Cerebellum (the part of the brain typically in control of physical coordination, motor planning, and anticipating events) are shown to be inflamed or overloaded with white matter. • Children with AU have enlarged Amygdala (which is responsible for determining threats in the environment and regulating emotion and social behavior), suggesting high levels of anxiety. • Difference in use of the brain: 2 • A tendency to use the visual centers in the back of the brain for tasks usually handled by the prefrontal cortex. Children with AU often look at the mouth instead of the eyes of someone who is speaking. Focus on the physical allegiances (a mouth that moves) vs. social allegiances (the longing gaze of a mother). • Research shows that a child with AU’s Amygdala (which registers threats in the environment) is activated when a child with ASD looks at faces.

7. What are children with ASD’s “unique needs” and what strategies can we use to help them learn?

8. Communication

9. Expressive Language • Echoing what is said directly, later, or in a slightly changed way. • Difficulty with word order in sentences. • Difficulty retelling experiences or stories. • Problems with speed, tone, volume of voice. • May have advanced vocabulary. • Speech may be overly formal or “professor-like”.

10. Strategies • Use pictures or graphic organizers to help with using full sentences, word order, communicating wants and needs, and retell an event or story. • Use visual cues to assist the student to regulate their tone or speed.

11. Comprehension • May be slow to process auditory information • Increased difficulty when verbalizations are too fast • Problems answering questions • Problems responding to directions • Problems understanding jokes, multiple meaning words, sarcasm, idioms

12. Strategies • Use visual strategies for teaching (esp. abstract concepts, step by step visual instructions, check off boxes) • Slow down your speech, use shorter sentences • Pause between instructions and check for understanding • Avoid asking vague questions such as “why did you do that?”, “How do you think it makes me feel when you do that?” • Give student time to respond before repeating a question or directive.

13. Pragmatic/Social Language • Difficulty understanding gestures and facial expression. • Difficulty understanding personal space. • Difficulty with the rules of conversation (frequently interrupts, makes irrelevant comments, difficulty switching topics). • May be argumentative. • Limited conversational turn taking • Poor eye contact • Lack of empathy

14. Strategies • Use visual cues to teach the meaning of facial expressions, gestures and non verbal language. • Teach rules of personal space (“arm’s length”), use visual cues as boundaries. • Write down and teach the “rules” of conversation and practice these. • Use visual cues/cards to remind students not to interrupt or talk off topic. • If student uses repetitive verbal arguing, and/or repetitive verbal questions, responding in a logical manner or arguing back seldom stops the behavior. The student is likely experiencing a loss of control or uncertainty about something. Use a visual cue or statement to put them at ease. • Write down an “appointment time” when the student will be able to meet with you to discuss his concern. Place the appointment time on a post it note on his desk. • Don’t insist on eye contact.

15. Social Skills • Easily stressed due to inflexibility and difficult predicting upcoming events • Insistence on sameness • Difficulty tolerating mistakes of self and others • Lacks tact • Difficulty understanding the rules of social interaction • Intense need for closure or completion of tasks/activities before transitioning to the next activity • Difficulty interpreting the actions of others • Difficulty understanding the rules of play and games • Difficulty taking other people’s perspectives • Vulnerable to teasing, bullying • May have rage reactions • Low self esteem • May have difficulty coping with the social demands of school

16. Strategies • Use schedules to help child to predict upcoming events and handle changes better • Teach child to be flexible and to only worry about themselves • Teach child about other people’s feelings, tact, empathy • Use social stories, videos, etc. to teach rules of social interaction • Teach social skills during “neutral” times, not in the middle of a behavioral conflict. Teach, practice, generalize to other settings. • Provide positive praise and tell student what he does right. • Teach relaxation techniques, and have a quiet place to relax. • Write down the rules for play, and games (including P.E.), and review them frequently. • Provide choices. • Use a “buddy system” to help with recess, lunch, and other unstructured activities. • Provide supervision and support during recess and breaks. • Educate peers about how to respond to the student’s disability.

17. Organization and independent work habits.

18. Need: Disorganization • Children with Autism tend to have great difficulty with both their internal and external organizational skills, including the following: • Organizing their thoughts and ideas to express themselves in a cohesive manner. • Organizing desk/locker, book bag, etc. • Keeping track of their belongings (including personal and education materials). • Filing, organizing, and keeping track of their school notes and assignments. • Taking notes home, and returning notes to school. • Gathering educational materials needed for specific tasks/homework. • Following multi-step directions • Completing multi-step tasks • Tolerating changes to their daily routine, substitute teachers, etc.

19. Strategy: Visual cues, Structure, Finished! • Use tape to create boundaries (on the floor, white erase board) • Post a Schedule (which is easily visible and can be readily changed) in each classroom: have a component which allows for change in schedule. • Post teacher expectations (for behavior, projects, etc.) • Use rubrics, writer’s checklists, etc. • Pair written directions with verbal cues whenever possible • Help students to compartmentalize “work in progress” and “complete” work: • For young students have a “to do” and “finished” box or folders. • For older children, help them create portable work systems (with color coded subject areas), and pockets for “notes to go home”, “notes for teacher”, “unfinished” and “finished work”. • Teach children to use an assignment notebook consistently. • Break multi-step tasks into sequential visual steps (which can be checked off) • E.g. 1, 2, 3, finished • Adapt worksheets • Structure writing activities • Sections and due dates for complex, lengthy projects

20. Sensory Processing

21. Need: Sensory Processing Difficulties • Sensory dysfunction is when a person exhibits an atypical response to sensory stimulation (or lack thereof) in a situation/environment. In other words: there is an inappropriate match between what the response should be, and what it is. • When sensory stimulation (touch, textures, odors, lights, movement, sounds, deep pressure input) → typical response = “Efficient Sensory Processing” → atypical response = “Sensory Dysfunction”

22. Need: Sensory Processing Difficulties • In a 2007 study with a sample of 281 children with Autism (between 3-6 years of age), over 95% were described as having sensory dysfunction. • Most of these children with sensory difficulties were overly sensitivity to touch/tactile input, smell/taste, and sound; and under-responsive to movement that interferes with daily routine (sensation seeking). • An example of over-sensitivity : • Unexpected touch/odors/taste, tags in clothes, messy activities, sticky textured foods, and/or fire drills may → distractibility, anxiety and stress (“Fight or Flight response = decreased readiness to learn). • An example of under-responsiveness to movement: • Table/chair or carpet time (still) activities may → rocking, fidgeting, “falling” out of chair, roaming around the classroom, moving into other children’s person’s space (disrupting other’s ability to learn).

23. Sensory Processing Difficulties continued… • As educators, we hope to have our students: • In calm and alert, “ready to learn” states. Stress causes a flight or fight reaction (sweating, increased heart rate, wanting to run). You can not learn if you are anxious and stressed! • Be able to participate in quiet, class activities without disturbing and distracting others. How do we help our children with Au and sensory processing difficulties, who tend to find some sensory input stressful, while tending to seek out movement input which may disturb/distract others?

24. Problem Solving Strategies for Sensory Processing Dysfunction • If you see a child with Autism react in a way which does NOT match the situation… think to yourself… “could the reaction be due to a sensory processing difference?” • If so…. Think “What can I… • Take out • Put in • Teach…. the child?”

25. What can I take out, put in and/or teach? • Most children with Au are overly sensitivity to touch/tactile input, smell/taste, and sound…. So, ask yourself… • What can I take out? • Ask parents to remove tags from clothing • Reduce unexpected touch (e.g. Place child at back of line) • Reduce background noise • What can I put in? • Muffler on intercom, plants in room • Indirect lighting • Tennis balls on chair feet • Wet wipe/cloth beside the child during messy/sticky activities • Offer noise reducing headphones • Allow the child to transition ahead of class • “Can I take a break?” card • What can I teach the child to do? • Warn child before fire/tornado drill • Ask adult/teacher for noise reducing headphones, wipe, etc.

26. What can I take out, put in and/or teach the child? • Most child with Autism are under-responsive to movement that interferes with daily routine (sensation seeking). So…ask yourself… • What can I take out? • Long sessions of seated work • What can I put in? • Visual boundaries of space (e.g. Tape on floor) • Movement breaks / errands • Air cushion / fidget toy (e.g. paperclip) • What can I teach the child? • To request a movement break or fidget tool (perhaps using a card on desk) • To use fidget tools appropriately without distracting others.

27. Summary of sensory needs and strategies… • When you see a behavior/reaction that does not match the situation…. Think to yourself… “Could it be due to sensory processing differences?” (increased sensitivity to sound, touch, taste, odors OR seeking movement) • If so… “What can I… • Put in, • Take out • Teach the child to help keep the child in an alert, “reading to learn” state, while decreasing disruptive and distracting behavior”.

28. Social-Emotional and Behavioral

29. Emotional Vulnerability Self-critical and unable to tolerate making mistakes anxious Utilize the child’s strengths and incorporate them into special projects/assignments to increase his/her self esteem. Teach the child coping strategies (like “just give me a minutes please”) or relaxation techniques (such as “take a deep breath and count to ten”). Social-Emotional and Behavioral Needs

30. Restrictive or perseverative range of interests Trouble “letting go” of thoughts or ideas (particularly relating to concerns or worries). Repetitive questions about interests, concerns or worries. Numerous one-sided conversations on their specific areas of interest Set aside specific times for the child to discuss high interest topics. Include “discussion time” on their schedule. Refer them to this visual reminder of when he can converse about this topic. Provide a written answer to repetitive questions (to assist in comprehension). Incorporate high interest topics into academics Social Emotional and Behavioral

31. Emotional Vulnerability • Autistic individuals may be self-critical and unable to tolerate making mistakes ---causes them to become overwhelmed, stressed, frustrated, and anxious. • What can you do to help? • Manage their environment • Rules are ever-changing • Sensory stimulation • Social demands

32. Understanding Behavior • Behavior is communication • Message about how the child perceives what is happening around him • Inappropriate/negative behaviors interfere with the child’s learning process • These behaviors must be exchanged with appropriate alternatives that fulfill the same function so that real learning can flow

33. 5 Guidelines for Approaching Behavior Incidents Involving a Child with ASD • Look for sensory issues • Never assume anything • Teach functional communication • Behavior occurs for a reason • Watch what you reinforce

34. 3 Major Types of Problem Behavior • Resistant/Avoidant Behavior • Aggressive Behavior: Hitting, Biting, Scratching, Spitting • Tantrums and Crises

35. 1. Resistant/Avoidant BehaviorAn Ounce of Prevention is Worth A Pound of Cure • Identify the source • Keep requests in the positive rather than the imperative • Does the student really know how to do what is being asked of him? • Does the student really know the rules – understand the reason for the rule?

36. Provide a breather – to allow for self-regulation before the behavior gets out of hand • Keep your behavioral expectations reasonable and age-appropriate • Timing is everything • Encourage parents to use similar processes at home, especially visual charts and schedules

37. 2. Aggressive Behavior: Hitting, Biting, Scratching • Identify where the behavior is coming from (social, academic, or sensory impairments) • Respond to the first infraction • Respond consistently each time • Do NOT respond to aggressive behavior with aggression • Use natural consequences • Praise appropriate social behavior

38. 3. Tantrums and Crises • Have a plan – Rehearse it ahead of time • Don’t try to teach during an episode • The more stressful the situation, the more concrete your language should be • Designate one person to provide directions and input • Time-outs are good!!! • Choose your battles

39. Why Good Plans Fail • Not looking at the “big picture” – ID the cause • Trying to deal with too many things at once • Focus on extinguishing behavior and NOT on teaching new replacement skills • Presuming the student understands • Reacting to difficult behaviors inconsistently • Not defining success • Forgetting that kids are kids

40. Consequences that Help the Student Understand His Behavior • Have the student apologize with an explanation of what he did wrong • Have the student explain, write or draw what he did wrong • Review the rule book or rule chart • Develop a social story that explains the rule that was broken • “Making up” for inappropriate behavior • Point or Ticket Systems • Temper Tantrums • Name Calling/Teasing • Back Talking • Profanity Should not be used for: • Incomplete assignments • Lack of organization • Inattention • Stress/anxiety due to environmental changes • Transition problems without modifications • Social problems that the student does not understand • Academic deficits

41. When to use: Aggressive behaviors such as hitting, kicking, biting, pinching, pushing or throwing objects Temper Tantrums Name calling or mean teasing Back talking Profanity When not to use: Incomplete assignments Inattentiveness Sensory processing difficulties Stress/anxiety due to lack of environmental modifications Transitions without modifications Social problems due to child’s inability to understand Academic deficits Time-Out

42. Safe Spot or Sensory Room • Sensory processing difficulties • Behaviors arising from anxiety, stress or depression often resultant of lack of modifications to environment, preparation for changes or inability to understand and function appropriately in social situations with peers or adults.

43. Our Role as Educators

44. What is our role as educators? • The Individuals with Disabilities Education Improvement Act (revised in 2004): • Free and Appropriate Public Education • What is a “free and appropriate public education” (FAPE)? • Appropriate placement - one that will allow them to make educational progress, in the least restrictive environment (LRE). The LRE is one in which children with disabilities have the greatest possible opportunity to: interact with children who do not have a disability; and to participate in the general education curriculum. • Appropriate education – one that is tailored to their special needs. • As educators, our challenge is to setup the educational environment and individualize our teaching methods, so as to meet children with ASD’s unique needs and learning styles.

45. Students with ASD in the Regular Classroom • Regulations governing Least Restrictive Environment • Inclusion versus pull-out • We must address both academics and social skill development if it is adversely affecting their education (and how can it not?)

46. Conclusion • Remember that each child on the spectrum has a different profile of characteristics. • Remember autism itself is not a cognitive disability. • Distinguish between what the student won’t (I choose not to) and can’t (I am unable to). When in doubt assume that they can’t. • Be proactive not reactive. • Identify triggers (for example: transitions and sensory) and seek solutions.

47. Questions and Answers