Autism

1. Autism Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

2. What is Autism? • Autism is a neurological disorder. • The common characteristics are social interaction deficit, communication deficit, and behavior problems. • Autism is a spectrum disorder that affects individuals differently and in varying degrees. • The spectrum includes Autistic Disorder, Childhood Disintegrative Disorder, Asperger Disorder, Rett’s Disorder, and Pervasive Developmental Disorder—Not Otherwise Specified • Every district has students identified with Autism Spectrum Disorder. • Autism Spectrum Disorders can be easily confused with ADD/ADHD, Obsessive Compulsive Disorder , Oppositional Defiant Disorder, Tourette’s Syndrome, Intellectual Disability Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

3. Autism Spectrum Disorder (ASD) “Classic” Autism PDD-NOS Pervasive Developmental Disorder—Not Otherwise Specified Asperger’s Disorder Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

4. Autism Facts • Autism affects 1 in every 110 individuals (2010) • It occurs before the age of 3 • It is 4X more common in boys than girls • Autism is found in all cultures, races, and social structures around the world. • Parents notice a change in their child’s development as early as 12 months and characteristics become obvious by 2-6 years of age. • ASD is the fastest growing developmental disability in the US • Only 56% of students with ASD complete high school. • No known single cause for ASD. It is generally accepted that it is caused by abnormalities in brain structure or function. Researchers are investigating a link between heredity, genetics, and medical problems. Some children are born with susceptibility to ASD, but researchers have not yet identified a single “trigger”. Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

5. Five behaviors identified by NICHD that signal further evaluation(National Institute of Child Health and Human Development) • 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 Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

6. Medical Diagnosis vs. Educational Identification • Medical Diagnosis-physician diagnosis based on assessment of symptoms, diagnostic tests, and DSM-IV-TR (2000) • Educational Identification-made by a multi-disciplinary team comprised of various school professionals and parents to determine whether a student qualifies for special education services under Individual Disabilities Education Act (IDEA) (2009) Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

7. A new case of autism is diagnosed almost every 20 minutes Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

8. Characteristics Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

9. Characteristics of Autism Spectrum Disorders (ASD) • Communication deficits • Repetitive patterns of behavior, interests, and activities • Social interaction deficits • Social maturity of someone 1/3 to 2/3 of their age (Asperger’s) • Behavior difficulties • Sensory processing issues • Emotional vulnerability • Cognitive delays • Motor skill deficits • Difficulty generalizing skills Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

10. Communication • Lack of development of speech or use of gestures—receptive and expressive skill deficits • Inability to initialize or sustain a conversation • Repetitive use of language—echolalic speech • Preoccupation and focus in areas of interest • Preoccupation with parts of objects • Monotone speech Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

11. COMMUNICATION ACTIVITY Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

12. Social • Lack of eye contact • Prefer to play alone • Lack of social reciprocity or empathy • Lack of imitating social play • Routines are important • Lack of facial expressions Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

13. Sensory • Sensitive reactions—more intense or lack of intensity than peers • Lack caution when playing, impulsive to meet sensory input needs, excitability • May seem uninterested, oblivious, unwilling to participate • Hyperactive, easily upset, withdrawn • Unable to complete tasks due to new stimuli capturing attention • Difficulty learning from experiences • May appear stubborn or self-absorbed Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

14. Behaviors Exhibited • Must finish an interest activity before going to the next • Poor organization skills • Handwriting tends to be difficult • Engage in activities beside and not with peers or no turn taking (reciprocity) • Do not understand humor • Literal thinkers—common expressions and idioms are understood literally • Impulsivity • Meltdowns—rages, aggressive or self-abusive behaviors, tantrums • Transition is difficult—routines or environments Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

15. Transition Examples • Home to bus • Locker to class • Class to first assignment • Getting and organizing materials • Between groupings (individual to peer groups) • Class to lunch • Waiting • Ending the day • Bus to home Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

16. Meltdowns vs. Temper Tantrums Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

17. Meltdowns and/or Rages • Causes: • Attention from peers or adults • Frustration • Confusion • Power/control • Sensory stimulation • Fear or relief of fear • To obtain something—activity, interaction, comfort, routine, object • Expression of internal stimulation—sick, hungry, tired, too hot • Unstructured time • Change of routine/lack of schedule Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

18. Why the behavior? • Stress • Excitement • Fatigue • Overstimulation • To gain attention • To escape/avoid • To meet sensory needs • Does not understand • Self-esteem fears • Need for control • Need for “sameness” Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

19. SENSORY ACTIVITY Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

20. If the only tool you have in your toolbox is a hammer, then everything looks like a nail. (So if we do not see the autism, we are treating all students the same. Each child has individual needs. Let’s explore the other tools in our toolboxes.) Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

21. Interventions Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

22. Visual-Organizational Support • Helps transition within and between activities • Helps understand expectations • Prepares student for a change • Lessens anxiety • Helps students comprehend verbal language • Teaches independence Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

23. Visuals/Organization Examples • Schedules • Color code • Models of expected outcomes • Graphic organizers • Consistent Classroom rules • Examples of how to head the paper • Homework assignment area in the room • Work stations • Sticky notes for preparing or calming a student • Example of correct finished products • 5 point scale Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

24. Five Point Scale Example Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

25. Classroom Examples • Class work • Shorten assignments • Odds/evens • Circle the ones you want them to complete • Top/bottom half • Allow the student to circle and do X number of problems • Highlight important or relevant points • Graphic organizers • Stopping and starting point on assignment Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

26. More ideas • Extended time to complete • Model expectations with visuals of the difference between an A paper and a C paper • Fill in the blank notes for lectures • Incorporate their interests in assignments • Allow them choices that you are comfortable with • Limit homework to daily in class work, an extra study time, no homework • To ease handwriting, use a computer or scribe Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

27. ACTIVITY G I 8 Q Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

28. Priming • Priming—preparing the student before the activity by telling, showing with a visual schedule, or using a social narrative. • Right before the activity • The day before • The period before • The beginning of class Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

29. Social Narratives-Power Cards • Social narratives and power cards use a student’s specific interest to engage the student. A story is written and illustrated with lots of visual pictures of what is acceptable behavior. • Examples • Preventing behaviors • Teaching a new skills • Showing a change in schedule (e.g., field trip) Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

30. Power Card • Back of power cardThe contestants on Survivor think everyone should have fun playing games. They also want you to remember three things when playing games with other people: • Games should be fun for everyone. • If you win a game, you can: Smile, give high fives, or say, "Alright!" • If you lose a game, you can: Take a deep breath and say, "Good job" to the opponent or say, "Maybe next time." Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

31. Hidden Curriculum • Hidden curriculum is the unwritten social rules and expectations of social behavior that most students just seem to learn without direct instruction. • Examples • Raising your hand to go to the restroom • When to use utensils and when not to when eating • Don’t say everything you think (telling teacher she is fat or breath stinks) • For kids with ASD, these skills often need to be taught directly through visual supports, examples, and role playing. Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

32. Safe Place/Sensory Breaks • Allow a safe place or frequent sensory breaks • They choose when they need a break • Short breaks • Walking, eating, fidgets, reinforcement of goals/behaviors • Be alert for high anxiety levels or need for breaks Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

33. VIDEO Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

34. Other Helpful Hints • Use language that is clear and concrete • Ask questions of who, where, when, what, instead of why or how • Use limited sarcasm, idioms, and inferences • Tell the student what to do, instead of what not to do • Give the student processing time (10-15 seconds) • Give directions and new information in small segments, teaching each step separately • Give praise often • Pair verbal with visuals (pictures or gestures) • Consistent routines Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

35. More Helpful Hints • Understand that behavior is a form of communication and that a change is needed on our part. • Encourage peer mentoring • Build on strengths and interests • Be aware of student’s sensory needs and concerns in all settings • Do things “with” instead of “for” the student • Have high expectations. We get what we expect! Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

36. Still More Helpful Hints • Consider the physical environment (lighting, noise, temperature, color, smell) • Treat the student with the same respect you treat your other students • Empower the student to be an active participant in all classroom and social activities Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

37. Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

38. Assistive Technology Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

39. Low to Mid Tech • Graph paper for math • Pencil grips • Mechanical pencils • Highlighters • Visual timers • Air pillow/cushion • Color code/paper • Delineate work area • Picture schedules/communica-tion notebooks • Comic strips • Stress relievers • Darkened rooms • Chew toys • Headphones • Power cards • Strategy cards • Puppets • Code words • Social Narratives • Weighted blanket • Menu of reinforcers • Graphic organizers Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

40. Nothing good in life ever happens quickly! Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

41. Websites to Explore • http://www.usd333.com/vnews/display.v/SEC/Special%20Education/LCNCK%7CAutism Go to usd333 website-special education-autism • AIM Modules– http://www.ocali.org/aim/- The Ohio Center for Autism and Low Incidence (OCALI). The AIM project is developing online modules on ASD including characteristics, diagnosis, interventions and supports, transition, and employment. • Autism Speaks- http://www.autismspeaks.org offers good information and links to helpful resources for parents and teachers. Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

42. More… • iCAN – http://www.autismnetwork.org – The Interactive Collaborative Autism Network site is for anyone who lives with, teaches, or otherwise supports children and youth with autism spectrum disorders, including parents, teachers, and individuals with ASD. • Kansas Autism Spectrum Disorders - http://www.kansasasd.com/KSASD/Home.html -The Kansas Instructional Support Network (KISN) is one of the Kansas Statewide Technical Assistance Resource System (K-STARS) projects funded through a Title VI-B grant from the Kansas State Department of Education’s Student Support Services. Contains many informational links and technical assistance to districts. • http://autismspectrum.illinoisstate.edu/courses/non-credit.shtml A 54 non credit contact hour course in autism. Basic level autism team training workshop Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

43. Resources • LCNCK Autism Intervention Team • Deb Reha, Coordinator • Anna Berger-Washington Elementary • Anita Breen-Concordia High School • Sharon Hartman—Clifton/Clyde Middle School • Lorri Meyer—Concordia Elementary • Lori Stahlman—SLP • Deb Tipton—SLP • Shawn Woolsey-Option/Opt2 • LCNCK website Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

44. AUTISM A.. Always U..Unique T.. Totally I.. Interesting S.. Sometimes M.. Mysterious Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants

45. Bibliography • www.kansasasd.org • National Institute of Child Health and Human Development • www.autism-society.org Deb Reha LCNCK Presented by Deb Reha and Deb Tipton, AIT Consultants