Autism and Mental Health

1. Autism and Mental Health Information and strategies for the classroom Penelope Chavez-Frigon, Psy.D. Jennifer Brinkdopke, MA, PCC; & Andrea Kirk, BS CT

3. Behavior Management • Structures and Lists Picture Exchange Communication System (PECS)

4. Behavior Management • Schedule of class

5. Behavior Management First / Then System

6. Behavior Management • Why use First/Then prompts and visual schedules • enhances receptive language • assists in providing meaning to students • assists with comprehension • provides another channel for learning • provides easy accessibility should a student need to be reminded of the day’s events. • allows student to act independently of adult prompts • reduces anxiety by allowing foreseeable future events • http://www.education.com/reference/article/visual-schedule-classroom-autism-ASD/

7. Behavior Management How to Make a First/Then Chart • Step 1 • Determine what events will be on your student’s chart.  • Consider: • Everyday events • Special and rare events i.e. parties, fire drills, minimum days •Preferred activities and rewards • http://www.nwresd.k12.or.us/autism/First-ThenChart.html

8. Behavior Mangement Step 2 • Determine how to present the items to the student. What is your student’s level of understanding? • The written word • Picture icons • Photographs • Mini objects or parts of real objects • http://www.nwresd.k12.or.us/autism/First-ThenChart.html

9. Step 3 Gather materials. Possible materials needed: Small dry erase board and pen Small chalkboard and chalk Post it notes Library pockets File folders Laminate or clear contact paper Velcro Tagboard Boardmaker computer program Clip art Camera Color printer Glue Miniature objects to represent school activities, events, and/or rewards Small items that are representative of school events, activities, and/or rewards Shoebox lids Clean Styrofoam meat trays Colored electrical tape Markers 3-ring binders Behavior Management

10. Behavior Management Ideas for how to use the materials • For a student who reads try: • A small dry erase board and pen • Post-it notes and a pencil • A pocket chart with cards inside a file folder • A chart with moveable laminated words attached with Velcro inside a file folder • A chart with picture icons attached with Velcro on a binder with storage for the icons inside of it • For a student who is not a reader try: • A chart with picture icons attached with Velcro on a binder or file folder with storage for the icons inside of it • A chart with photos attached with Velcro on a binder or file folder with storage for the icons inside of it • A chart with miniature objects or parts of objects that sit inside the lid of a shoe box  or a Styrofoam meat tray • http://www.nwresd.k12.or.us/autism/First-ThenChart.html

11. Behavior Management • Step 4 • Create a chart. • Things to consider: • Size • Portability • Storage of pictures, icons, or laminated words • Clearly define the “First” side from the “Then” side • Handout: First/Then • http://www.nwresd.k12.or.us/autism/First-ThenChart.html

12. Behavior Management • Step 5 • Introduce the chart to your student • Find a quiet time where you can teach the student how the chart will work • Chart must be directly taught and consistently used • http://www.nwresd.k12.or.us/autism/First-ThenChart.html

13. Behavior Management • Step 6 • Follow through with First/Then • As the teacher, you must be sure that earned positive reinforcer (Then) is provided/permitted • Positive reinforcer (Then) should be given immediately when possible • Positive reinforcer (Then) cannot be taken away if task if completed as a way to discipline for other behavioral concerns

14. Behavior Management Parent Coaching Cards Dr. Steven Richfield

15. Behavior Management • Parent Coaching Cards are used to help develop and expand the social and emotional skills in children • The child and parent/teacher work together to “master” concepts that are encountered in daily life. • As concepts are “mastered” improvements in self-esteem are seen.

16. Behavior Management • Reacting Side – may lead to trouble • Thinking Side – helps solve situations • Understanding skills taught (Cards)

17. Behavior Management Low and Slow Technique (Bolick, 2001) • The way to engage a child who is stressed or in danger of becoming stress/reactive. • Based on fight or flight response • Individual respond more calmly when others are calm • Even more of an issue when children are responding to an adult’s level of regulation

18. Behavior Management LOW • Keeping a safe distance (don’t want to be kicked) lower your self to eye level or lower • Lower you voice including volume and pitch • Short sentences, non-complex language, minimize questions

19. Behavior Management SLOW • Slow your heart rate • Slow rate of speech • Take as long as you need, don’t rush what you are saying

20. Behavior Management BEHAVIOR RESPONSE PLAN

21. Behavior Management • Behavioral Response Plan- • What is a Behavior Response Plan • Detailed plan for teacher response to student behavior • Provides clear outline for each stage regarding student behavior at that stage • Provides pre-determined plan of action for teacher each stage

22. Behavior Management • PURE Script • When a child is engaging in an unacceptable behavior, move close to the child and get down on their level. Use the following PURE script to stop the behavior and prevent the situation from escalating. • Positive intent “You wanted…” (CRITICAL first step is to meet the child with an empathic response) • Unacceptable “but you can’t….” • Reason “because…” • Explore alternatives: help to problem solve

23. Emotional Expression and Regulation Sensory Issues

24. Emotional Expression and Regulation EMOTIONAL EXPRESSION/ LABELING

25. Emotional Expression and Regulation Labeling feelings For children with Autism the world of their own and others emotional experience can be difficult to understand. Much of the learning that people do regarding feelings is from observing and imitating social cues and non-verbal responses from others. This is known to be an area of challenge for persons with ASD. This needs to be an area of direct instruction.

26. Emotional Expression and Regulation Teaching can occur in the following areas • Emotional labeling for self • Emotional intensity rating for self • Cues to understand the emotions of others • Directions for how to manage emotional responses

27. Emotional Expression and Regulation What we need to remember: • Emotional labels and responses that we just “know” need to be taught • Persons with ASD are more likely to attribute their emotional response as that of others around them • Persons with ASD often misread social cues and the finer points that distinguish complex emotions

28. Emotional Expression and Regulation • Anxious feelings often result in “stuck” behaviors which appear non-compliant • Children are less anxious and less “stuck” when they have a clear plan ahead of time • A plan is reviewed often in times of calm is more likely to be used in times of stress

29. Emotional Expression and Regulation Feelings Identification Charts • Basic feelings charts provide pictures which depict emotions the child is likely to experience • Feelings words will need to be described to the child in terms of how they look, when they may occur, and how the body feels during that feeling • Child should be allowed to chose their emotion pictorially if they cannot chose verbally • Handout feelings identification charts

30. Emotional Expression and Regulation Feelings application work • Simple scenarios are provided which allow the child to practice labeling what may be a typical emotional response • The practice allows the child to begin to associate different experiences with specific emotions • Examples: I won the race… I feel _______; Someone takes my toy… I feel_______; I have a bad dream…I feel________

31. Emotional Expression and Regulation Rating the intensity of emotions • Emotions occur at varying intensities • Feelings such as anxious or angry may need to be rated using a picture scale or a number rating scale • The picture or number rating allows the child to give you more information without having to verbalize too much about the situation • Handout - Rating Emotions charts

32. Emotional Expression and Regulation Charts to instruct Emotional management • Once a child is able to label their emotions or after an adult helps the child to label that emotion, charts that identify a course of action for emotional management are helpful • Charts should give clear instructions for activities that the child has already learned and practiced consistently while calm • Calm places in the room and materials to use to calm down can be labeled to match the child’s emotional management chart • Handout- Emotional Management charts

33. Emotional Expression and Regulation Anxiety Management • Know signs and triggers for your student • Identify Your School Triggers Worksheet • Anxiety thermometer

34. Emotional Expression and Regulation • What are your stress management options? • Relaxing music • Take 3-5 big deep breaths • Counting • Meditation • Jump rope • Physical stimulation • Progressive muscle relaxation (worksheet) • Visual relaxations (worksheet) • Yoga relaxation (worksheet)

35. Communication • Be concrete and literal • Balance eye contact • Understanding body posturing

36. Communication • Why are nonverbal cues important for children with an Autism Spectrum Disorder? • Children with an ASD are visual learners • Visual options you can utilize in the classroom • Sign language • Picture Exchange Communication System (PECS)

37. Communication Managing Bullying • Bully Proof Plan • Finding the student a “buddy”

38. Communication Social Stories

39. Communication What are social stories? • Social stories are used to teach social skills to children with autism. A social story is a simple description of an everyday social situation, written from a child's perspective. • The idea is that the child rehearses the story ahead of time, with an adult. Then, when the situation actually happens, the child can use the story to help guide his or her behavior • http://autism.healingthresholds.com/therapy/social-stories

40. Communication When can social stories be used: • To help child learn a new skill • To help child understand the unwritten rules for social interaction • To help child understand their own emotional experience • To help child prepare for a change in routine

41. Communication Sample social stories can be found at: • Handout sample social stories • http://www.einstein.edu/rx_files/yourhealth/airport_social_stories_einstein.pdf • http://www.polyxo.com/socialstories/ss0017.html • http://kidscandream.webs.com/page12.htm

42. Communication Acronyms: • PATHS • Helpful for teaching students how to initiate a conversation • SENSE • Helpful for teaching students appropriate nonverbal communication skills

43. Communication Teamwork

44. Communication When expecting students to work in groups • Directions need to be clear • Purpose of the activity should be clear • Expectations for team work should be clearly defined • Handout : Rules for Teamwork

45. Communication Directions for the activity • Directions should be given verbally and in writing • Directions need to be clear for the role that each child will play in the activity • Directions for how to seek assistance should be given verbally and in writing • Directions for how to solve common teamwork problems should be reviewed

46. Communication Common Teamwork Troubles • Help students to identify common problems • Help students identify possible solutions • Provide solutions through verbal instruction, role play and written format • Handout: Teamwork Troubles

47. Communication Managing communication styles • Perseveration – redirection • Transitioning – schedules and warnings • Auditory processing – short simple instructions • Interruptions – be patient