Autism Spectrum Disorders: Identification, Learning Characteristics and Teaching Considerations

1. Autism Spectrum Disorders: Identification, Learning Characteristics and Teaching Considerations Presenter: Jane Hancock

2. What’s in a name? • Autism, Autism Spectrum Disorders, Autistic Disorder, Kanner’s Autism, Asperger’s Syndrome (disorder), High Functioning Autism, Pervasive Developmental Disorders Not Otherwise Specified……. • Terms ‘autism’ and ‘autism spectrum disorder’ (ASD) interchangable

3. Defining ASD • The word autism derives from the Greek word “autos” meaning ‘self ’ • Complex developmental disability in which there is dysfunction of some parts of the brain and central nervous system • Autism is now seen as a “spectrum disorder” varying from classic (“Kanner’s”) autism to more subtle “Asperger” cases, close to the boundary between autism and the ‘neurotypical’ population

4. History of ASD • The term ‘autism’ first used around 1919 • 1943, Leo Kanner’s published first accepted clinical paper describing psychological features of ‘autistic’ children and ‘autistic aloneness’ • Notion of ‘Refridgerator Mother’ advanced by Bruno Bettleheim in 1956 (lack of empirical evidence)

5. History of ASD (cont’d) • 1964, Bernard Rimland proposed autism to be biological (neurological) disorder not an emotional illness • 1979 Lorna Wing and Gould identified cluster of features (‘triad of impairments’) which became core diagnostic criteria for autism

6. History of Asperger Syndrome • 1944 Dr Hans Asperger, Austrian paediatrician, described a group of similar, unusual and intriguing children. • 1981, Lorna Wing summarised Asperger’s paper and introduced ‘Asperger Syndrome’ to the English-speaking world • Wing noted similarities between Asperger syndrome and autism and raised question of whether they are the same disorder

7. Occurrence of ASD • 1 in 160 school children aged 6 – 12 yrs (Autism Advisory Board Report 2007) • Across all ethnic and social backgrounds • Genetically-based with several different genes believed to be implicated • More boys than girls are diagnosed but it is possible that girls with AS are better at learning and copying social skills

8. Differences in the ASD brain “…..evidence of differences in how the brain is organised, in how it functions, even in its size. Thinking differently is not a choice in autism…” (Minshew & Williams, 2008, P45)

9. Impacts of ASD Affects ability to; • Make and keep friends • Carry out everyday social interactions • Deal with change Individuals with ASD typically have; • Repetitive behaviors • Intense/unusual interests in certain subjects They often have problems with; • Abstract thinking • Motor/coordination skills • Recognizing/coping with emotions • Sensory processing

10. Quote – Hans Asperger “The nature of these children is revealed most clearly in their behaviour towards other people. Indeed their behaviour in the social group is the clearest sign of their disorder and the source of conflicts from earliest childhood ”

11. Diagnosing ASD • Diagnostic criteria developed in 1989 • So-called ‘Triad of Impairments’ – Qualitative impairments in communication & social Interaction, repetitive behaviour and restricted interests • The DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, fourth ed) is the most commonly used diagnostic system in Australia

12. DSM-IV PDD Categories

13. Autistic Disorder and Asperger Syndrome There are those who say that children with autistic disorder live in a world of their own, while those with Asperger Syndrome live in our world but in their own way

14. Adapted from Ulliana in Dodd (2005) The changing picture of ASD

15. Quote – Stephen Shore “If you have met one person with autism you have met one person with autism.”

16. The Diversity of ASD nonverbalverbal Communication SocialInteraction aloof passiveactive/odd RepetitiveBehavior RestrictedInterests mild marked hyposensitivehypersensitive Sensory Learning Style Visual learner, kinaesthetic, detail focused, poor executive functioning, gestalt learner IntellectualAbility severe moderate mildaverage gifted

17. Key Issues for Students with ASD

18. Key Issues for Students with ASD • Communication development • Friendships/making social connections • Sensory processing • Behaviour • Anxiety • Bullying • Characteristics of ASD: • Communication impairment • Social impairment • RB/RI • Sensory • Information processing

19. Communication development • Communication involves all types of interactions where a message is sent or received • Comprehension requires understanding of speech, nonverbal/environmental cues & pragmatics, plus shared semantic concepts

20. ASD impact on comprehension Sensory/attention/working memory deficits Differences in information processing, storage & retrieval Theory of mind, recognition of emotion/affect Auditory Comprehension Semantic/concept Comprehension Social Comprehension

21. How do impairments manifest? • Receptive language – attention, slow processing, eye gaze • Expressive Language – formal/pedantic style, precocious language, unusual prosody • Pragmatics (knowing what to say, how to say it, and when to say it - and how to "be" with other people) • Literal/concrete interpretation • Difficulty initiating/sustaining conversation • Problems with inference/subtext • Functional use of language rather than for social purpose • Tangential or perseverative in conversation

22. Development of social connections • Problems with ‘Theory of Mind’ • Typically have fewer friends; may prefer company of older or younger students • May want friends but have trouble making/sustaining peer relationships • May isolate themselves by choice • Limited understanding of socioemotional cues (e.g. facial expressions, vocal tone) • Social skills issues – greeting, turn-taking, appropriate use of language, empathy • Unwritten social rules

23. Quote – Luke Jackson “If the person asks something like ‘Does my bum look fat?’ …that is called ‘fishing for compliments’. These are very hard things to understand, …..instead of being completely honest……answer with something like ‘Don’t be daft, you look great!’. You are not lying simply evading an awkward question and complimenting at the same time. Be economical with the truth!”

24. Restricted interests & repetitive behaviours • Need for sameness/routines/structure • Rigidity • Difficulty coping with change • Difficulty with prediction/social imagination • Anxiety in unfamiliar situations • Interests/obsessions • Stereotyped motor mannerisms

25. Quote – Sean Barron “I loved repetition. Every time I turned on a light I knew what would happen. When I flicked a switch, the light went on. It gave me a wonderful sense of security, because it was exactly the same every time”

26. Autistic thinking • Visual learning style • Good rote memory skills • Information processing • Executive Functioning difficulties (working memory, planning/organising/prioritising tasks, sequencing, narrative, attention, generalization of knowledge/skills, self-monitoring, changing strategy, impulse control, utilising feedback, predicting) • Weak Central Coherence (can’t ‘see wood for trees’; framework for understanding what is happening or what is expected;gist;relevant details)

27. Quote – Luke Jackson “Everything is so busy at school and everyone else seems to have a purpose and I never have quite fathomed out what that purpose is. I know we are there to learn but there is so much more going on….It is like beginning a game without knowing any of the rules or passwords”

28. Autistic thinking Empathy Impairment: • Theory of Mind - Difficulty “mind reading” affecting understanding of why people feel, think and do the things that they do. Need to learn what the rest of us do intuitively • Attention (orienting, selecting, filtering) • Concrete/literal thinking

29. Sensory-processing issues • Sensory processing – ability to organise and interpret information received from the 7 senses (visual, auditory, tactile, gustatory, olfactory, vestibular, proprioceptive) • Hyper/hypo sensitivity • Anxiety due to unpredictable/overwhelming environment • “Stereotypies” (rocking, finger flicking) or ritualistic behaviors to filter/block excess stimulation or to calm the body

30. Some ASD characteristics • Difficulty coping with change • Obsessive • Ritualistic • Egocentric • Difficulty monitoring/controlling own emotional state • Dislike criticism/making mistakes • Functional purpose to behaviour

31. Positive Behaviour Support • All behaviour is functional • PBS is proactive rather than reactive • Aims to prevent challenging behaviors by manipulating physical/social elements of environment and teaching appropriate replacement behaviors • A-B-C approach

32. Assets of students with ASD • rote memory • Factual learning strengths • Attention to detail • uneven profile of abilities • Specialised interests • Indifference to peer pressure • Rule-based • Refreshingly frank and logical • Honest

33. What can teachers do to help? “Otherwise skilled and competent educators often report that they consider themselves to be less than fully capable of meeting the needs of students with ASD because of the baffling nature of the disorder” (Roberts, 2006)

34. Teach to strengths “It can be puzzling that a bright child can struggle so much when expectations seem clear and straight-forward.” (Jacobsen, 2005) teachers must “teach from a new frame of reference, one aligned with the autism way of thinking” (Grandin, 2008)

35. Teaching strategies

36. Capitalise on visual strengths • Communicate in way AS students understand best • Support verbal communication by showing them something visual (e.g. lesson overview,photographs, diagrams, flow charts, written instructions, schedules, gestures) • Non-transient stimuli help AS students encode, retrieve, organize and remember information

37. Examples

38. Examples

39. Communication • Spoken word alone often not registered/remembered • Check that student is attending before speaking • Do not insist on eye contact • Keep instructions short/unambiguous • Allow sufficient ‘wait time’ (auditory processing delays) • Check for comprehension of spoken instructions • Provide clear rules to clarify classroom/school expectations • System for home/school communication (e.g. book, email) • Be aware of difficulty with idioms, metaphors, irony & sarcasm

40. Fine/gross motor difficulties Can impact on: • Handwriting • Participation in sports

41. Assisting emotional regulation AS/HFA students must be taught to recognise the warning signs of increasing stress and have strategies for staying calm or calming down

42. (Shore, et al., 2006) Emotion ‘thermometers’

43. Visual communication strategies

44. (Gray, 1994) Social skills Social Stories™ and Comic Strip Conversations provide information on what people in a given situation are doing, thinking or feeling………the what, when, who and why aspects of social situations (Gray 1994)

45. Makebeliefscomix.com

46. Using special interests 90% of ASD students have special interests which can be powerful motivators or rewards

47. Instructional considerations Students with ASD will be assisted to undertake learning tasks if the following questions are answered: • What am I expected to do? (activities, play etc) • How much am I expected to do? • How will I know when I am finished? • What will I do next?

48. Example

49. Structured learning environment • Complement ASD strengths (preference for ‘sameness’ and visual learning style) by ensuring: • Organization of classroom and academic tasks to be understandable and meaningful • Consistent use of visual cues, schedules, routines and timetables • Advanced warning of change and transitions • sensory accommodations (e.g. “chill-out zone”, headphones) • structure group work

50. Final thought “It only takes one person to believe in you and you can achieve all sorts of things” Wendy Lawson