Los Angeles Unified School District Division of Special Education

1. Los Angeles Unified School District Division of Special Education Schools for All Children Autism Spectrum Disorder Donnalyn Jaque-Antón Associate Superintendent

2. Autism Spectrum Disorder Developed by: Pat Grayson-DeJong, M.Ed. & Debbie Moss, M.A. Autism Specialists, LAUSD Autism Program Support (213) 241-8051

3. Pervasive Developmental Disorder Autism PDD – NOS Asperger Syndrome Rett’s Syndrome Childhood Disintegrative Disorder AUTISM SPECTRUM DISORDER Profound (severe) Autism Moderate Mild (High Functioning) Asperger Syndrome

4. Autism Spectrum Disorder • First described by Leo Kanner in 1943 • Lifelong disorder: there is no cure at this time • Can be present at birth, but typically appears prior to age 3 • Affects 1 in 166 • Four to five times more common in boys

5. Autism Worldwide Increase Possible Reasons: • Medical and Educational community better informed • Genetic evidence for predisposition in some families • Compromised immune system and environmental factors • Vaccines???

6. IMPORTANT FACTORS TO CONSIDER WHEN PROJECTING STUDENT OUTCOMES • Early Intervention Quality of Intervention • Consistency of Intervention Cognitive Ability

7. Core Areas of Deficit • Speech and Language Deficits Non-Verbal Echolalic/sterotypical language Hyper-Verbal • Social Skill Deficits Range from isolative to indiscriminately social • Limited/Repetitive Behavioral Repertoire Self Stimulation Rigidity Perseverative Inflexibility

8. Autism Continuum Measured I.Q. Severe Gifted Social- Emotional Interaction Aloof Passive Active but Odd Communication Non-verbal Verbal Motor Skills Awkward Agile Fine Motor Uncoordinated Coordinated Sensory Hypo Hyper

9. Communication Deficits • Severe delay or complete absence of speech • Immediate or delayed echolalia • Poor auditory processing • Odd voice quality/volume • Understanding of language is literal/concrete (e.g., “listen up.” “It’s raining cats and dogs”) • May repeat sounds/questions/phrases

10. Strategies to address Communication needs • Language occurs throughout day and taught byeveryone • Use augmentative communication to stimulate verbal language (e.g. PECS) • Use visual cues to facilitate understanding of abstract concepts (e.g. pictures, drawings, written words) • BE CONCRETE

11. Communication Strategies (con’t) • Teach for generalization by teaching in variety of settings, using different materials (e.g., color red: apple, stop sign, shirt, crayon) • Auditory processing deficits: allow extra time for student to respond

12. Social Skill Deficits • Infants/children irritable and hard to comfort • Isolative • Poor/no eye contact; odd eye gaze • Inappropriate giggling or laughing • No understanding of “friendship”

13. Strategies for Improving Social Skills • Shape desired behaviors • Teach and practice appropriate social skills in natural environments • Establish a “friendship system” for community integration • Have neurotypical peers or adults prompt/cue appropriate social skills • Capitalize on child’s strengths in integrated settings

14. Academic Challenges • Children adapt poorly to others and changes in routines • Do not use toys for intended purpose (e.g., spins, lines up, flips, etc.)

15. Academic Challenges (con’t) Uneven development of skills: - Decodes words but unable to comprehend meaning - Good computation skills, but unable to apply - Excellent visual matching skills - Gross/fine motor skills range from superior to very poor

16. Strategies that Address Academic Challenges • Avoid surprises • Visual Schedules assist with daily routines and transitions • Provide predictable structured, safe, environments • Use priming techniques • Visual supports

17. Visual Supports Michael Today’s Schedule • Breakfast • Speech – Ms. Jane • OCR – Ms. Nelson • Written Language • Recess • Math • Social Studies • Lunch • Reading Comprehension • Art or Music • Homework Review • Dismissal

18. Strategies that address Academic Challenges • Break tasks into smaller parts • Teach how to use toys/games appropriately • Stress “functional use” of academic skills • Fade cueing

19. Sensory Deficits • Sensitivity to environmental conditions • Hyper or hypo sensitivity to auditory, visual, smell/taste, tactile/kinesthetic

20. Response to Sensory Input • Under/over reaction to sound • Eye contact avoidance • Focus on details of objects • Avoids specific foods/odors/textures, etc.

21. Strategies to AddressSensory Differences • Remove environmental conditions, if reasonable (e.g., odors) • Desensitize in small steps (consulting with O.T.) • Implement sensory diet, as prescribed by O.T.

22. Asperger Syndrome

23. Asperger Syndrome (AS) • First described by Hans Asperger in 1944 (Mildest and highest functioning end of ASD) • Abnormalities noted in 3 broad aspects of development  Social interaction and emotional relatedness  Unusual patterns of narrow interests  Behavioral and stylistic characteristics involving repetitive/perseverative features

24. Asperger Syndrome (con’t) • Students more likely found in general education classrooms and often undiagnosed or misdiagnosed as ADD, ED, LD, or just odd • Genetic factors more prevalent in AS. Often family history of autism, most often on the father’s side

25. Characteristics: • Higher cognitive abilities (average to superior) • Lucid language by 4 years • Present with considerable pragmatic language difficulties • Speech often stilted and repetitive; conversations revolve around rote, factual topics

26. Additional Characteristics • Often engage in rituals • Worry excessively when they do not know what to expect

27. Deficits in Pragmatic Language • Turn-taking skills (within play and conversation) • Gestalt processing (seeing the big picture) • Perspective-taking • Problem solving • Organization

28. Additional Issues with Pragmatics • Social Expectations • Proximity, eye contact, intonation • Conversational skills - Talking too much - Interrupting - Changing topics without transition (From Gail Hallenberg, M.S.,CCC-SLP)

29. Strategies to Improve Pragmatic Language • Teach rules of communication • Teach conversational skills step by step, using visual aides and representations • Role playing • Start with easier tasks and add complexity as the student gains skills and confidence

30. Work on different contexts and generalization • Repetition/practice • Always explain “why” -- Helps students see the perspective of others (From Gail Hallenberg, M.S., CCC-SLP)

31. Academic Challenges • Verbal abilities higher than performance skills • Lack higher level abstract thinking and comprehension skills • Impressive vocabularies give false impression that they understand (may be parroting what read or hear)

32. Academic Challenges (con’t) • Excellent rote memory skills, but mechanical in nature • Exhibit poor problem solving skills • Literal and concrete thinkers Reading Writing 16 X 3 = 48

33. Educational Strategies for Academic Challenges • Individualized academic programming designed to offer consistent success • Make learning rewarding, not anxiety provoking • Redirect away from following their own impulses • Insure student’s understanding of presented material via his/her demonstration of it

34. Big job: Clean your desk Little chunks: 1. Put pencils in pencil box 2. Close covers of all books 3. Throw away all wrinkled/ torn papers 4. Put important papers in a folder 5. Put books in a neat stack Break reading comprehension into smaller parts and analyze 1 section at a time Expectations must be set for amount and quality of work produced. Start small and increase as skills develop Earning time toward doing what intereststhem is often a good motivator to do what is expected. Academic Strategies (con’t)

35. First Then Behavior Support

36. Strategies • Simplify abstract concepts. Use visuals as much as possible • Teach the difference between general knowledge and personal ideas to help with writing skills Love

37. Emotional Vulnerability • Often don’t have the emotional resources to cope with the demands of the classroom (esp. from 3rd grade on) • Easily distressed due to inability to be flexible and lack of organizational skills • Intolerant of making mistakes, low self-esteem • Prone to depression • Rage and tantrum reactions common response to stress and frustration

38. Educational Strategies: Emotional Vulnerability • Provide high level of consistency to prevent outbursts • Teach students strategies to cope with their stress: Make list of concrete steps to follow when they become upset (e.g., 3 deep breaths, count fingers of left hand 3 times, ask to take a break outside of classroom, write steps on card, etc.) • Be alert to changes in behavior that signal depression: More disorganized, inattentive, isolative, crying/suicidal remarks, increased levels of stress, etc.

39. Social Challenges for Students with AS • Self observation/ evaluation of impact on others • Perspective taking; empathy • Applying problem solving skills • Dealing with change/novel stimuli • Body awareness/personal space

40. Additional Social Challenges • Coping with change/not getting your own way • Understanding subtle/ complex verbal and nonverbal communication • Processing and understanding emotion • Mastering the increasing complexity of games and rules • Learning to enjoy social contact

41. Addressing Social Skills in the School • SocialStories • Model desired social skill • Social skill scripting • Social skills discussion • Direct teaching of desired social skill

42. Application to Natural Settings • Opportunities to apply new skills in a natural peer context • Start with more structured situations and then try with less structures; provide enough support to ensure success • Coaching should still be given before and after, as needed • Should be practiced across all settings • School clubs, teams, activity groups • Recess, P.E., lunch • Mainstreaming classroom