Collabarative Program For Autism In University of Northern Colorado

1. Collabarative Program For AutismIn University of Northern Colorado Wiranpat Rattanasatien ,MD Yuwaprasart Child & Adolescent Psychiatric Hospital, PMH

2. Iceberg of Autism Cultural of autism Social relatedness Joint attention&reciprocity Communication Expressive deficit :intent,mean Receptive deficit :meaning,processing Sensory processing integration and modulation of inputs Difficulties with change limited interest repetitive behavioral rigidity Cognitive style problems with organization& sequencing&planing attention&relevance abstraction&generalization

3. The Colorado Working with Children with Autism Spectrum Disorder for Teachers, Service Provider and ParentsDeveloped by Colorado Task Force June 2000 • The child’s and the parent’s culture(s) be recognized and respected • Services and supports for the child be individualized • Services and supports be based on experience and research that meet recognized scientific and academic standards (i.e. academic peer review) • Each child be taught with a curriculum that is age-appropriate ,individually appropriate and culturally appropriate

4. Diagnostic and Statistical Manual of Mental Disorder IV Citeria for Autistic Disorder • A) A total of six (or more) items from (1),(2), and (3), with at least two from (1) and one each from (2) and (3): • qualitative impairment in social interaction, as manifestated by at least two of the following : • marked impairment in the use of multiple nonverbal behaviours such as eye-to-eye gaze ,facial expression ,body postures ,and gestures to regulate social interaction • failure to develop peer relationships appropriate to developmental level • a lack of spontaneous seeking to share enjoyment,interests ,or achivements with other people (e.g. by a lack of showing .bringing . or pointing out items of interest) • lack of social or emotional reciprocity

5. qualitative impairments in communication as manifested by at least one of the following : • delay in . or total lack of ,the devepment of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime) • in individuals with adequate speech . marked impairment in the ability to initiate or sustain a conversation with others • stereotyped and repetative use of language or idiosyncratic language -lack of varied . spontaneous make-believe play or social imitative play appropriate to the developmental level

6. restricted repetative and stereotyped patterns of behaviour ,interests and activities , as manifested by at least one of the following : • encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus • apparently inflexible adherence to specific ,nonfunctional routine or rituals • stereotyped and repetative motor manerisms (e.g.,hand or finger flapping or twisting , or complex whole-body movements) • persistent preoccupation with parts of objects. • B) Delayed or abnormal functioning in at least one of the following areas ,with onset prior to age 3 years (1)social interaction ,(2)language as used in social communication ,or(3)symbolic or imaginative play.

7. Assessment • The Autism Diagnostic Observation Schedule-Generic (ADOS-G) • Autistic Diagnosis Interview. (ADI-R) • Vineland Adaptive Behavior Scales • Mullen’s communication Scales

8. Planning Strategies • Use child profiles that look at strengths ,interests and needs • Incorporate family input in the IEP/IFSP process • Determine the child’s motivational interests and needs • Establish clear goals • Design meaningful curriculum • Practice authentic assessment • Employ formal and informal assessments • Use choice of learning styles • Develop the IEP/IFSP goals and objectives • Write transitional plans • Employ strategies for evaluation of IEP goals and objectives • Understand issues related to identification

9. Data Collection for Analysis , and Program Changes • Design student progress measurement systems • Conduct assessment and evaluation • Use data-based decision-making

10. Environmental and Classroom Arrangement • Employ visual strategies • Use techniques of structured teaching • Use consistency in designing the learning environment • Monitor and modify environmental stimuli

11. Collaborative Systems Education • Proactive home-school communication • Collaborative working relationships with all providers : Active family participation • Establishing prioritized goals with families • Identifying family strengths ,capacities and styles • Utilizing strategies Flexibility and openness to new ideas • Proactive medical support

12. Generic Instructional Strategies • Sensory Integration Strategies • One-on-one teaching • Information and skills to address needs • Functional skills embeded within routines Curricular adaptation and modification • Normal development • Build on strengths • Positive behavioral approaches for difficult behaviour • Differential Instruction to meet individual needs • Intentional teaching to increase flexibility and independence for learners • Blend best practices with behavioral intervention and standard

13. Employ strategies for evaluation of IEP goals and objectives • Rating scales • Observations based on frequency ,duration or amplitude of behaviors • Observations based on correct responding . error and adult prompts • Observations based on level of independent performance • Interviews with key informants (families .teachers ,peers) • Understand issues related to identification • Discrete trial training : using antecedent ,behavior , and consequence format • Task Analysis • Errorless learning with structure tasks for student success and reinforce successive approximations toward the target behavior (shaping) • Cooperative groups • Social skills training • Positive behavioral support plans • Assistive technology and augmentative communication • Future/individualized planing • Applied behavior analysis • Facilitated play

14. Intervention Approaches to Autism Spectrum Disorder • Activity Based Intervention • Challenging behaviors using a functional assessment approach by • Attempting to understand the intent of the unconventional behaviors • Subsequent replacement of more conventional means of interaction • The adaptation of the extrinsic or environmental variable to lead to more successful interaction

15. Baby Signs • Teach babies to use simple, easy-to-do gestures for communicating with their parents and caregivers. These gestures or “signs” represent an item or concept, like “cat,” “eat,” or “all gone.” • Using signs gives babies a way to “talk” with their parents, before they can talk. • Babies and toddlers often use signs as a natural part of the communication process.

16. Head Start and Early Head Start Comprehensive child development programs that serve children from birth to age 5, pregnant women, and their families. They are child-focused programs and have the overall goal of increasing the school readiness of young children in low-income families.

17. Even Start A Part A preschool program using an Even Start model must integrate early childhood education, adult literacy or adult basic education, and parenting education into a unified family literacy program.

18. Denver Model of Intensive Therapy for Yong Children with Autism The main goals of treatment are • Bringing the child into coordinated ,interactive social relations for most of his/her waking hours ,and social experience can occur • Intensive teaching to “fill in” the learning deficits that have resulted from the child’s past lack of access to the social world due to the effects of autism The main tools are • Teaching imitation • Developing awareness of social interventions and reciprocity • Teaching the power of communication • Teaching a symbolic communication system • Making the social world as understandable as the world objects : social milieu

19. Beliefs at the Core of the Denver Model • Families should be at the helm of their children’s treatment. • Each child with autism and family is unique. • Children with autism can be very successful learners. • Autism is at its core , a social disorder. • Children are members of families and communities. • Children autism have minds ,opinions ,preferences ,choices ,feeling.

20. Autism is a complex disorder affecting virtually all areas of functioning. • Children with autism are capable of becoming intentional ,effective ,symbolic communicators • Systemic instruction is a powerful tool for young children with autism. • Play is one of the young child’s most powerful cognitive and social learning tools • Successful intervention needs more than 20 hours per week

21. The Inclusive ,Community-Based Model • Teaching within family routines. • Teaching within inclusive preschool settings. • Intensive 1:1 Teaching

22. Main aspects of the Intervention Approach • Design and Implementation of the Intervention Plan. • Emphasis on Relationships ,Share Control ,and Positive Emotion.

23. Content Areas • Communication • Teaching the child to use nonverbal communicative gestures. • Teaching motor imitation. • Teaching the meaning and important of communication. • Teaching symbolic representation.

24. Play • social ,physical ,constructive ,symbolic, and independent. • Age-appropriate play skills • Individual teaching and directly guided in inclusive preschool experiences.

25. Sensory-based activities : attention ,arousal and affect. • Through sensory-social dyadic routines. • Through planned group sensory activities. • Personal independence and participation in family routines. • Social skills. • Motor skills :development ,sequencing ,planning • Behavioral Management.

26. Typical Daily Schedules of Intervention 7:30-8:30amHome dressing and mealtime programs. 9:00-12:00 Inclusive preschool intervention. 12:00-1:30 Mealtime programs ,hygiene programs. 1:30-4:30 1:1 structured teaching programs. 4:30-5:30 Play indoors and outdoors. 5:30-7:00 Chores ,mealtime program ,communication programs. 8:00-Bedtime Book routines

27. Role of families : • Families are at the helm of their child’s treatment. • Parents are the primary teachers • Home visits are scheduled as needed.

28. Transition Outcomes • Workplace competencies • Knowledge of community resources and referral procedures • Vocational assessment strategies • Community-based learning experiences