Social Communication and autism spectrum disorder

1. Social Communication and autism spectrum disorder Erica Howell, Ph.D.

2. Welcome! • Are you pumped to learn a variety of free and easy-to-implement strategies that support your students’ social understanding and involvement?

3. Table of Contents • Theory of Mind • The Impact of TOM on the Educational Setting • Social Interventions • The Hidden Curriculum • SODA • Social stories • Social Scripts • Comic Strip Conversations • Power Cards

4. I. Theory of Mind (TOM) What is Theory of Mind and why is it important?

5. Theory of Mind • Theory of Mind (ToM) is the ability to infer the mental states of others in relation to their knowledge, intentions, beliefs, desires and the ability to use this information to interpret what another says, make sense of the behavior and predict what he or she will do next • Depending on the researcher or interventionist, ToM may also be referred to as perspective taking, social thinking, social cognition, or empathy

6. Theory of Mind cont. • ToM is hypothesized to be the core, central impairment of autism • Functions as a continuum of impairment with some individuals with autism exhibiting more theory of mind impairment than others • ToM is CRUCIAL to social, interpersonal, and communicative relationships • Mistakes in understanding and interpreting social interactions can have serious implications for relationships with others.

7. Theory of Mind cont. • Social Challenges may impact the following: • Joint attention • Emotion recognition and sharing • Understanding knowledge • Deception • Humor • Teasing • Mental state language (e.g. know, think, feel, guess)

8. How does a Theory of Mind develop?

9. Theory of Mind Development • Typical developing children have “theory of mind” by the age of three or four, but it develops as early as infancy with behaviors such as • Pointing or vocalizing to direct another’s attention toward an object (establishing joint attention) • Learning what an item is like based on positive or negative reactions from an adult (social referencing)

10. Theory of Mind Development cont. • Theory of mind also affects how children understand emotions: by the age of three, children should understand that a situation affects emotion • By the age of four, children can take into account someone’s desires and beliefs, predict how they will feel

11. II. The Impact of TOM on the Educational Setting Why is ToM an important construct for general and special educators to understand?

12. Importance of ToM With the impact of IDEA and NCLB, the inclusion of students with autism spectrum disorder and testing results hold higher importance for general educators than previous years Teachers must learn to examine the relationship between ToM, behavior, classroom instruction, and educational content

13. School and Classroom Navigation A typical school day requires repeated social navigation and can be exhausting for the student with ASD. Classroom interactions that occur between the teacher and student, peer work groups, and sharing space are examples of common scenarios where a ToM is needed to interact.

14. School and Classroom Navigation Cont. • For example, one middle school student with high-functioning autism I worked with was distressed whenever a classmate sneezed. Upon seeing or hearing the action, she would exclaim in a loud voice how disgusting the “sneezer” was. Her impaired ToM prevented her from interpreting her classmates’ snickers and facial expressions as a response to HER inappropriate behavior. • Another student often exclaimed, “I’m bored!” during his teacher’s instruction.

15. School and Classroom Navigation Cont. • Everyday school activities such as recess or PE hold social challenges for our students on the spectrum • Recess/PE: Typically consists of a large unstructured area where kids run around, engage in group games without explicit rules, and use social language. How overwhelming! • Teach recess and PE skills explicitly! • Most of these students want to be part of a group, but don’t know how to.

16. III. Social Interventions Now that you have background knowledge on what TOM is and why it is important, let’s learn about some interventions that facilitate social understanding

17. The “Hidden Curriculum” of Schools • Implicit or unstated social rules make up a “hidden curriculum” • When these rules are violated, an individual may be teased, bullied or ostracized • e.g. boys don’t wear “pretty” shirts, a teenager playing “detective” around the neighborhood will be mistaken for a stalker • The hidden curriculum differs according to age, gender, groups of people, and culture • The movie “Elf” demonstrates this perfectly!

19. The Hidden Curriculum Cont. • Our students on the autism spectrum need these rules explicitly taught to them • When I was an elementary school teacher, my young male students with autism continually violated the hidden curriculum of using the bathroom . Neuro-typical peers would often tattle that my students dropped their pants all the way down to their ankles when using the urinals.

20. Can you think of the hidden curriculum of a Birthday Party? *Hint: Don’t blow out the candles on the birthday kid’s cake!

21. Stop, Observe, Deliberate, Act (SODA) • SODA is a tool for interpreting behavior and problem solving how to respond • Typically used with individuals with Asperger Syndrome in order to promote social interaction skills and helps guides students on how to act in novel situations

22. Stop • This component helps the student develop a framework for a specific situation that requires social interactions. When the student enters a novel situation, she uses self-questioning to decide what to do. The first question guides the student to develop an organizational schema for the setting (i.e., Where should I go to observe? What is the room arrangement?). The student identifies a place to stand to observe and learn about the social situation.

23. Observe • The second step, Observe, helps the student become more aware of social cues other people use in the setting. In this step, the student should pay attention when she can hear other people’s conversations. She can also note how others conduct themselves (formal vs. informal language), length of conversations, conversation topics, whether individuals stay in groups or move from group to group, etc. However, the student should be careful not to eavesdrop on people’s private conversations or be seen as suspicious by loitering. During this step, the student seeks to understand the roles of various social cues and the meaning of typical phrases or behaviors used in the setting (i.e., When people say, “Where have you been?” you are not supposed to name all of the places you have visited). Thus, the goal of the Observe step is to identify what others are doing.

24. Deliberate • The overarching question that should be asked during this stage is, “What do I need to do to successfully participate in this setting?” This component helps the student decide what to say and how other people will perceive her. The student can ask herself, “What would I like to do?” and “How will other students react if I say this?” • The secondary issue to be addressed during this stage is to identify particular aspects of the event that might be problematic and identify strategies to address these. For example, if the situation is loud and the student is sound sensitive, she may need to remind herself to wear her earplugs or immediately create a plausible excuse that will allow her to leave the situation quickly.

25. Act • The final step guides the student in how to interact with others. The student identifies people with whom she wants to interact in the specific setting and acts according to the plan she developed during the Deliberate stage.

27. Social Narratives

28. Social Stories A social story is an individualized story from the perspective of a person with ASD They can be created in a variety of formats, including pictures with words, text alone, audiotapes, videotapes, PowerPoint, etc.

29. Who is Line Leader? My name is Andrew. I am in the first grade. Sometimes, the children in my class form (one, two, three, etc.) lines. www.graycenter.org

30. The children in my class stand in a line when we are getting ready to go to another part of the school. Children do move a little when they stand in a line. Children may move to scratch, or fix their shirt, or their shoe. Sometimes, because they are standing close together, children may touch one another. Many times, it is an accident when children touch one another in line. They were not planning to touch another child.

31. Usually, children stand and walk in lines for a short period of time. Once the children reach their destination, their teacher often doesn't need them to stay in the line anymore.

32. Sometimes, I may be the Line Leader. This means that the other children in my class will walk behind me.

33. Sometimes, I may be second, or third, or fourth, or another position.

34. Many children in my class like to be the Line Leader. My teacher knows who should be first in line. Teachers know about being fair, and try to make sure each child is Line Leader now and then.

35. It's important to follow directions about who is Line Leader. My turn to be Line Leader again gets closer every time the children in my class walk in a line!

36. Social Story Formula -The Four Basic Sentences • Descriptive sentences - answer “wh” questions, truthful, opinion & assumption free statements of fact, only required sentence of the four basic sentences • Ex: At work we bag the breadsticks. • Perspectives sentences - describe feelings, beliefs, thoughts, motivation of social situation • -Ex: Eric likes working in the cafeteria.

37. The Four Basic Sentences(continued) • Directive sentences - offer or suggest response or choice to a social concept or situation, based on a student’s effort • Ex: I will try to walk to the cafeteria. • Affirmative sentences - used to stress an important point, refer to a rule or law, or reassure the individual, often express a socially agreed upon value or opinion • Ex: Most people eat dinner before dessert.

38. Social Story Ratio • For every directive sentence, there needs to be at least two to five descriptive, affirmative, or perspective sentences in the story. • This ratio ensures a descriptive quality to the social story.

39. Essential Elements of a Social Story • Written from the perspective of the student • Answers “wh” questions • Written in positive language • Has an introduction, body, and conclusion • Is literally accurate • Uses language matching ability • Can be adapted by using pictures, illustrations, audio and video

40. Going to get a pole

41. My name is Keira Howell. Sometimes I go to the hospital to get medicine.

42. After I arrive at the hospital and go to my room, the nurses ask me to put some medicine in my mouth. Sometimes I don’t like this!

43. When it is time to take the medicine in my mouth, I can sip the medicine or swallow it quickly. Fancy Nancy likes taking medicine that tastes like grape, bubble gum, or cherry.

44. Next, the nurses use soda *POP* because it helps my arm not hurt when the needle goes in. Soda pop is loud! Mom can help by covering my ears.

45. Now it is time to put the needle in my arm. This is how the medicine gets inside my body. The medicine helps my body feel good and stay healthy.

46. It is good to snuggle my mom and stay calm. If I kick and move, the nurses and mom have to hold me still. I don’t like when they do this. If I start to get scared, I can: • Let my mom hold me • Remember that God will keep me strong, and • Know that it will be over very fast!

47. Cousin Brooke thinks it is very cool that I can take my medicine in my mouth and stay still while the needle goes in my arm!

48. Sometimes the medicine makes me sleepy. That’s good because mommy loves when I snuggle her! Mommy and I can put on a movie, watch it together, and I can fall asleep on my mom if I’m tired.

49. When I wake up, I can play with toys if it is not already time to go home. There are a lot of fun activities to do at the hospital.

50. Once all the medicine is in my body, it is time to take the needle out. Sometimes, the tape hurts. It is good if I let the nurse or mommy use the alcohol wipes to take the tape off. This will help it not hurt so much.