Teaching Life, Social, and Community Skills to Tweens with Autism Spectrum Disorders

1. Teaching Life, Social, and Community Skills to Tweens with Autism Spectrum Disorders Presenter: Christina Whalen, PhD, BCBA-D Vice President, Director, Vocational & Life Skills Academy (SARRC) Consulting Assistant Professor (Stanford School of Medicine)

2. Pre-Teens and ASDs • “Tweens” – Ages 10-13 years • Middle School – challenging time in life for ALL children (and their parents) • Paucity of research and service models for this age group • Shortage of inclusion programs and opportunities to interact with typical peers • Decrease in activity opportunities in middle and high school (becomes more competitive) • Increase in anxiety and depression for children with ASDs at this age • Greater expectation of independence for children at this age • General education teachers have limited knowledge of ASDs, bigger issue when student begins to have MANY teachers (i.e. changing classes)

3. Common Middle School Problems • Self-esteem • Academic pressure • Drama/Bullying – peeks in middle school years! • Temptation/Peer Pressure • Disappointment/Rejection • Organization • Problem Solving • Dealing with Conflicts • Emotion Regulation • Perspective Taking/Theory of Mind • Self-Management • Health, Fitness, Hygiene • Puberty!

4. Research • Children with ASDs spend more time in solitary activities, less time in cooperative activities with peers, and more time in reactive aggression than those with no special needs or those with dsylexia (Humphrey & Symes, 2011) • ASD teens have less experiences with friends outside of school and are 3-5 times more likely to never get together with friends than peers with other disabilities (Shattuck, Orsmond, Wagner, & Cooper, 2011) • Children with ASDs spend less time and engage in fewer physical activities than their peers (Bandini, et al., 2012) • Children with ASDs tend to have lower social network salience and receive fewer friendship nominations across the school year than their peers (Locke, Kasari, Rotheram-Fuller, Kretzmann, & Jacobs, 2012) • Teens with ASDs are much more likely to experience bullying than typical peers (those with some conversational skills are more likely to be bullied than those with no conversational skills, and those in general education settings reported more bullying than those in special education classrooms) (Sterzing, Shattuck, Narendorf, Wagner, & Cooper, 2012)

5. Skills to Build Independence • Functional Life Skills • Social Understanding and Skills • Conversation Skills • Coping Skills/Emotion Regulation • Executive Function Skills • Health and Fitness • Self-Advocacy • Hygiene and Appropriate Dress • Self-Management • Career Interest and Skill Building

6. Inclusion • 86% of teens with ASDs take at least 1 special education class, while only 62% take at least 1 general education class (IES report, 2007) • Typical teens spend more time with peers, while those with ASDs spend more time with family (Shattuck, Orsmond, Wagner, & Cooper, 2011) • What do Middle School children think about autism? • https://www.youtube.com/watch?v=p9-l19CKISg

7. Transition Into Middle School Strategies • Start preparing ASAP (school year prior) • Make the schedule fun and usable for YOUR child (e.g. photos, color-coded, map, etc.) • Teach them to use a combination lock before starting school • Organization system that works for YOUR child (e.g. 1 binder instead of 8 notebooks) • Ask for 2nd set of textbooks to keep in home • Participate in a social skills program • Have a meeting with all of the teachers if possible before school starts • Prepare a daily log for your child to complete if he/she has trouble telling you about their day • Go on a tour of the school and practice walking to each class, video tape this!

8. Peer Mentors

9. Life Skills Interventions • Goal is to increase independence • Assessment of Functional Living Skills (AFLS) (Partington & Mueller) • Teach skills using: • Token systems • Self-management • Video modeling • Peer modeling • Pivotal Response Training (PRT)

10. AFLS Modules Self-Management Basic Communication Dressing Toileting Grooming Bathing Health, Safety & First Aid Nightime Routines Basic Mobility Community Knowledge Shopping Meals in Public Money Phone Time Social Awareness and Manners Basic Living Skills Module Community Skills Module Meals at Home Dishes Clothing and Laundry Housekeeping and Chores Household Mechanics Leisure Kitchen Cooking Classroom Mechanics Routines and Expectations Meals at School Social Skills Technology Common Knowledge Core Academics Applied Academics Home Skills Module School Skills Module

11. Sample AFLS Data Sheet

12. Life Skills Video

13. Social Skills Interventions • PEERS (Program for the Enrichment & Education of Relational Skills) Program (UCLA – Laugeson, et al.) • Reciprocal Imitation Training (RIT) (Ingersoll, Walton, Carlsen, & Hamlin, 2013) • Cognitive Behavior Therapy (Koning, Magill-Evans, Volden, & Dick, 2011)

14. PEERS Targets • How to use appropriate conversational skills • How to find common interests by trading information • How to appropriately use humor • How to enter and exit conversations between peers • How to handle rejection, teasing, and bullying • How to handle rumors and gossip • How to be a good host during get-togethers • How to make phone calls to friends • How to choose appropriate friends • How to be a good sport • How to handle arguments and disagreements • How to change a bad reputation

15. PEERS Outcome Measures

16. Conversation Probes • First 1 minute (0-1 minute)– members can discuss any topic they desire. Facilitator says: “During the first minute you can talk about anything you want. You can start now.” The one minute starts as soon as this instruction is given and ends when the minute has past. • 2. Second minute (1st-2nd minute) – members discuss object provided by the facilitator from the bin (randomly selected). Facilitator will randomly select an object from the bin, put this in the middle of the table, and state, “Now you will talk about (name of object). You can start now.” The one minute starts as soon as this instruction is given and ends when the minute has past. • 3. Third minute (2nd-3rd minute) – members discuss a general topic as provided on a card by the facilitator (randomly selected from the envelope). Facilitator will randomly select a card from the envelope, show this to the participants, put this in the middle of the table, and state, “Now you will talk about (topic on card). You can start now. The one minute starts as soon as this instruction is given and ends when the minute has past. • 4. Fourth minute (3rd-4th minute) – members discuss feelings denoted by a picture provided by the facilitator (randomly selected from the envelope). Facilitator will randomly select a card from the envelope, show the picture to the participants, put this in the middle of the table, and ask, “Please talk about the feelings you think this person has (or these persons if the picture shows more than 1 person). You can start now.” The one minute starts as soon as this instruction is given and ends when the minute has past. • 5. Fifth minute (4th-5th minute) – members hold a mock phone call. Facilitator will hand the telephones phones to the participants and state, “Now pretend that you are having a phone call with each other. You may begin now.” The one minute starts as soon as this instruction is given and ends when the minute has past.

17. Tween PEERS Outcomes

18. PEERS Behavioral Observation Videos

19. PEERS Structured Conversation Videos

20. Self-Management • Facilitates independence • Improves stimulus generalization • Improves self-awareness • Improves observational skills • Improves discrimination skills • Decreases need for parent, teacher, or clinician intervention • It is a “pivotal” skill that can help build other skills

21. Self-Management Procedures • Prioritize behaviors and begin with high frequency behavior • Prepare the specific system to be implemented • Teach the learner to use the system • Implement the system with support • Promote independence with the system (fade supports) • Begin to use system for new target behaviors

27. PowerWorks® • Local YMCA’s and SpoFit • Cardio • Zumba • Free weights • Swimming • Circuit training • Yoga • Team sports • Karate • Cycling • Hiking • Nutrition/Health • Social Rules and Safety • Self-Management

28. Outcomes/Video

29. Conclusions • There is an increasing need for programs for children in Middle School • Programs need to focus on building independence and social development • Programs should have an inclusion model for more social learning opportunities • Research is needed on what interventions are effective for this age group • And, for the record, TWEENS ROCK =)

30. Christina Whalen, PhD, BCBA-D 602-218-8223 cwhalen@autismcenter.org Contact Information www.autismcenter.org