Anne Arundel County Public Schools Division of Special Education Para Educator Training Series

1. Anne Arundel County Public Schools Division of Special EducationPara Educator Training Series Autism Spectrum Disorders

2. PRE ASSESSMENTPlease Submit To Your Administrator AACPS – Division of Special Education – Para Educator Training Series Name: School: Date: • Circle the five disabilities that are Pervasive Developmental Disorders (on the Autism Spectrum). Autism Asperger’s Disorder Retts Syndrome Traumatic Brain Injury PDD-NOS Childhood Disintegrative Disorder Intellectual Disability Sensory Integration Disorder

3. PRE ASSESSMENT 2) Autism is characterized by: a) restricted independence, academic achievement and self-determination b) impaired social interaction, communication and patterns of behavior c) limited inclusion, ability to feel and educational opportunities 3) What are examples of sensory seeking behaviors? a) doesn’t like clothes, takes off shoes b) fidgeting, touching, chewing c) doesn’t enjoy art, overreacts to being touched 4) What is a First/Then used for? a) gives students clear expectations and helps motivate and assist with task completion in a positive manner b) assists children with understanding teacher expectations and the class schedule c) teach and reinforce appropriate social skills

4. PRE ASSESSMENT 5) What is an indication that a student has a sensory need in the area of proprioceptive? a) The cover their ears b) They have problems with touch and balance c) They cover their eyes 6) What is a sensory diet? a) A communication system that children with autism use to support them in the least restrictive environment b) A gluten and wheat free diet c) A systematic planned group of activities to provide sensory input at specific times throughout a school day 7) All students with autism have cognitive disabilities. True False

5. PRE ASSESSMENT 8) What are social stories? a) Stories that help with reading comprehension b) Stories that teach and reinforce appropriate social skills c) Stories that give students rewards for completing 9) When using a positive behavior support, students should always get a reward after they complete one activity. True False 10) Rewards will help a child with their sensory needs. True False

6. Varying Diagnoses:“Pervasive Developmental Disorders” Regressive neurological disorders Autism Spectrum Disorders Childhood Disintegrative Disorder Autism PDD-NOS Asperger’s Syndrome Rett’s Syndrome Continued development of new skills Progressive permanent loss of skills

7. Childhood Disintegrative Disorder • May appear by age two, but usually between three or four • Before – age-appropriate skills in communication and social relationships • Long period of normal development and then regression • Loss of bowel and bladder control • Often have seizures and very low IQ

8. Rett’s Syndrome • Very rare – most exclusively affects females • One out of every 10,000 to 15,000 people • Normal development between 6 and 18 months and then regression • No longer responds to parents and pulls away from social contact • Mutation in the sequence of a single gene • Impairment in communication skills and social interactions • Restrictive, repetitive, and stereotyped patterns of behavior

9. Aspgerger’s Syndrome • Most distinguishing symptom – child’s obsessive interest in a single object or topic • High level of vocabulary and formal speech patterns • “professor like” • Repetitive routines or rituals • Socially and emotionally inappropriate behavior • Problems with nonverbal communication • Clumsy and uncoordinated motor movements

10. Autism • Difficulties with social interaction • Problems with verbal and nonverbal communication • Repetitive behaviors or narrow, obsessive interests • Reduced sensitivity to pain but increased sensitivity to sound, touch or other sensory stimulation • Range from mild to disabling

11. Pervasive Developmental Disorder – Not Otherwise Specified • Delay in the development of social and communication skills • Wide array of abilities, intelligence and behaviors

12. Defining Characteristics Social Skills Communication Restricted Repertoire of Interest/Behavior

13. Defining Characteristics of ASD Social Skills Deficits • Interpretation of others’ words (i.e. sarcasm, multiple meanings, jokes, etc.) • Interpretation of others’ body language and facial cues • Lack of understanding regarding how actions and words impact others • Lack of initiation and/or maintaining reciprocation of typical, social interactions • Understanding of “rules” and/or expectations across settings • Taking another person’s perspective • Inferring another person’s interest and sharing enjoyment

14. Characteristics of ASD Restricted Repertoire of Interests or Behavior • Repetitive behavior (for stimulation, to reduce anxiety, in times of stress, etc.) • Perseveration… “getting stuck” • Talking about a favorite topic • Completing a task • Physical movement • High level of interest in one topic and low in others

15. Characteristics of ASD Communication Challenges • Verbal skills vary • May be more proficient with gestures or pictures • May use vocabulary that is different than original meaning • Repetitive words may be used out of context • Concrete vs. abstract understanding of vocabulary and idiosyncratic phrases • Typically process visual information more effectively than auditory information

16. They Don’t Like Change! • Desire to follow set patterns of behaviors and interactions • Desire to keep objects in a certain physical pattern • May have difficulty transitioning between activities • May want to control interactions • They may exhibit aggression or self-injurious behaviors

17. Underlying Medical Issues • Children with autism sometimes suffer from co-existing medical conditions. • They may be dealing with seizures, allergies, sleep issues, gastrointestinal discomfort, or other medical conditions. • These conditions can typically be diagnosed with medical testing.

18. Some typical sensory behaviors Sensory Seeking Behaviors • Fidgeting • Toe tapping • Staring out the window • Standing at desk • Walking around the room • Making noises • Playing with hair • Touching other students • Chewing on objects • Pressing hard when writing Avoiding Behaviors • Refuses to touch textures • Has to be at the end of the line • Overreacts to being touched • Taking off shoes

19. First/Then Purpose: The First-Then strategy gives students clear expectations and helps motivate and assist with task completion in a positive manner. This strategy helps engage them in working from a non preferred activity to preferred activities. The First-Then format allows the child to focus on the current activity and rewarding activity without engaging in unneeded conversation. It also helps to eliminate a power struggle.

20. First/Then Directions: • Place a picture of the activity or activities the child needs to complete under “first”. Place a picture of the rewarding or preferred activity under “then.” • Set up in close visual proximity. • Can be used in a stationary area or made portable. • Use blank sides with replaceable tasks/schedule pictures/preferred visuals. • If student is a non reader you can use different colors for First side/Then side.

21. First Then Math Activity Build with blocks

22. Visual Schedule Purpose: The Visual Schedule assists children with understanding teacher expectations and the class schedule. It helps to keep the student on task, and reduces anxiety by letting the student predict what comes next. The visual schedule gives the student a sense of accomplishment and control over their day.

23. Schedules • Daily, whole class • Individualized • Mini-schedules/within a task • Location/multiple functions • Student/teacher developed • Embed choices • Use computer • Differentiate as needed (photos, words, PCS, etc.)

24. Visual Schedule Directions: • The schedule pictures should be laminated, cut, and mounted with Velcro. Put a small piece of Velcro on the back center of each picture. Use the same type of Velcro for the back of the pictures and the opposite type for the schedule board. • Place pictures of the daily schedule in sequential order, on a laminated visual schedule folder/strip or a To Do/Done Chart. Breaks and Rewards/”Special” Activities can be added into the schedule when needed.

25. Visual Schedule Directions continued: • Show the schedule to the child. Work with the child on becoming familiar with the schedule. • Model using the schedule by hand-over-hand, touching, or pulling off the pictures and placing them in the envelope. Remove pictures with the child at the end of each activity and place in pocket/bag/envelope. Child can do this independently, once familiar with the system. • Keep the schedule in close proximity to the child and at eye level. Use the schedule as part of the class routine. Establish a routine for “checking in” with the schedule throughout the day.

26. Sample Daily Schedules

27. Visual Prompts/Cues Purpose: Visual prompts provide a positive reinforcement for behavior/classroom expectations. Students are reminded of expectations in a positive, non disruptive, and explicit manner. Visual prompts provide consistent and concrete reinforcement of rules and routine classroom expectations. Students often need visual supports, along with verbal reminders to gain a better understanding of what is expected throughout the school day.

28. Visual Prompts/Cues • Directions: • Visual Promptscan be individual pictures cards in a variety of sizes, or on a key ring with multiple pictures. • The pictures should be placed near the teacher for use when reminders are needed. • Pictures can be displayed in the front of the whole group area as reminders of behavior expectations. (teacher could point or hold up appropriate picture, as needed) • Student and/or Teacher/TA/TSA could have pictures on a ring for a quick reminder of the behavior expectations.

29. Sample Visual Prompts

30. Positive Behavior Token System Purpose: A positive reward/token system provides a visible and tangible acknowledgement of the desired, target behaviors. It modifies undesirable behaviors. The token system teaches appropriate behaviors, and reduces the focus on negative behaviors. It also gives the student a sense of accomplishment and builds self esteem.

31. Positive Behavior Token System Directions: • Token System should be created based on the child’s preferences. It should be used consistently, and be portable to go with the student throughout the school day. • Use stars, smiley faces, favorite cartoon character, stickers, etc. as tokens. • Set up a system that allows the student to earn specific number of tokens working towards a reward. Provide two activities to choose from for a predetermined activity. • Students can put tokens on the reward system strip or move clip when each token is earned. (model doing this)

32. Positive Behavior Token System Directions continued: • After earning the specified number of tokens, the student would then have a specified amount of time to engage in the chosen activity. (5 -10 minutes is a reasonable time) • A timer can be set. When the time is up they go back to their work area and begin to earn new tokens, working for their next chosen activity. • Rewarding of tokens should be frequent with the initial implementation, and/or when inappropriate responses are frequent. Lengthen the time between earning tokens as the target behaviors begin to increase, and the inappropriate responses decrease.

33. Sample Token System Use my words. “ “Block please” Keep my hands to myself. 5 Stars = Choice Activity

34. Social Stories Purpose: Social stories teach and reinforce appropriate social skills. Ex. “How to Ask A Friend to Play” They also help to modify undesirable and inappropriate behaviors. Ex. “ Keeping My Hands to Myself” Social stories offer acceptable replacement problem solving ideas. Ex. “What I Can Do When I Get Angry?” A social story helps prepare a student when faced with change or an anxiety causing situation. Ex. “What Happens When I Have a Substitute Teacher?”

35. Social Stories Directions: • Can be made on one sheet of paper or made into a booklet. • Should be laminated to ensure durability. • Send a copy home, when appropriate, for practice and reinforcement. • Keep it simple.

36. Social Stories Directions continued: • Can be used with the whole class. • More effective when stories are personalized to reflect the student and the setting. • Positively state desired behaviors. • Read and use often in a pro-active manner!!

37. Sample Social Stories

38. Work Task Schedule Purpose: Work task schedules foster and encourage independent task completion. They help students stay on task and complete all steps. The use of visual task pictures decrease the need for verbal prompting. A work task schedule gives the student a sense of accomplishment and success when completing the task.

39. Work Task Schedule Directions: • Use folded, laminated paper or long strip of laminated paper to display work task pictures. (attach Velcro pieces on paper strip and work task pictures) • Task pictures should be placed in sequential order and numbered. • Model and practice using the work task schedule. • Keep on student’s desk or work area. • Student can remove each picture as task step is completed.

40. Sample Work Task Schedules

41. Visual/Material Guides For Instructional Areas Purpose: Visuals such as footprints, lines, or shapes help students learn important classroom routines such as lining up, walking in line, staying in defined spaces, etc. Visuals can support classroom areas to define space, closed areas, teacher areas, etc. Placing carpet squares or cushions in the whole group instructional area help define spaces for students to sit during instruction. Visual supports/materials provide needed structure and consistency in the classroom environment.

42. SampleVisual Guides for The Classroom Lentini, R., Vaughn, B. J., & Fox, L. (2005). Teaching Tools for Young Children with Challenging Behavior. Tampa, Florida: University of South Florida, Early Intervention Positive Behavior Support. Footprints to designate spots for lining up. Cushion or carpet square to designate spot for sitting on carpet or floor. Stop sign for closed areas. STOP Google Images @ thisnext.com

43. Sensory Difficulties • Body responds to sensory information differently • Sensory difficulties are concerning if they are excessive and interfere with participation in daily living activities • Can be hypo or hyper sensitive • Hypo sensitive – You need more stimulation to trigger a response • Hyper sensitive – It does not take much to trigger a response • Can be sensory avoidant or sensory seeking • Sensory avoidant – Avoiding stimulation that is uncomfortable • Sensory seeking – Seeking stimulation to either arouse or self-regulate

44. Sensory Impact on Behavior • Changes to the physical environment and how activities are structured may decrease the likelihood of meltdowns • Rewards or punishment are not effective strategies for sensory issues

45. Tactile Sense (Touch) Characteristics • Oversensitivity to unexpected, light touch • Instantly show a “fight or fright” response to harmless touch • Dislike messy activities • Be bothered by certain types of clothing • Prefer wearing a certain type of clothing • Dislikes swimming, bathing, brushing teeth or having a hair cut • Reacts negatively when approached from behind

46. How to Help • Student use gloves • Avoid heavy and light touches • Talk to families about cutting tags in clothing • Let pace or walk around to help with memory • Give fidgets – let move around • Do not do well sitting at desk – let move around and stand • Frequent breaks • Allow to sit in a bean bag • Use sensory diet

47. What is a Sensory Diet? • Sensory diet is a systematic planned group of activities to provide sensory input at specific times throughout a school day • The “diet” is child specific based on whether the child needs arousal or calming • It is usually done for preparation for learning and not as a response to a behavior

49. Vestibular Sense (Balance and Movement) Characteristics • Overreact to ordinary movement • Some dislike physical activities while others swing for a long time • Enjoys being upside down or not • Fall frequently out of their seat (could be age related) • Thrill seeker - remember boys can be boys

50. How to Help • Use wiggle seats or T-Stool • Use trampolines • Heavy work • Weighted vests • Weighted book bags • Elastic bands • Frequent breaks • Jump