Promoting Effective Social Skills for Children and Adolescents Across the Autism Spectrum

Transcription

1 Promoting Effective Social Skills for Children and Adolescents Across the Autism Spectrum Frank Cicero, PhD, BCBA Eden II Programs Presented for the Regional Professional Development Academy November 17, 2015 Eatontown, NJ

2 Myself Eden II Programs

3 Autism Spectrum Disorder Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) American Psychiatric Association (2013)

4 A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history: 1. Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back and forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions. 2. Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication. 3. Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interests in peers. Eden II Programs

5 B. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history: 1. Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases). 2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day). 3. Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests). 4. Hyper or hyporeactivity to sensory input or unusual interests in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement). Eden II Programs

6 C. Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life). D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning. E. These disturbances are not better explained by intellectual disability or global developmental delay. Intellectual disability and ASD frequently co-occur; to make comorbid diagnoses of ASD and IDD, social communication should be below that expected for general developmental level. Eden II Programs

7 Note that individuals with a well established DSM-IV diagnosis of autistic disorder, Asperger s disorder, or pervasive developmental disorder, not otherwise specified should be given the diagnosis of autistic spectrum disorder. Individuals who have marked deficits in social communication, but whose symptoms do not otherwise meet criteria for ASD, should be evaluated for social (pragmatic) communication disorder. Eden II Programs

8 Severity Levels Level 3 Requiring very substantial support Social Communication Severe deficits in verbal and nonverbal social communication skills cause severe impairments in functioning, very limited initiation of social interactions, and minimal response to social overtures from others. For example, a person with few words of intelligible speech who rarely initiates interaction and, when he or she does, makes unusual approaches to meet needs only and responds to only very direct social approaches. Restrictive, Repetitive Behaviors Inflexibility of behavior, extreme difficulty coping with change, or other restricted/repetitive behaviors markedly interfere with functioning in all spheres. Great distress/difficulty changing focus or action. Eden II Programs

9 Level 2 Requiring very substantial support Social Communication Marked deficits in verbal and nonverbal social communication skills; social impairments apparent even with supports in place; limited initiation of social interactions; and reduced or abnormal responses to social overtures from others. For example, a person who speaks simple sentences, whose interaction is limited to narrow special interests, and who has markedly odd nonverbal communication. Restrictive, Repetitive Behaviors Inflexibility of behavior, difficulty coping with change, or other restricted/repetitive behaviors appear frequently enough to be obvious to the casual observer and interfere with functioning in a variety of contexts. Distress and/or difficulty changing focus or action. Eden II Programs

10 Level 1 Requiring support Social Communication Without supports in place, deficits in social communication cause noticeable impairments. Difficulty initiating social interactions, and clear examples of atypical or unsuccessful responses to social overtures of others. My appear to have decreased interest in social interactions. For example, a person who is able to speak in full sentences and engages in communication but whose to and fro conversation with others fails, and whose attempts to make friends are odd and typically unsuccessful. Restrictive, Repetitive Behaviors Inflexibility of behavior causes significant interference with functioning in one or more contexts. Difficulty switching between activities. Problems of organization and planning hamper independence. Eden II Programs

11 Specifiers With or without accompanying intellectual impairment With or without accompanying language impairment Associated with a known medical or genetic condition or environmental factor Associated with another neurodevelopmental, mental or behavioral disorder With catatonia Eden II Programs

12 Typical Developmental Milestones

13 CDC Developmental Milestones 2 months through 5 years As you can see, there are many areas where individuals on the spectrum will veer off from typical development effecting the development of social skills. Veering off from typical development occurs as early as within the first three months of life.

14 AutismSpeaks Video Glossary

15 Assessment and Treatment Planning Four Areas to Consider Autism Severity Level Level of Integration and Independence Preference for Socialization Chronological Age

16 Autism Severity Level Average to Above Cognitive Abilities No Interfering Behaviors Mild Language Deficits Only Within Social Realm Social Awareness with Mild Issues Severe Cognitive Challenges Severe Interfering Behaviors No Language or Significant Deficits in Language Lack of Social Awareness Low Average to Average Cognitive Abilities Limited to No Interfering Behaviors Mild Language Deficits With Sig Deficits in Social Realm Social Awareness with Sig. Issues Mild-Moderate Cognitive Challenges Moderate Interfering Behaviors Moderate Language Deficits Limited Social Awareness

17 Integration and Independence General Education with No Supports Integrated Classrooms without Personal Supports Specialized Recreational Activities Integrated Classroom with Personal Supports Competitive Employment without Supports Integrated Social Integrated Social Settings without Settings with Support Supports Independent Residence with Personal Supports Competitive Employment with Supports Self Contained Specialized Employment Recreational Activities without Supports Self Contained Environment Recreational Activities with Personal Supports Specialized and Supervised Residential Setting Independent Residence without Supports

18 Interest in Socialization High Interest Regardless of Ability Some Interest Regardless of Ability No Interest Regardless of Ability

19 Chronological Age What skills need to be taught is all moderated by chronological age and typical development milestones and abilities What types of play do 2 year olds engage in? How should an infant interact with an adult? What types of conversations do 5 year olds engage in? How do peers interact at 13? When do people start to show interest in sexual relationships? Etc.

20 So.. Choosing social skills goals is not a simple task Choosing a curriculum to follow is not a simple task Choosing teaching methods to use will not be a simple task

21 Socialization.what is it? Play Conversation Socially acceptable behavior Joint attention Emotional expression Responding to others verbally and nonverbally Awareness of social schemas and routines Empathy and perspective taking Etc.

22 Benefits of Play Promotes physical development Gross motor movements such as climbing and riding a tricycle Fine motor movements such as stacking dominos, dressing a doll etc. Promotes intellectual development Problem solving Expanding cause and effect knowledge/prediction Understanding concepts Knowledge of function of objects

23 Promotes social development Knowledge of social roles and schemas Uses of verbal and nonverbal bids for attention Development of emotions Emotional reciprocity Emotional control and tolerance

24 Promotes creativity Varied problem solving Seeing things from different angles Promotes leisure Promotes independence Increases fun Self esteem and competence

25 Teaching Play Why specifically teach play to young children on the autism spectrum? Play is how young children learn about their environment and how to establish and maintain relationships Children on the autism spectrum may not achieve play milestones naturally

26 Children on thee autism spectrum may have highly limited, restricted and repetitive play skills Play may not advance stages Appropriate play behaviors may compete with and decrease stereotypic behaviors

27 Stages of Play Solo/Isolated/Solitary Play Independent manipulation of a toy or object for a period of time. Observed in children as young as 3 months of age. Solitary Play

28 Onlooker Play The child stopping what they are doing to briefly observe and listen to what other children are doing. Common during the early toddler years. Onlooker Play

29 Parallel Play Two or more peers engaged simultaneously in the same activity. Child may imitate other children s play but doesn t actively engage with them. Typically occurs by the age of three. Parallel Play

30 Associative Play Children are playing together but there is not a common goal or any real structure. Language becomes important, imagination increases and dramatic themes are emerging. Usually occurs by age 4. Associative Play

31 Cooperative Play Sharing the same activity with one or more peers towards a mutual goal. The children devise rules and structure and act as a group. Develops at around 5 years of age Cooperative Play

32 Other Forms of Play Isolated pretend play Cooperative pretend play Pretend play with objects Scripted/Modeled pretend play with or without objects Cooperative activities (singing, clapping etc.) Structured game play Structured sports

33 Learner One Two years old Recently diagnosed Autism Severe range of autism characteristics Nonverbal, high rate stereotypic repetitive behavior, no functional object use, no eye contact, limited direction following, aggressive tantrum behavior Supervised setting Supervised at all times due to age. At home and part time parent and me program. No special services yet at this time. No interest in socialization Does not seem to show an awareness of others

34 Assessment Standardized assessments Autism Diagnostic Observation Schedule 2 (ADOS2) Vineland Adaptive Behavior Scales II Pervasive Developmental Disorder Behavior Inventory (PDDBI)

35 Assessment Direct Naturalistic Observation Alone With adults With peers Direct Analog Observation With adults With peers

36 Assessment What are you looking for? Modeling from others Excited expression with other children Playing next to others Interest in simple chase games Pointing to objects and pictures when named Looking for hidden objects Simple make believe and pretending with objects

37 Showing to others Apprehension around strangers Affection towards caregiver Pointing to show interest Following points and eye gaze of others Gestures such as shaking head and waving Handing things to others Happy expression with cause and effect toys and interactive games like peek-a-boo A level of tantrum behavior and defiance is okay

38 Goals and Teaching Methods Reduction of aggressive behavior Rationale: Aggressive behavior towards peers and adults will prevent all effective socialization. Development of functional behavior plan 20 step task analysis for developing BIP Functional assessment Develop proactive and reactive strategies according to function

39 Increasing onlooker and parallel play Rationale: Cooperative play will not be able to emerge if learner continues to show no interest in the activities of others and cannot maintain play next to peers.

40 Teaching onlooker play Set up child with a preferred activity Engage in a provocative and salient activity near the child (i.e. mechanical toy with movement and noise, bubble wrap popping, dancing etc.) Reinforce attention to the new activity with verbal praise, engagement and/or external reinforcers (edibles, tokens, stickers) Prompt attention if not spontaneous Repeat trials until consistent Generalize to different people, places and activities

41 Teaching parallel play Set up learner and peers with preferred toys and activities on an area carpet, mat or taped in area Deliver verbal praise and external reinforcers on a schedule when learner engages in the activities within the area Prompt the learner to stay in the area as needed Begin to fade reinforcer schedule as parallel play is maintained Begin to fade structured area Generalize to different locations, peers and activities

42 Increasing independent task engagement Rationale: Promote functional object engagement which eventually will be used for parallel and cooperative play Increase independent leisure Decrease engagement in stereotypic and repetitive behavior

43 Teaching leisure task completion Conduct preference assessment Choose preferred activities Prompt engagement for predetermined period of time Reinforce engagement at end of interval Task Completion Increase length of interval as independence increases Fade reinforcers Generalize to different activities and locations Chain activities into independent activity schedule Independent Activity Schedule

44 Encouraging joint attention Rationale: Development of socialization and communicative language hinges on the development of joint attention (which typically develops very early in development) Joint attention review

45 Teaching joint attention Withhold preferred items and wait for an eye gaze before delivery (prompt as needed) Reinforce following your eye gaze and point Make activities even more exciting when someone is socially referenced follow eyes game Teaching JA through Reinforcement 1-6

46 Learner Two 16 years old Diagnosis Asperger s Disorder Mild range of autism characteristics Fully verbal with deficits in social communication. Some rigidity in thinking. Enjoys routines. Intense interest in movie statistics. Engages in behavior interpreted as rude when not interested. Has engaged in behaviors interpreted as stalking with girls. Easily becomes depressed when social situations are not successful. Fully integrated setting History of special education but currently in a general education high school without supports. Interested in attending a live away college No interest in socialization High interest in socialization with friends, however very self centered with regards to interests. Very interested in getting a girlfriend.

47 Assessment Standardized Assessment Vineland Adaptive Behavior Scales II Social Responsiveness Scale 2 (SRS-2) Social Skills Improvement System (SSIS) Interview/interaction With learner With others

48 Assessment What are some things you are looking for? Problem behavior preventing socialization Perspective taking Attention to others Social conversation skills Topics of interest Toleration of the interests and behaviors of others Ability to predict actions and routines

49 Knowledge of social schemas Portrayal of attitude towards others Adherence to social conventions (space, touch, facial expression) Appropriateness of language, topics and questions Expectations of friendships Romantic interests Knowledge of sexual behavior if interested Knowledge of socio-sexual behaviors (dating, flirting, romantic expectations etc.)

50 Goals and Teaching Methods Taking the perspective of others (theory of mind) Rationale: The concept that people have different thoughts than you might have and that they might have different perspectives on ideas, topics, opinions and sensations seems to be a core deficit of individuals on the autism spectrum Without perspective taking, maintaining close social relationships with others is nearly impossible because conflicts will frequently arise and you will not be able to truly share experiences Difficult skill to assess and teach

51 Sally-Anne false belief tasks Sally-Anne Test

52 You can assess and teach perspective taking through multiple choice format scenarios Use initial response as assessment Discuss response(s) in individual or small group session Use similar scenarios as assessment of concept learning

53 You go out on a date and it did not seem to go well. Your date seems kind of annoyed and is not really talking to you. At the end of the date you ask her out for the following night and she says that she is busy for the next few weeks. What do you think she is thinking? a) She is hoping she is free soon so you can go out again b) She is upset that she is so busy c) She is thinking that she does not want to go out with you again

54 You have been dating this guy for five months. You have not yet done anything sexual besides kissing, but you think you want to. You let him know that you think you should move to the next level sexually and he says that he would rather wait to do anything further. He says that he will let you know when he feels ready but only wants to kiss for now. What do you think he is thinking? a) He is thinking he would rather wait to do anything further b) He is thinking that he wants to have sex c) He is thinking that he no longer wants to go out with you

55 perspective taking video 1 perspective taking visual activity

56 Tolerating interests of others Rationale: Learner s current behavior is interpreted as having rude intention which will lead to a lack of success in maintaining friendships Include in small group that meets regularly Take turns talking about activities they did since the last time the group met and each person needs to comment to each other or ask a question Teach each other a special skill or interest Group contingency contract outlines expected social behavior which should include tolerance of the interests of others Include a reinforcement system if needed

57 Flirting and Dating skills Can be introduced and practiced in individual sessions or small social skills group Social scripts Discussion, practice and fading Topics can include: Flirting to show initial interest Asking out on first date Making conversation on first date What to say at end of first date that went well What to sat at end of first date that did not go well How to call after first date and ask out second date How to make relationship exclusive What to say if you are being rejected Etc. written script for asking someone out on a date

58 Awareness of socio-sexual interpersonal relationship issues and behaviors Rationale: Learner has an interest in establishing romantic relationships, however his current behavior is sometimes misinterpreted and can lead to serious issues in the future. Becoming aware of social rules, conventions and expectations as well as gaining knowledge of socio-sexual behaviors will help in preventing self-damaging occurrences Host a group movie night Watch a movie with themes a member of the group can benefit from Hold guided discussion during and after the movie Practice skills as needed

59 Grease Dating Indirect Sexual situations Pregnancy Peer pressure Male/Female perspective differences

60 16 Candles Sexual situations Adolescent development Pursuing someone Romance vs. sex Sexual joking Peer pressure Perspective taking

61 Role Plays Good for introducing and practicing a variety of social skills Reduces anxiety by increasing the ability to predict Increases competence and self esteem Can be done in individual sessions or in small groups Facilitator should be familiar with role play rules Flirting and Dating Role Play Activity

62 Self instruction through books and groups

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65 Dealing with frustrating situations Repeated Failure Low Self Esteem Depression Cognitive behavioral counseling Regular sessions to build rapport and trust Fade to as needed sessions when appropriate Therapist must understand ASD issues Work with the leaner as well as the family

66 Learner Three 9 years old Diagnosis Autism Moderate range of autism characteristics Is able to speak in sentences but often speaks in single words and tends to only use language to request. High rates of stereotypic verbalizations. Very limited interests and limited functional object use. Eye contact is inconsistent. Ability to follow verbal directions and respond to questions when asked. Cries runs away from group when things do not go his way. 6:1:1 ABA school program and lives with parents Future settings are not decided at this time Some interest in socialization Shows interest in peers but cooperative play is limited to only a few minutes and often needs adult prompting. Limited to very few activities. Can answer questions but does not engage in reciprocal conversation and does not show spontaneous initiation

67 Assessment Standardized assessments Autism Diagnostic Observation Schedule 2 (ADOS2) Vineland Adaptive Behavior Scales II Pervasive Developmental Disorder Behavior Inventory (PDDBI) Social Responsiveness Scale 2

68 Assessment Direct Naturalistic Observation With adults With peers Direct Analog Observation With adults With peers

69 Assessment What are you looking for? Quality, variety and duration of cooperative play with an adult Quality, variety and duration of cooperative play with peers (without prompting from an adult) Quality and duration of conversation skills Frequency and intensity of interfering verbal stereotypy

70 Social initiation towards peers Spontaneous social language besides requests Variety of competent functional object use Ability to tolerate things that don t go his way and his associated behavior Structured game play

71 Decrease stereotypic verbalizations Rationale: Engagement in stereotypic verbalization competes with engagement in social conversation, cooperative play and peer acceptance Differential reinforcement of omission of behavior (DRO)

72 Decide on environment and duration for the session Define stereotypic verbalizations Divide session into small time intervals (starting off at a very small interval duration to increase success) Reinforcement provided at end of interval when learner did not engage in stereotypic verbalizations Interrupt behavior and stop timer when learner engages in stereotypic verbalization Start interval over Collect data to make treatment decisions Increase interval duration as success is noted Generalize to different environments

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74 Increasing spontaneous commenting and questioning Rationale: Although the learner will consistently respond to questions from others, he does not make any spontaneous comments when not directly asked a question. This will prevent conversations and will cause peers to think he has no interest

75 My That s favorite crazy! color Suns is aren t blue purple I m going to My favorite color make the sun is green purple

76 Scripts with prompting and reinforcement using a time delay procedure Script out situations and responses Start with a zero second prompt delay to the SD Reinforce responding Increase the prompt delay Continue to reinforce responding Provide more potent reinforcer for independent responding prior to the time delay Generalize to different responses Use differential reinforcement to promote novel responding

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78 Video Modeling A form of observational learning in which desired behaviors are learned by watching a video demonstration and then imitating the behavior of the model May include in vivo prompting and reinforcement components

79 Video Model Sharing Video Model Sharing Video Model Initiating Play

80 Reasons to Use Video Modeling Reduces social demands and anxiety Eye contact is not required towards a person but towards a screen No social demands are placed on the learner while they are watching the video No history of noncompliance with videos Increases motivation Videos (electronic media) might be more interesting an captivating to the learner Learner may have a history of success with videos

81 Video modeling may make the whole learning environment and situation more fun to the learner Supported in the literature as an evidence-based procedure for teaching skills to individuals on the autism spectrum Vide modeling may be an efficient way to teach skills to individuals and small groups Can be used to support other teaching programs for the same skill

82 Prerequisite Skills for Video Modeling Imitation of actions and sequences Interest in watching videos Ability to attend to a task Receptive language skills (if using language in the video)

83 Preparation for Video Modeling Collect language samples of the learner Choose a topic/target Choose an environment and a model Assess vocabulary and language complexity that will be used in the video

84 Start with a short video of a mastered skill to teach the concept Introduce the actual video when the learner seems to have the concept Decide if the learner will require in vivo prompting and reinforcement while or after watching the video

85 Teaching Cooperative Play Rationale: Cooperative play leads to increased opportunities for socialization and the making of friendships. Start with structured game play and gradually introduce less structured play and cooperative pretend

86 Start with structured games that don t involve many rules and can almost be played in isolation

87 Start off with short duration Adult prompts engagement as needed Reinforce throughout with verbal praise and/or tokens Preferred reinforcer earned at end of required time Introduce different games at the same time in order to teach the concept, not the specific game Gradually increase duration of game and fade adult oversight

88 Begin to introduce games with longer durations and more structured rules. Tailor difficulty level to learner abilities

89 Begin to introduce activities with less structure and more pretend. Tailor activities to learner s language skills, cognitive skills, object manipulation skills and imagination Make sure that play is cooperative and not parallel

90 Use a MotivAider (process needs to be taught) to prompt play actions, interactive language and social concepts such as sharing and switching activities.

91 Increasing toleration when things don t go his way Rationale: Often times things in life do not go the way you desire. You need to be able to handle these situations instead of showing problem behavior. Problem behavior and avoidance will decrease future opportunities for socialization

92 Social Stories Social Stories by Carol Gray Social story anger Social Story Turn Taking

93 Learner Four 25 years old Diagnosis autism with severe intellectual disability disorder Severe range of autism characteristics Nonverbal. Communication limited to one or two signs used inconsistently. High rates of motor stereotypy. Severe self injury that can occur within and outside of tantrums. Dependent on others for all daily living routines. Object engagement is largely restricted to a few learned tasks (sorting, pegging) and stereotypy with objects. ABA-based adult program with 1:1 para and lives in group residence No interest in socialization Usually does not seem to show an awareness or interest in his surroundings. Very hyper and does not remain seated for even 5 minutes.

94 Assessment Standardized Assessment Standardized assessment specific to socialization skills is most likely not beneficial Direct Assessment Observation in natural settings with others Structured interaction with examiner ABC data/functional analysis of self injury

95 What are you looking for? Interference caused by problem behavior Duration of staying with others (remaining seated or engaged) Tasks which prompt the most engagement Activities which gain some attention or positive affect Eye contact or facial turn directed towards others

96 Vocalizations or movements which seem to have an attention seeking function Methods used to communicate wants Responses to social bids from others Reactions of others in response to his behaviors and actions

97 Reduction of self injury Rationale: Self injury can be harmful to self and will prevent socialization with others due to the hesitation that people will often have interacting with him (given the possibility of causing and having to then deal with self injury). Self injury is also socially stigmatizing when occurring in a community setting.

98 Development of a function-based behavior intervention plan Task analysis for BIP Target behavior Operational definition Data collection Functional assessment

99 Proactive strategies Noncontingent reinforcement Differential reinforcement Environmental engineering Reactive strategies Extinction Punishment Response interruption and redirection Crisis management Fading criteria

100 Once behavior intervention plan is developed training must be conducted in all needed environments: Day program staff Residential staff Parents Related service providers Other people as needed

101 Increasing independence in self care Rationale: Although the learner will always need a level of care from others, being more independent in personal self care will lead to people feeling more comfortable with him and enjoy interactions with him. Also, negative social stigmatization will be reduced.

102 Helpful standardized measures: Vineland Adaptive Behavior Scales -2 Scales of Independent Behavior Revised The Assessment of Functional Living Skills (AFLS)

103 Teach through the method found to be most beneficial for the learner Discrete trial instruction Prompting with correction or errorless Picture task analyses Video modeling (with prompting and reinforcement) Generalize to all settings and caregivers

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105 Video Model Tooth Brushing Video Model Eating Cereal Make environmental modifications as needed to increase independence. Some may be able to be faded, some may be permanent modifications

106 Increase simply staying with a group Rationale: It may be likely that the learner will never show an interest in cooperative socialization Absence of language prevents conversation Significantly delayed cognitive skills prevent active engagement in most age appropriate social activities Activities consistent with cognitive level will be socially stigmatizing and not true engagement in peers Simply staying within a group will expose the learner to social opportunities and expand experiences across different activities Staying within a group will be perceived by others as interest Staying with a group will promote safety

107 Noncontingent Reinforcement and Environmental Enrichment Conduct a preference assessment (formal or informal) on activities that the learner might enjoy on some level Align activities with preferences as much as possible Activities that are more preferred are more likely to engage the learner and promote staying with the group

108 Provide external reinforcers on a time schedule throughout the activity only contingent on remaining in the group (not on active participation) Reinforcers are only available within the group activity Prompt towards the group activity if needed, however avoid prompting tantrum behavior. Tantrum behavior associated with the group activity will work against your goal.

109 Increase functional communication Rationale: At this point, communication is limited to a few inconsistently used signs. Giving the learner a way to communicate wants and needs will increase their interactions with others Will also lead to reductions in problem behavior

110 Functional Communication Training When a person cannot communicate effectively, they are prone to challenging behavior to get their needs met. Teach the individual some communicative response that serves the same function for them as the challenging behavior. Must conduct a functional assessment first to discover what the individual wants to gain from the behavior. You then systematically reinforce the new communication response

111 Choose an appropriate form of communication for the individual. Verbal words Picture exchange Manual signs Physical movements (i.e. tap, point) Button presses Voice output systems The mode of communication should be at least as easy for the individual as any challenging behavior.

112 Mand training verbal PECS Proloquo2go

113 assistive communication caution FC Caution

114 Socialization is Socially significant Individualized Able to be promoted and improved behaviorally Necessary and appropriate for individuals on all levels of the autism spectrum

115 Socialization is Something that cannot be taught using a cookie cutter curriculum Something that cannot be taught through the same teaching method for every individual A very diverse concept ranging from conversation skills to theory of mind to independence in daily living skills and decreasing problem behavior

116 Socialization is Something that can include just fitting in with others or actively initiating with others Something that changes with age Something that changes with motivation and personal preference Something that affects all individuals on the spectrum to varying degrees and in various ways

117 Socialization is Something that we are aware of and effects our behavior at all times even when we are alone Something that has rules and norms which are sometimes overt and sometimes very subtle Something that we need to keep studying as a field so that we can further assist learners in living happy and successful lives

118 QUESTIONS COMMENTS