6/5/2018 SYLVIA J. ACOSTA, PHD

Transcription

1 SYLVIA J. ACOSTA, PHD ASSOCIATE PROFESSOR SUMMER INSTITUTE JUNE 1

2 Introduction to Autism Spectrum Disorder (ASD) for Educators JUNE 15,

3 Objectives Participants will: Identify the 2 diagnostic categories for Autism Spectrum Disorder (ASD) Understand the impact of ASD symptoms for students Make considerations for their own educational environments for students with ASD 3

4 What is Autism Spectrum Disorder (ASD)? A complex neurodevelopmental condition 1. Impairments in social communication 2. Presence of restricted behavior interests and activities 4

5 ASD is a spectrum condition The skills and challenges among individuals with ASD can vary widely. The level of impact of ASD can also depend on other developmental and behavioral health factors. 5

6 The prevalence of ASD has increased Centers for Disease Control Autism and Developmental Disabilities Monitoring Network (ADDM) 2018 Or 1.7% 6

7 ASD eligibilities rising in schools 600 Children with ASD in schools Autism accounts for about 5-6% of all disabilities served as part of IDEA and many participate in regular education for at least part of the day U.S. Department of Education, National Center for Education Statistics. (2016). Digest of Education Statistics, 2015 (NCES ), Chapter 2. 7

8 Educational eligibility of ASD focuses on the learning impact Educational need Educational eligibility can only be determined when all aspects of the evaluation, as defined by the Public Education Department, are completed Educational eligibility does not require a medical diagnosis 8 8

9 Medical diagnosis of ASD focuses on the impact of functioning Medical professional (pediatrician, neurologist, psychiatrist) provides, or participates on a multi-disciplinary team that provides, a diagnosis (criteria is based on DSM-5) May include some medical tests to explore other possible diagnoses, symptoms and related issues 9 9

10 ASD consists of 2 core deficit areas: Deficits in social communication Presence of restricted, repetitive patterns of behavior, interests and activities 10

11 Levels of support vary for each core deficit area Symptom severity is variable. How much support does an individual need at this point in time? How might this translate to their presentation in the school setting? 11

12 Social communication differences can impact learning 12

13 Social-emotional reciprocity May prefer to play alone Identify ways to integrate into activities May struggle to respond Be sure to give plenty of time to process May struggle with back and forth conversation Provide appropriate coaching Difficulty understanding idioms Use plain language 13

14 Nonverbal social communicative behaviors Limited facial expressions Gain attention Limited gestures Check for understanding Difficulty integrating nonverbal behaviors Visual supports Imitation is limited Imitate and expand on their behaviors 14

15 Relationships/play Limited interest in relationships Link favorite activities with people Sharing space challenges Structure activities for give and take Pretend play Model 15

16 Repetitive behaviors and special interests can impact behavior 16

17 Repetitive behaviors Unusual or intense movements Repetitive noises Echolalia Evaluate the form and intensity of repetitive movements and noises Do they interfere with other activities (i.e. will the child stop when asked or when there is something else to do)? Do they interfere with learning? Do they interfere with social relationships? Evaluate whether stopping/changing them is a priority 17

18 Routines/rituals Insistence on sameness Difficulties with transitions Schedules Visual aids Structure and routine 18

19 Special interests Integrate! Incorporate strengths 19

20 Sensory differences Strong reactions to sensory input (e.g., noise, lights, sounds, smells) Quiet environments (visual, auditory) are usually best May seem over or under reactive to sensory experiences 20

21 ASD has a high number of comorbidities that can influence learning Intellectual Disability Genetic conditions Fragile X Tuberous sclerosis Tourette syndrome Mood Disorder ASD Anxiety Language Disorder ADHD Medical Conditions Seizure disorders Gastrointestinal disorders Feeding and eating problems Sleep disorders 21

22 Individuals with ASD have a range of intellectual capacities Approximately 30% of those diagnosed with ASD have an intellectual disability and 24% have borderline intellectual functioning. Deficits in adaptive functioning can occur with individuals with ASD regardless of cognitive abilities. 22

23 Individuals with ASD have a range of language capacities Difficulties in the acquisition and use of language Language abilities substantially below age expectations, impacting functioning Reduced vocabulary, limited sentence structure, impairments in discourse 23

24 Medical problems can be common in ASD Sleep Gastrointestinal problems Seizures Feeding 24

25 Comorbid behavioral health diagnoses can impact a student with ASD ADHD Depression Anxiety Disorders Other 25

26 Inevitably, behavior problems can occur Problem behaviors begin because they allow the child to get needs met Get something Escape from people, places or activities Get attention Allow the child to get, or get away from, sensory input 26

27 National Standards Project Phase 2 (NSP2) ESTABLISHED TREATMENTS (14) Behavioral Interventions Cognitive Behavioral Intervention Package Comprehensive Behavioral Treatment for Young Children Language Training (Production) Modeling Naturalistic Teaching Strategies Parent Training Peer Training Package Pivotal Response Training Schedules Scripting Self-Management Social Skills Package Story-based Intervention 27

28 National Standards Project 2 FOR CHILDREN TO YOUNG ADULTS UNDER 22 YEARS Emerging (18) Augmentative and Alternative Communication Devices Developmental Relationship-based Treatment Exercise Exposure Package Functional Communication Training Imitation-based Intervention Initiation Training Language Training (Production & Understanding) Massage Therapy Multi-component Package Music Therapy Picture Exchange Communication System Reductive Package Sign Instruction Social Communication Intervention Structured Teaching Technology-based Intervention Theory of Mind Training Unestablished (13) Animal-assisted Therapy Auditory Integration Training Concept Mapping DIR/Floor Time Facilitation Communication Gluten-free/Casein-free diet Movement-based Intervention SENSE Theatre Intervention Sensory Intervention Package Shock Therapy Social Behavioral Learning Strategy Social Cognition Intervention Social Thinking Intervention 28

29 National Standards Project 2 For adults 22 years and older Established (1) Behavioral Interventions Emerging (1) Vocational Training Package Unestablished (4) Cognitive Behavioral Intervention Package Modeling Music Therapy Sensory Integration Package 29

30 A multi-university center to promote the use of evidence based practice for children and adolescents with autism spectrum disorders. (2008) 30

31 National Professional Development Center on ASD (2014) Antecedent-Based Interventions Cognitive Behavioral Intervention Differential Reinforcement Discrete Trial Training Exercise Extinction Functional Behavior Assessment Functional Communication Training Modeling Naturalistic Intervention Parent-Implemented Intervention Peer-Mediated Instruction and Intervention Picture Exchange Communication System (PECS) Pivotal Response Training 31

32 National Professional Development Center on ASD (2014) cont. Prompting Reinforcement Response Interruption/Redirection Scripting Self-Management Social Narratives Social Skills Training Structured Play Group Task Analysis Technology-aided Instruction and Intervention Time Delay Video Modeling Visual Support 32

33 Resources available for educators Implementation Briefs Definition Step by step guidelines Information regarding evidence base Data collection On-line Modules

34 Neurodiversity in ASD Neurological conditions such as ASD are normal variations in the human genome Self-advocacy Identity-first language Cure vs. Treatment 34

35 References American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. Baio J, Wiggins L, Christensen DL, et al. Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, MMWR Surveill Summ 2018;67(No. SS-6):1 23. DOI: National Autism Center. (2015). Findings and conclusions: National standards project, phase 2. Randolph, MA: Author. National Research Council (2001) Educating Children with Autism. Washington, DC: National Academy Press. Wilkinson, L.A. (Ed.). (2014). Autism Spectrum Disorder in children and adolescents: Evidence-based assessment and intervention in Schools. Washington, DC: American Psychological Association. 35