Specific ASC needs. Karen Ferguson and Juliet Ruddick

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1 Specific ASC needs Karen Ferguson and Juliet Ruddick

2 Definition Autism is a lifelong, developmental disability that affects how a person communicates with and relates to other people, and how they experience the world around them. National Autistic Society

3 The Triad of Impairment DSM 5 This is now the DYAD of impairment as social / emotional and Communication and Language are now combined.

4 Difficulty with Social Interaction Often unaware of the social rules within society and therefore lacks social skills Rarely show empathy unaware of others feelings Prefer to be alone Rarely seeks comfort Can behave in strange ways or what as seen as inappropriate Difficulty in expressing emotions or feelings. High levels of anxiety Can appear aloof, distant and uninterested

5 Difficulty with Language and Communication Wide variation in extent of difficulty Attention difficulties Internal and environmental Both verbal and non-verbal communication Non-verbal e.g.: Tone of voice, Facial expressions, Body posture, Gesture Verbal communication e.g.: Unusual patterns, Echolalia, Making up words, Difficulty with I and You Often a very literal understanding Jokes and sarcasm will be misunderstood Metaphors and idioms are difficult for the student to process.

6 Activity Happy Sad Worried Angry Excited Surprised

7 Difficulty with Thought and Imagination Problems with imagination, often limited to one scene repeated Difficulty in understanding consequences of actions Rarely able to predict what happens next or possible outcomes Limited awareness of danger Often struggles during choice making Limited ability to access abstract concepts Find it difficult to interpret others feelings and actions Need a long time and extra help during times of change and planning for the future Will struggle in new situations or with new people.

8 Behaviour All behaviour has a purpose We need to decipher it then respond accordingly For a student with poor or limited communication this can be the only way to influence their environment If we analyse the behaviours we may be able to replace them by teaching alternatives.

9 Behaviours which can cause difficulties Repetition of words or actions Preoccupations with topics, objects, people Resistance to change Problems making choices Reaction to sensory experience Wanting to be alone Hurting, e.g. self-injury, harm to others, or damage to property Unusual behaviours, e.g. rocking, jumping, twisting and turning, flicking fingers or objects, flapping hands.

10 The Iceberg Theory of Behaviour

11 Child A Diagnosis of Autism, ADHD and Challenging Behaviour Age 6 Mainstream placement had broken down Extremely challenging at home Family in crisis LEA referred Child A for an assessment at Percy Hedley Lower School

12 Assessment Process and Findings 2:1 Assessment in the Green Room (Teacher, SaLT, OT) Findings consistent with dual diagnosis Language and social communication difficulties Difficulties with motor planning, organisation and execution Poor attention Hyperactivity Sensory modulation issues (sensory defensive and sensory seeking) Significant difficulties with emotional regulation Extreme focus on special interests (fragile link to reality) Anxiety driven demand avoidance Fluctuating presentation (pattern throughout the day)

13

14 Child A had STRENGTHS!!! He demonstrated cognitive ability He responded to strategies (some of the strategies, some of the time) He understood the work system He demonstrated prior learning (e.g. polite when requesting lunch) HE SHOWED HUGE POTENTIAL HOORAY!!!

15 Prepare! Prepare! Prepare! Core Team identified (Lead Teacher, Specialist SaLT and OT, 2 x Specialist Support Assistants) Environmental Design and Modification Communication Approach and Strategies Structured Work System and Task Design Ordering/Collecting Equipment (e.g. sensory, plastic boxes for structured tasks)

16 The Communication Environment Aiming for a quiet environment with minimal distractions Clear, concise, positive, consistent Think of communication as a additional demand (e.g. during transition tasks) switch off voices at times of de-regulation Refer to visual support (e.g. gently pointing to timeline to re-focus)

17 Environmental Modification Low arousal free from visual, auditory distractions resources kept to a minimum and out of view safety considerations (furniture, resources) Clear visual support timelines reward systems physical structure areas allocated for different purposes if possible Incorporate Sensory Strategies

18 Low arousal learning environment

19 Visual Cues to Support Understanding Timeline for morning transition up to break time: Job list for activities with immediate sticker rewards: Two step timeline with Velcro symbols:

20 Transition Tasks What are they? Calming and organising Within developmental ability Can be completed independently When were they used? Following transitions from different contexts To assist with emotional regulation

21 Transition Tasks

22 Structured Tasks Are visually clear Short in duration Have a clear start and finish point Are within developmental level (fine motor, motor planning, cognitive) Do not rely on/involve verbal communication Are self-contained (hence the term Shoebox )

23 Structured Activities

24 Sensory/Physical Learning Breaks Slotted at intervals throughout the day as part of a sensory/movement diet Made explicit on timeline Purposeful (in-built structure and good for self-esteem) Clear start and finish point Consider whether 2:1 is required for transitions Schedule choice time to follow the transition back to classroom/individual work space.

25 Ideas for Sensory/Physical Learning Breaks Checking the post in the office Running/scooting around a track Dropping books back to library using a backpack Visually structured games outside (e.g. running to coloured spots, animals, numbers in the yard)

26 An occupational therapist can provide a sensory diet

27 Further Considerations Front load resources (e.g. to make resources, staff timetables, formulate consistent plan) Ensure staff are extremely well supported and there is time to discuss strategies Close communication with home (e.g. home/school diaries, phone calls, meetings) Close communication with medical professionals and other agencies

28 Questions

29 Jordan & Jones (1999 adapted) It is more helpful and more respectful to children with an ASD to view their behaviour as different rather than deficient.temple Grandin, a very able woman with autism, has said that continually trying to work out what to do and what to say is like doing quadratic equations in your head..there is no magic solution to helping children with ASD and no one that will have all the answers. What is important is that we are prepared to listen and learn.and to be flexible in our approach. The most important part is the change of attitude, from judgement and fear, to openness and concern.

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