A is for Asperger s (Autism Spectrum Disorder) Understanding and Helping the Student (previously diagnosed) Asperger s Disorder

A is for Asperger s (Autism Spectrum Disorder) Understanding and Helping the Student (previously diagnosed) Asperger s Disorder

AGENDA Basic Information-Characteristics Thought Processes Sensory Issues Lens of Interpretation Self-Regulation Social Needs Supports

GOALS FOR TODAY Understand the characteristics of students with high functioning AU Gain ideas for helping students with social skills Gain ideas for supporting students in work and study skills

HISTORY OF ASPERGER S Asperger s Syndrome (Disorder) was first described by Hans Asperger, a Viennese physician, in 1944, when he published a paper describing the behavior pattern of several young boys, who, despite normal intelligence and language development, displayed autistic-like behaviors and marked deficiencies in social and communication skills. It is a neurobiological disorder that was added to the DSM IV in 1994, but has only recently been recognized by professionals and parents. Asperger s is a Pervasive Developmental Disorder, considered a part of the Autism spectrum. It is mainly distinguished from Autistic Disorder because there are no clinically significant delays in language.

DSM-5 Diagnosis Autism Spectrum Disorder Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history» Deficits in social-emotional reciprocity» Deficits in non-verbal communicative behaviors used for social interaction» Deficits in developing, maintaining, and understanding relationships

DSM-5, Cont. Restricted, repetitive patterns of behavior, interests, or activities, manifested by at least 2 of the following, currently or by history» Stereotyped or repetitive motor movements, use of objects, or speech» Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behaviors» Highly restricted, fixated interests that are abnormal in intensity or focus» Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment

DSM-5, Cont. Symptoms must be present in the early developmental period but may not fully manifest until social demands exceed limited capacities, or may be masked by learned behaviors later in life Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning Not better explained by intellectual disabilities, or global developmental delay

DSM-5, Cont. Severity must be specified based on social communication and restricted, repetitive behaviors: Level 3- Requiring very substantial support Level 2-Requiring substantial support Level 1- Requiring support

KEY FEATURES Social Interaction Average to above average IQ No verbal/performance split Socially isolated Tense with social demands Difficulty reading social cues Lack of friendship strategies Immature and socially inappropriate

KEY FEATURES Social Communication Language tends to be formal and pedantic or stilted Voice may lack expression and may not read vocal tones of others Difficulty using and interpreting non-verbal communications Often understands things literally May fail to grasp implied meanings May tend to recite dialogue from movies, etc.

KEY FEATURES Other Social and Motor Skills Often has an all-absorbing interest Rigid-insists on certain routines, etc. May be limited in ability to think and play creatively Often has difficulty generalizing skills Motoric clumsiness-awkward-may walk, run, and move funny Organizational problems May find it hard to write or draw neatly

THOUGHT PROCESSES Think in concrete terms Fails to understand metaphorical or abstract concepts Takes figures of speech literally Have difficulty in thinking about thinking -have a form of mind blindness -and may have difficulty appreciating that others have intentions, needs, desires,and beliefs that are different from theirs Difficulty with predicting, reading intentions, understanding emotions, explaining behaviors, reading and reacting to other s interests, understanding social interactions Susie, Johnny, and the tapping pencil

EXECUTIVE FUNCTION Executive functions are higher order thought processes that allow us to plan, sequence, initiate, and sustain our behavior towards some goal, adjusting along the way by using feedback. People with AU have difficulty with executive function, especially with pre-planning, sustaining effort, delaying action when necessary, integrating information from various sources, shifting attention from one task to another, starting and stopping, and operating on multiple levels.

SENSORY ISSUES One or more sensory systems are usually affected such that ordinary sensations are felt as unbearably intense The mere anticipation of a stimulus can lead to anxiety or panic Most common-sound and touch Also can be taste, light intensity, colors and smells Approximately 40% of people with autism spectrum disorders have some abnormality of sensory sensitivity

BEHAVIOR THE LENS OF INTERPRETATION All behavior serves a purpose It is functional or intended to be It is necessary to understand the function of the behavior-from the viewpoint of the child The point of view of a student with AU will lead them to interpret things differently from the normal point of view In order to impact behaviors, we must look at things through an Autistic lens and determine the function of the behavior and find another way to meet that need

HOW TO HELP Identify the signs of overload Identify situations that are problematic Identify current strategies Identify environmental factors and modifications Teach students how to read sensations and behaviors and how to manage

WHAT TO DO Communication and environment Reduce distractions Give instructions in most efficient sensory channel Provide auditory frames Provide visual frames Use graphic organizers Use Low and Slow Use cognitive portfolios (visual, stepwise procedures) to remind students of strategies and behaviors Use timers or visual cuing for changes in activity

WHAT TO DO Activity level and arousal management Slow, rhythmic activities-deep breathing, walking, music,pressure-ask the student what works Tolerate reasonable levels of movement Provide frequent motor breaks Engage everyone in motor breaks-wall push-ups, stretching, deep breathing Walk and talk Allow student to stand while working or talking Teach allowable movement strategies

WHAT TO DO Emotional and Social Support Teach 5 part approach-remember Low and Slow Help the student to interpret social situationsutilize rehearsals Use SOCCSS Use Social Autopsies Use Social Stories Use cognitive portfolios/social scripts Use Social Skills instruction-be blunt!

SOCIAL SUPPORTS SOCCSS Social Scripts and Stories Social Autopsies Cue cards Direct Social Skills Instruction Social clues

Conversations Cue Cards

Social-Emotional Cues Cues to calm down

SOCCSS Situation Options Consequences Choices Strategy Simulation

SOCIAL SCRIPTS Helping the child structure the behavior by working with the student to design a script of what to do and say in a specific situation. For example, a child and her teacher may design a script for joining in with a group who is playing at recess.

Social Script-Ask a Friend to Play Script

SOCIAL STORIES A social story is a story that describes social situations specific to individuals and situations. A social story is written for a specific child and a specific situation.

A SOCIAL STORY My name is Jane. I go to Cook School. At lunch time, everyone in my class goes to the lunchroom. We go through a line and get a tray, then sit at tables to eat. I do not like the lunchroom-it is noisy and crowded, and my ears hurt. My teacher Mrs. Smith tells me that I have to eat there every day. She helps me find ways to make it easier. First, Mrs. Smith showed me that putting in my earplugs helps with the noise. They are small and no one can see them. Every day, I go to the restroom before lunch and put them in, then take them out after lunch. She also lets me be the line leader or the caboose. That helps me feel less crowded. The best part is, lunch is short! I know by looking at my watch when it will end, and I tell myself that I will be fine until then.

SOCIAL AUTOPSIES Debriefing a social error in order to determine: The cause of the error The damage done by the error How to prevent the error from happening again

SOCIAL SKILLS INSTRUCTION Conversational skills-exchanges Cooperative Play Skills Relationship Skills Classroom Skills Maximize by: Instruction and Interpretation Coaching-generalization

POSITIVE SUPPORTS Priming-previews activities where student is likely to have troublevideo on priming- http://gizmodo.com/5980749/this-is-howyour-brain-works Home base-at end of day or after stressful subjects Safe person/safe place Transitions-routines, warnings,activities,signals, buddies

Visual Cuing in the Classroom Line up cue

Visual Cuing in the Classroom Visual Cuing in the Classroom

MODIFICATIONS Highlight texts Sample problems worked out as guide Directions individually One direction at a time Cue cards Graphic organizers Cognitive portfolios for steps

MORE SUPPORTS Provide information visually-written directions, schedule Preferential seating-near compliant peers, away from bullies, away from high traffic Assistance with organization-picture cues (take a picture of a clean desk, organized locker, etc.)

Morning Routine Visual Schedules

Portable schedule Visual Schedules

Classroom Schedule Visual Schedule

Visual Schedule Full Day Home Routines

RESOURCES Asperger s Syndrome: A Guide for Parents and Professionals by Tony Attwood Asperger Syndrome and Adolescence by Teresa Bolick Asperger s Syndrome and Difficult Moments by Myles and Southwick Asperger Syndrome-Practical Strategies for the Classroom by Leicester City Council and Leicester County Council Freaks, Geeks and Asperger Syndrome by Luke Jackson Power Cards by Elisa Gangnon Navigating the Social World by McAfee Pretending to be Normal by LeeAnn Holiday-Wiley The Incredible 5 Point Scale by Buron and Curtis

Resources www.fraser.org www.autismspeaks.org www.autismschedules.com http://kidscandream.webs.com/page12.htm (many ideas and social stories-not professional)