Learning Objectives. Structured TEACCHing. Visual Supports. Structured TEACCHing. Visual Supports: Evidence-Based Intervention

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Gladys A. Williams, Ph.D., M.P.H. TEACCH Autism Program Carolina Institute for Developmental Disabilities Community Talk Series: February 8, 2017 University of North Carolina Learning Objectives List the four levels of visual supports used in Structured TEACCHing Identify three learning-style characteristics for which visual supports can be beneficial Describe examples of visual supports that can be used in home and community settings Structured TEACCHing The intervention approach developed at TEACCH over the last 50 years. It highlights the use of visual supports. Its foundation is provided by the understanding of learning styles and learning differences. The specifics of the visual supports are individualized. Are blended with other strategies or curricula to support and enhance skills in all areas: communication, daily living, vocational, community, leisure, academics and functional academics, self-advocacy, emotion regulation and social skills Structured TEACCHing Learning Differences and Styles Intervention Based on Understanding of Learning Differences and Styles Higher quality of life and increased wellbeing Increased social engagement Increased learning and independence Increased flexibility Fewer behavioral difficulties : Evidence-Based Intervention Wong, C., Odom, S. L., Hume, K. A., Cox, C. W., Fettig, A., Kurcharczyk, S., et al. (2015). Evidence-based practices for children, youth, and young adults with autism spectrum disorder: A comprehensive review. Journal of Autism and Developmental Disorders. Advance online publication. doi: 10.1007/s10803-014-2351-z AFIRM Team. (2015). Visual supports. Chapel Hill, NC: National Professional Development Center on Autism Spectrum Disorder, FPG Child Development Center, University of North Carolina. http://afirm.fpg.unc.edu/visual-supports 1

: Categories Organization of the Environment (Physical Structure) Schedules Activity or Work Systems Visual Structure of Materials and Instructions Organization of the Environment (Physical Structure) Schedules Activity or Work Systems (To Do Lists) Visual Structure of Materials and Instructions Some of the Learning Styles Associated with ASD and Other Disabilities Differences in Attention and Understanding Visual Learner Executive Function Difficulties Sensory Processing Influences 2

Learning Styles: Attention and Understanding Sticky Attention Focus on details Difficulty disengaging and shifting Understanding Relevant vs. not relevant Problems seeing big picture Concrete thinking Modify the environment to reduce distractions Use visual structure to direct attention to important and relevant information Use visual supports to enhance meaning and understanding of more abstract concepts Use a variety of visual cues to help shift attention Learning Styles: Visual Learner Strength in visual processing Learn from what is seen Thinking in pictures Auditory processing not as strong Delayed processing Provide information and instructions visually Tailor verbal instructions and information to the individual s receptive level (typically talk less!) Provide processing time Learning Styles: Executive Functioning Weak organizational skills Sequencing / planning Trouble with initiation Understanding finished Set shifting / flexibility Difficulty with transitions Provide visual sequences of activities Develop and teach organizational strategies Provide concrete indicators for passage of time and concept of finished 3

Learning Styles: Sensory Processing Influences Problems filtering and modulating input Hyper-reactivity (overstimulated) Aversion, avoidance, over-aroused Hypo-reactivity (understimulated) Sensory seeking May not notice sensory input Organize and segment the environment to decrease stimulation Reduce sources of sensory overload Provide calm and quiet spaces Schedule breaks throughout the day, including sensory input if needed Direct attention to important and relevant information Support understanding, organization, planning and generalization Support routines that enhance flexibility Use strengths and interests to increase engagement Are highly individualized Examples of Individualize!! Examples of physical (environmental) structure Examples of schedules, activity systems, structure of tasks: More abstract learner More concrete learner Physical Structure (Organization of Environment) Uses physical elements to define boundaries and segment larger rooms or spaces into smaller areas: Where should I be? Adds contextual cues, to add meaning and context to an area or environment: What do I do here? Controls distractions in learning, working and living environments Reduces sensory overload Schedules Visual cue or cues which provide information about what activities will occur Provide information about the order of activities Facilitate transitions and increase flexibility 4

Individualizing the Schedule Type of visual cue Written, picture, object, combination Length Full day, part day, first-then, one activity Routine to check schedule Verbal cue, name/check schedule card, schedule brought to individual Manage Mark off, turn over, carry the object/picture Personalization: Incorporate interests Promoting Flexibility Tips: The routine being learned is to follow the schedule Promote flexibility by changing order, number, activities Provide opportunities for choice-making Activity or Work System (To Do List) Provides an individualized, systematic way to approach the things that are to be completed It visually provides information and organization What is to be done? How much is to be done? Am I making progress? When am I finished? What will I do next? This learned strategy builds independence, flexibility, and facilitates the generalization of skills into other environments Individualizing the Activity System Visual Cue for What work and How much written word, matching cue, concrete task Organizational Sequence: Top to bottom or left to right Managing Activities/Concept of Finished mark off, back on shelf, separate shelf, tasks disappear in basket/box Motivation or Interest: what happens next? Promote flexibility by changing order, number, activities Provide opportunities for choice-making Visual Structure of Materials and Instructions Provides a strategy for approaching the task and using the materials in a flexible manner Answers the question, How do I complete this task or activity? Visual instructions Visual clarity Visual organization Are individualized Direct attention to important and relevant information Use visual structure to support understanding, organization, planning and generalization, and independence Teach routines that enhance flexibility Use strengths and interests to increase engagement with learning 5