Introduction We created Practical Ideas That Really Work for Students with Asperger Syndrome for educators and other school-based professionals who work with students with Asperger syndrome or high-functioning autism. This resource provides an assessment system and set of intervention ideas for students who are identified or exhibit many of the behaviors associated with Asperger syndrome. The materials are intended for use with students in kindergarten through Grade 12 and include two main components: Evaluation form with a rating scale and ideas matrix. The rating scale portion of the evaluation form is a criterion-referenced measure for evaluating behaviors that affect student learning. The items on the scale are specific descriptors that are correlated to the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM IV TR) indicators for Asperger s Disorder. The ideas matrix on the evaluation form provides a systematic way of linking the results of the rating scale to interventions. We hope that educators use the matrix as a tool for selecting effective interventions to meet each student s specific needs. Resource manual. The practical ideas were written to assist teachers and other professionals in improving students social interactions, academic performance, and language skills and decreasing their behavior problems related to restricted interests and stereotypical behaviors. The book contains an explanation of each idea, along with reproducible worksheets, examples, illustrations, and tips designed for easy implementation. The next section of this introduction will describe the development of the rating scale and the ideas, then provide directions for their use. The Rating Scale The criterion-referenced rating scale is intended for use by teachers or other school-based professionals to rate students according to the DSM IV TR criteria for Asperger s Disorder. The measure was designed to assist teachers in conducting a careful and thorough assessment of the specific problems to guide the selection of intervention strategies. 1 The rating scale is divided into the two areas of Asperger syndrome defined by the DSM IV TR: Social Interaction and Repetitive and Stereotyped Patterns. Based on a review of the literature, we also included a section called Other Characteristics, which includes cognitive processes, language, and sensorimotor skills. Although these areas are not included in the DSM IV TR definition, there is consensus among researchers that students with Asperger syndrome often have problems in these three areas. We have included ideas for all three areas. However, there are relatively few ideas included for motor-skill deficits because a student identified with Asperger syndrome is usually provided services by a multidisciplinary team, which sometimes includes an occupational therapist and a physical therapist. In addition, students with Asperger syndrome also may receive services in adaptive physical education classes. The ideas in this book are written for classroom teachers, counselors, other educational professionals, or parents to implement in the classroom or the home environment. We believe that professionals who work with motor skills would be better equipped to provide interventions for deficits in this area. The measure consists of 33 items three items for each of the eight DSM IV TR criteria and three items for the additional areas of cognitive processes, language, and sensorimotor skills. Educators can use the scale s 4-point Likert scale to complete a rating, with a 0 meaning the student never exhibits the behavior and a 3 meaning the student consistently exhibits the behavior to the point where it almost always interferes with the student s ability to function in the social or learning environment. For each DSM IV TR criterion, the range of possible scores is 0 to 9; the higher the score, the more the behavior interferes with social interactions and learning. The criterion-referenced measure was field-tested in three school districts in Texas with 34 students. All of these students were identified as having either Asperger syndrome or high-functioning autism. Thirty-three students were male and 1 student was female. Twenty-five students were European American, 3 were African American, and 6 were Hispanic American. All students were in Grades 1 through 11.
An item analysis was conducted. The resulting reliability coefficients were.88 for the Social Interaction,.84 for the Repetitive and Stereotyped Patterns, and.85 for Other Characteristics. The magnitude of these coefficients strongly suggests that the rating scale possesses little test error and that users can have confidence in its results. In addition, we compared the mean ratings of the four subscales for the two groups, students identified as having Asperger syndrome and students not identified, using a t ratio. Our hypothesis was that students identified as having Asperger syndrome would be rated higher than students not identified. Because we made three comparisons for each group, we used the Bonferroni method to adjust the alpha level and set alpha at.01. In each case, the mean differences between the two groups were large enough to support our hypothesis. The probability in all cases was.001. We can conclude that the rating scale is sensitive enough to discriminate between the two groups. Practical Ideas That Really Work Teachers and other school-based professionals are busy people with many responsibilities. In our discussions with teachers, supervisors, and counselors about the development of this product, they consistently emphasized the need for materials that are practical, easy to implement in the classroom, and not overly time-consuming. We appreciated their input and worked hard to meet their criteria as we developed the ideas in this book. In addition, we conducted an extensive review of the literature, so that we stayed focused on ideas supported by data documenting their effectiveness. The result is a book with 34 ideas, most with reproducible masters, all grounded in our research and collective experiences as well as those of the many educators who advised us and shared information with us. Directions for Using the Materials Step 1: Collect Student Information The first step is to complete the first page of the Evaluation Form for the child who is identified as having Asperger syndrome or who exhibits many of the characteristics associated with the syndrome. As an example, Larry s completed Evaluation Form is provided in Figure 1. Space is provided on the front of the form for pertinent information about the student being rated, including name, birth date, age, school, grade, rater, and subject area. In addition, the dates the student is observed and the amount of time the rater spends with the student can be recorded here. Also included on the front of the form are the DSM IV TR criteria for Asperger s Disorder. Step 2: Rate the Behaviors of the Student Pages two and three of the Evaluation Form contain the rating scale. The items are divided into the three areas discussed previously. Instructions for administering and scoring the items are provided on the form. Space is also provided to total the items for each criterion, to check the three problems to target for immediate intervention, and to record the intervention idea and its starting date. Step 3: Choose the Ideas To Implement The last page of the Evaluation Form contains the ideas matrix. After choosing the three priority problems to target for immediate intervention, the professional should turn to the ideas matrix and select an intervention that corresponds to that problem. The professional should write the idea number and the starting date on the space provided on the rating scale. For example, in Figure 1, Larry received the highest ratings in the areas of poor peer relationships and social or emotional reciprocity. His teacher has targeted this area and has chosen Ideas 25, 31, and 32 from the ideas matrix. Assessment often provides much useful information about the strengths and deficits of students. However, unless the information gathered during the assessment process impacts instruction, its usefulness for school-based staff is limited. We designed the ideas matrix so that educators can make the direct link between the information provided by the rating scale and instruction in the classroom. We believe that this format stays true to our purpose of presenting information that is practical and useful. Step 4: Read and Review the Practical Ideas That Have Been Selected The teacher, other professional, or parent should read the explanation for each idea selected in Step 3. To aid in implementation, most of the ideas have at least one reproducible form on the page(s) immediately following the explanation. Some ideas did not lend themselves to a reproducible form, but are supported with explanations, suggestions for use, illustrations, tips, resource lists, and 2
boxes with further information. Ideally, the teacher, other professional, or parent should also decide how and when to evaluate the effectiveness of each strategy selected. In our example with Larry, this could be accomplished through observation. Step 5: Implement the Idea After the teacher is familiar with the idea and has prepared all necessary materials, implementation can begin. The practical ideas selected for implementation can easily be integrated into an overall instructional design that reflects good instructional practices for all students. Research Supporting the Practical Ideas The next section provides references that support the practical ideas in the book. The most recent reauthorization of the Individuals with Disabilities Education Act (IDEA; 2004) requires that interventions for students with disabilities be based on peer-reviewed research. The suggestions provided in the manual all meet this requirement, and professionals can use them with confidence. The references provide interested professionals with relevant information related to research and prior practice, should they wish to learn more about the interventions described. The references are grouped by general category. Using Visuals and Cues To Teach and Structure Communication, Organization, and Routines Bryan, L. C., & Gast, D. L. (2000). Teaching on-task and onschedule behaviors to high-functioning children with autism via picture activity schedules. Journal of Autism and Developmental Disorders, 30, 553 567. Bullard, H. R. (2004). Ensure the successful inclusion of a child with Asperger syndrome in the general education classroom. Intervention in School & Clinic, 39(3), 176 180. Savner, J. L., & Myles, B. S. (2000). Making visual supports in the home and community: Strategies for individuals with autism and Asperger syndrome. Shawnee Mission, KS: Autism Asperger Publishing. Swanson, T. C. (2005). Provide structure for children with learning and behavior problems. Intervention in School & Clinic, 40(3), 182 187. Tissot, C., & Evans, R. (2003). Visual teaching strategies for children with autism. Early Child Development & Care, 173(4), 425 433. 3 Enhancing Social Skills Development Using Social Stories, Social Skills Lessons, and Cartoons Adams, L., Gouvousis, A., VanLue, M., & Waldron, C. (2004). Social story intervention: Improving communication skills in a child with an autism spectrum disorder. Focus on Autism & Other Developmental Disabilities, 19(2), 87 94. Gary, C. A. (1994). Comic strip conversations. Arlington, TX: Future Horizons. Gutstein, S. E., & Whitney, T. (2002). Asperger syndrome and the development of social competence. Focus on Autism and Other Development Disabilities, 17(3), 161 171. Myles, B. S., & Simpson, R. L. (2001). Understanding the hidden curriculum: An essential social skill for children and youth with Asperger syndrome. Intervention in School & Clinic, 36(5), 279 286. Rogers, M. F., & Myles, B. S. (2001). Using social stories and comic strip conversations to interpret social situations for an adolescent with Asperger syndrome. Intervention in School & Clinic, 36(5), 310 313. Solomon, M., Goodlin-Jones, B. L., & Anders, T. F. (2004). A social adjustment enhancement intervention for high functioning autism, Asperger s syndrome, and pervasive developmental disorder NOS. Journal of Autism & Developmental Disorders, 34(6), 649 668. Thiemann, K. S., & Goldstein, H. (2004). Effects of peer training and written text cueing on social communication of school-age children with pervasive developmental disorder. Journal of Speech, Language & Hearing Research, 47(1), 126 144. Enhancing Social Emotional Development Using Rehearsal, Role Play, Modeling, and Video Modeling Apple, A. L., Billingsley, F., & Schwartz, I. S. (2005). Effects of video modeling alone and with self-management on compliment-giving behaviors of children with highfunctioning ASD. Journal of Positive Behavior Interventions, 7(1), 33 46. Barnhill, G. P., Cook, K. T., Tebbenkamp, K., & Myles, B. S. (2002). The effectiveness of social skills intervention targeting nonverbal communication for adolescents with Asperger syndrome and related pervasive developmental delays. Focus on Autism & Other Developmental Disabilities, 17(2), 112 118.
Bashe, P. R., & Kirby, B. L. (2001). The OASIS guide to Asperger Syndrome. NY: Crown. LeBlanc, L. A., Coates, A. M., Daneshvar, S., Charlop-Christy, M. H., Morris, C., & Lancaster, B. M. (2003). Using video modeling and reinforcement to teach perspectivetaking skills to children with autism. Journal of Applied Behavior Analysis, 36(2), 253 257. Webb, B. J., Miller, S. P., Pierce, T. B., Strawser, S., & Jones, W. P. (2004). Effects of social skills instruction for highfunctioning adolescents with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 19(1), 53 62. Griswold, D. E., Barnhill, G. P., Smith Myles, B., Hagiwara, T., & Simpson, R. L. (2002). Asperger syndrome and academic achievement. Focus on Autism and Other Development Disabilities, 17(2), 94 102. Rock, M. L. (2004). Graphic organizers: Tools to build behavioral literacy and foster emotional competency. Intervention in School & Clinic, 40(1), 10 37. Improving Fine and Gross Motor Skills Bledsoe, R., Myles, B. S., & Simpson, R. L. (2003). Use of a social story intervention to improve mealtime skills of an adolescent with Asperger syndrome. Autism: The International Journal of Research & Practice, 7(3), 289 295. Increasing Self-Monitoring Skills Through Problem Solving, Decision Making, and Contracts Bock, M. A. (2001). SODA strategy: Enhancing the social interaction skills of youngsters with Asperger syndrome. Intervention in School & Clinic, 36(5), 272 278. Dwairy, M. (2005). Using problem-solving conversation with children. Intervention in School & Clinic, 40(3), 144 150. Malian, I., & Nevin, A. (2002). A review of self-determination literature: Implications for practitioners. Remedial and Special Education, 23(2), 68 74. Moyes, R. A. (2002). Addressing the challenging behavior of children with high-functioning autism/asperger syndrome in the classroom: A guide for teachers and parents. London: Jessica Kingsley. Myles, B. S., & Simpson, R. L. (2003). Asperger syndrome: A guide for educators and parents (2nd ed.). Austin, TX: PRO-ED. Using Graphic Organizers To Increase Academic Achievement Baxendell, B. W. (2003). Consistent, coherent, creative: The 3 C s of graphic organizers. Teaching Exceptional Children, 35(3), 46 53. Green, D., Baird, G., Barnett, A. L., Henderson, L., Huber, J., & Henderson, S. E. (2002). The severity and nature of motor impairment in Asperger s syndrome: A comparison with specific developmental disorder of motor function. Journal of Child Psychology & Psychiatry & Allied Disciplines, 43(5), 655 668. Rinehart, N. J., Dudley, A. L., Tonge, B. J., Bradshaw, J. L., Iansek, R., Enticott, P. G., et al. (2003). Movementrelated potentials and gait functioning autism and Asperger s disorder. Australian Journal of Psychology, 55, 208 212. Modifying Reactions to Sensory Input Alcántara, J. I., Weisblatt, E. J. L., Moore, B. C. J., & Bolton, P. F. (2004). Speech-in-noise perception in high-functioning individuals with autism or Asperger s syndrome. Journal of Child Psychology & Psychiatry & Allied Disciplines, 45(6), 1107 1114. Dunn, W., Saiter, J., & Rinner, L. (2002). Asperger syndrome and sensory processing: A conceptual model and guidance for intervention planning. Focus on Autism and Other Development Disabilities, 17(3), 172 185. Williams, K. (2002). Understanding the student with Asperger syndrome: Guidelines for teachers. Intervention in School & Clinic, 36(5), 287 292. 4
Practical Ideas That Really Work for Students with Asperger Syndrome Kathleen McConnell Gail R. Ryser Larry Johnson Name 2-26-94 11 Birth Date School Age Matthews Middle School 6 Michael Rosen Grade Rater English Subject Area 9-1-05 10-15-05 Dates Student Observed: From To Evaluation Form Amount of Time Spent with Student: DSM IV TR Diagnostic Criteria for Asperger s Disorder A. Qualitative impairment in social interaction, as manifested by at least two of the following: (1) marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction (2) failure to develop peer relationships appropriate to developmental level (3) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people) (4) lack of social or emotional reciprocity B. Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following: (1) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus Per Day Per Week (2) apparently inflexible adherence to specific, nonfunctional routines or rituals (3) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements) (4) persistent preoccupation with parts of objects C. The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning. D. There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years). 50 min. 250 min. E. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood. F. Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia. Note. From the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision, 2000, Washington, DC: American Psychiatric Association. Copyright 2000 by American Psychiatric Association. Reprinted with permission. Figure 1. Sample Evaluation Form, filled out for Larry. 5