The Autism Spectrum

1. The Autism Spectrum Tracey.Lindroth@sde.ok.gov 405-521-4881

2. What is under the umbrella? * Autism * Aspergers Syndrome * PDD-NOS (Pervasive Developmental Disorder – Not Otherwise Specified) * Rett’s Syndrome * Childhood Disintegrative Disorder

3. Some interesting facts • Autism is now 1:50 in the US. • There is no known cause and no known cure for Autism. • “Refrigerator Moms” and poor parenting do not cause Autism. • Boys are 5 times more likely than girls to be diagnosed on the spectrum. • Early intervention is a proven method for helping children become more developmentally equivalent to their same age peers. • Autism runs in families. • Autism costs a family $60,000 a year on average.

4. Good news • New research is coming out all the time. • A genetic link has been found. • There are current trials happening in Boston about a potential blood test to predict Autism in newborns. • Autism can now be diagnosed as early as 6 months therefore allowing more time for early intervention • Due to early intervention, intensive therapies and pharmacological help, many individuals with autism are able to lead productive, fulfilling lives.

5. PeRson First Language • It is very important to get into the habit of using person first language when referring to any individual that has a disability. • Matt has autism NOT Matt is autistic. • Having Autism (or any other disability) is simply a part of who a person is, it doesn’t define who they are.

6. What is the DSM V? (released in may 2013) • Diagnostic and Statistical Manual of Mental Disorders V (DSM V)provides a common language and standard criteria for the classification of mental disorders. It is used by clinicians, researchers, psychiatric drug regulation agencies, health insurance companies, pharmaceutical companies, and policy makers. The current version is the DSM-V-TR (fifth edition, text revision). It is organized into a five-part 'axis' system, with the first axis incorporating 'clinical disorders' and the second covering personality disorders and intellectual disabilities

7. Core Characteristics The three core characteristics associated with Autism in the DSM-V-TR are: 1.a qualitative impairment in social interactions 2.a qualitative impairment in communication 3.a restricted or stereotyped pattern of activities, interests and behaviors In addition to the three core characteristics, the diagnostic criteria listed in the DSM-V-TR specify that delays or abnormal functioning be observed prior to the age of 3 years, in at least one of the following areas: (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play http://casd.binghamton.edu/node/14

8. Marked impairment in eye gaze, facial expression • Lack of spontaneous need to share with others • Delay or lack of spoken language • Inability to sustain a conversation • Repetitive use of language • Restricted patterns of behavior/interest • Hand flapping • Failure to develop peer relationships • Marked impairment in eye gaze and facial expression • Lack of social/emotional reciprocity • All encompassing preoccupation with a specific area of interest • Inflexibility to changes in routine, repetitive motor mannerisms • Children with AS do not generally exhibit a delay in language or cognitive development Classic Autism Asperger’s Syndrome

9. Temple Grandin reminds us that individuals with Autism are: “Different but not less”

10. In her own wordshttp://www.youtube.com/watch?v=YeWks6cgJ-k

11. Hans Asperger observes: “ It seems that for success in science or art, a dash of autism is essential”

12. Look familiar?http://www.youtube.com/watch?v=d7lQa3q_OAk

13. Many times, students who are actually gifted are mistaken for students with autism. There are many similarities, and we as educators need to be very careful when talking to parents.

14. Gifted or Asperger’s Syndrome?Gallagher, S., Gallagher, J. (2002). Giftedness and Asperger’s Syndrome: A New Agenda for Education. Understanding Our Gifted, 14(2). * Socially isolated * Independent of same age peers * Highly focused interest * Sophisticated vocab * Complex cognition * Advanced understanding * Socially Inept * Unskilled with peers * Highly focused interest * Hyperlexia * Simple cognition * Advanced memorization Highly Gifted Asperger’s Syndrome

15. Gifted? Asperger’s? Both? • The principal looks around the table bewildered. The math teacher claims that 7 year old Jason is a genius and that’s why he has such a hard time talking with his peers (he’s about 2 years ahead). In English, however, his teacher is concerned that while he is using impressive language she feels he doesn’t always understand what the words mean and speaks with very flat affect. The other kids call him geek, dork etc. Jason’s parents are very confused. • What do you think? Why?

16. Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) • This is considered Atypical Autism. This is a category used when there is a severe impairment in social interaction, communication skills and interests, but does not meet specific criteria due to atypical symptomology, late age onset or sub-threshold symptomology.

17. Temple Grandin, The Way I See It: A Personal Look at Autism & Asperger's “What would happen if the autism gene was eliminated from the gene pool? You would have a bunch of people standing around in a cave, chatting and socializing and not getting anything done.”

18. Rett’s Syndrome • Primarily found in girls. • Normal growth and development until between 5-48 months • Decline in head growth • Loss of previous hand skills and social engagement • Severe language impairment and significant psychomotor retardation

19. Childhood Disintegrative Disorder (CDD) • Primarily found in boys. • Normal development until between 2 and 10 years old. • During this time period, the child exhibits significant loss of previous skills including motor skills and bowel/bladder control. • This diagnosis only comes after PDD and Schizophrenia have been ruled out.

20. Methods • There are a variety of research based methods that have been proven to help train students with varying degrees of Autism. Each child is unique in the manner they carry their different abilities and therefore teaching methods must be catered to the individual child. • All students on the Spectrum do benefit from a highly structured learning environment, consistency and patience, regardless of their functioning level. • Applied Behavior Analysis (ABA) is a very effective and research driven tool for many children on the Spectrum, but again, remember that each child is individual so ABA may be a great fit or one child and not at all for another, or used in bits and pieces with another. http://www.autismspeaks.org/what-autism/treatment/applied-behavior-analysis-aba

21. Some ideas for the classroom • Daily schedule on board (picture schedule as appropriate). • Discuss any potential changes to routines in advance. • Everything can become a social skills lesson. Take every opportunity to make an issue a teachable moment. • Remember that students on the Spectrum are generally visual learners and/or hands on learners, so lectures will be difficult. • Many students on the Spectrum are also diagnosed as having ADD or ADHD, so plan for their need to move and fidget in a way that will not disrupt the other students but will satisfy that need.

22. Plan ahead • Have a plan for emergencies such as melt downs, social snafus, unplanned schedule changes/school crisis, and be sure that the student is very aware of the contingency plan and how to deal with whatever it is. What would you do? • The day is flowing nicely, you are in the middle of a terrific lesson when suddenly the school is placed on immediate lock down. Children are following directions and moving to the safe spot, but Charlie is starting to freak out. He is scared and is starting to cry and trying to run for the door to find his Mom. How do you get Charlie back while maintaining control of the other 18 kids?

23. The most important thing a provider can remember is:

24. Communication • Picture Exchange System (PECS) • Assistive Technology (AT) • American Sign Language (ASL) • Speech therapy

25. Picture Exchange Communication System PECS

26. Assistive Technology (AT)

27. American Sign Language

28. Georgia O’Keefe reminds us that we all communicate in different ways: “I found I could say things with color and shapes that I couldn’t say any other way, things I had no words for”

29. Behavioral Approaches • Chaining • Pivotal Response Training(PRT) • Positive Behavior Supports (PBS) • Reinforcement • Prompts • Early Intensive Behavioral Intervention (EIBI) • Self management

30. Usually in General Education…. • In a general education setting, most likely you will utilize Positive Behavior Supports, Self Management, Prompts and Reinforcement as that these are systems that will work equally well for all students.

31. Embrace their differences – it is what makes each person on the spectrum wonderfully quirky, challenging, fun and each one uniquely them.

32. Social Skills • Direct instruction • Social stories • Comic strip conversations • Priming • Peer training

33. Comic strip ideas

34. Social Story Sample Angry Feelings My name is Tracey. Sometimes, my teacher Miss Smith tells me I have to wait to use the computer. That makes me feel very upset, frustrated, and angry. Miss Smith says that everybody feels that way some of the time. All kids and grown-ups sometimes get angry. It's important to keep thinking, even when I'm upset. Here are some good things to think about the next time I'm upset: • I won't be upset forever. Soon, I will calm down and feel good again. • There is a way to solve this problem. I can ask an adult to help me think of a good solution. Here are some good things to do the next time I'm upset: • I can take 10 deep breaths and count to 10 slowly. • I can use words and signs to tell people how upset I feel. • I can draw a picture that shows what I feel. • I feel better when I am calm, and proud of myself, too! I can practice and be calm at home and at school now!

35. Case #1 • Your 7 year old student Matt is having a difficult time keeping his hands to himself. The other students are complaining but he thinks he is just playing around. • Choose 2 methods that could help Matt understand the importance of keeping his hands to himself and the concept of personal space. Develop an example of each to share.

36. Case #2 • Cindy Lou, is 6 years old and is having a difficult time distinguishing the appropriate time to discuss bodily functions and this is beginning to upset and alienate her from her peers. • Choose 2 methods that may be useful to Cindy about proper time and place for such conversations. Develop an example of each to share.

37. Early Intervention • Early intervention is one of the most important things we can do for our kids. While there is no known cause and no known cure for Autism, research states that the earlier a child is diagnosed and begins receiving intensive intervention strategies including, but not limited to, speech therapy, occupational therapy, physical therapy, and medication the odds of the child breaking through increase significantly.

38. Sensory Integration Disorder (SID) • Many students on the Spectrum have profound sensory issues stemming from sounds, textures, touch and light. • Occupational therapy can help a child learn coping skills, but the educator needs to be aware of these triggers and help the child develop appropriate coping skills. • Some helpful ideas: auditory therapy, deep pressure, brushing, a sensory area in your class for decompression (usually a dimly lit space with soft music, ball pit, weighted blankets, noise cancelling head phones etc.) • Helping children cope with SID can improve behavior, peer interaction and academic achievement

39. Case #3 • You have noticed that whenever there is a school assembly or large group activity, Sam becomes very tense, stimming, pacing, covering his ears. • List some ideas on how to help Sam cope with a loud, large group setting.

40. 10 Things your student with autism wish you knew http://www.youtube.com/watch?v=RlEWEO4cEAo

41. Resources • Gallagher, S., Gallagher, J. (2002). Giftedness and Asperger’s Syndrome: A New Agenda for Education. Understanding Our Gifted, 14(2). • www.nationalautismassociation.org/ • http://www.autism-community.com/resources/for-educators/ • http://www.easterseals.com/site/PageServer?pagename=ntlc8_autism_service&s_src=Google+AdWords&s_subsrc=autismsigns&gclid=CNiHmeWl_rECFQQ3nAodRXEACQ • http://www.autismspeaks.org/family-services/resource-guide?gclid=CJqEgvml_rECFQY3nAodWEkA6g • http://autismcenter.org/ • http://www.okautism.org/ • http://www.cec.sped.org/am/template.cfm?section=Home • www.autismspeaks.com

42. http://www.researchautism.org/resources/OAR_Guide_Asperger.pdfhttp://www.researchautism.org/resources/OAR_Guide_Asperger.pdf • http://abcnews.go.com/Nightline/story?id=3007970 • http://www.aspergersyndrome.org/ • http://www.nimh.nih.gov/topics/topic-page-autism-spectrum-disorders-pervasive-developmental-disorders.shtml • http://www.centerforautism.com/ • http://autism.healingthresholds.com/therapy • http://www.rethinkautism.com/parents/intro.aspx?utm_source=AdWords&utm_medium=CPC&utm_content=Parents%2BABA&utm_campaign=PARENTSABA&gclid=CL_fg4Wq_rECFQsGnQodj1oAmw • http://www.thegraycenter.org/social-stories • http://atstar.org/ • http://www.autismspeaks.org/what-autism/treatment/applied-behavior-analysis-aba • http://www.templegrandin.com/

43. http://www.aspergersyndrome.org/ • http://www.nimh.nih.gov/topics/topic-page-autism-spectrum-disorders-pervasive-developmental-disorders.shtml • http://www.centerforautism.com/ • http://autism.healingthresholds.com/therapy • http://www.rethinkautism.com/parents/intro.aspx?utm_source=AdWords&utm_medium=CPC&utm_content=Parents%2BABA&utm_campaign=PARENTSABA&gclid=CL_fg4Wq_rECFQsGnQodj1oAmw • http://www.thegraycenter.org/social-stories • http://atstar.org/ • http://www.autismspeaks.org/what-autism/treatment/applied-behavior-analysis-aba • http://www.templegrandin.com/

44. http://abcnews.go.com/Nightline/story?id=3007970 • http://www.aspergersyndrome.org/ • http://www.nimh.nih.gov/topics/topic-page-autism-spectrum-disorders-pervasive-developmental-disorders.shtml • http://www.centerforautism.com/ • http://autism.healingthresholds.com/therapy • http://www.rethinkautism.com/parents/intro.aspx?utm_source=AdWords&utm_medium=CPC&utm_content=Parents%2BABA&utm_campaign=PARENTSABA&gclid=CL_fg4Wq_rECFQsGnQodj1oAmw • http://www.thegraycenter.org/social-stories • http://atstar.org/ • http://www.autismspeaks.org/what-autism/treatment/applied-behavior-analysis-aba • http://www.templegrandin.com/

45. http://www.researchautism.org/resources/OAR_Guide_Asperger.pdfhttp://www.researchautism.org/resources/OAR_Guide_Asperger.pdf • http://abcnews.go.com/Nightline/story?id=3007970 • http://www.aspergersyndrome.org/ • http://www.nimh.nih.gov/topics/topic-page-autism-spectrum-disorders-pervasive-developmental-disorders.shtml • http://www.centerforautism.com/ • http://autism.healingthresholds.com/therapy • http://www.rethinkautism.com/parents/intro.aspx?utm_source=AdWords&utm_medium=CPC&utm_content=Parents%2BABA&utm_campaign=PARENTSABA&gclid=CL_fg4Wq_rECFQsGnQodj1oAmw • http://www.thegraycenter.org/social-stories • http://atstar.org/ • http://www.autismspeaks.org/what-autism/treatment/applied-behavior-analysis-aba • http://www.templegrandin.com/