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Head to Toe: TOOLS! to Use with Students on the Autism Spectrum. Heather Knox, LISW sociallearningabq@yahoo.com www.sociallearningabq.webs.com. Going to A Training. Sometimes I go to a training. I can learn new things. I can get a break from being at my school. Going to a Training .

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head to toe tools to use with students on the autism spectrum

Head to Toe: TOOLS! to Use with Students on the Autism Spectrum

Heather Knox, LISW

sociallearningabq@yahoo.com

www.sociallearningabq.webs.com

going to a training
Going to A Training
  • Sometimes I go to a training.
  • I can learn new things.
  • I can get a break from being at my school.
going to a training4
Going to a Training
  • Sometimes I learn new ideas.
  • But sometimes I hear ideas I already know.
  • I might be frustrated.
  • I might wonder why I am here..
going to a training5
Going to a Training
  • When this happens, I can try to think about new ways to help other people understand important ideas.
  • Or I can chill out and think about the cute guy/girl I saw at the grocery store yesterday.
  • When more people understand ideas that can help my students, everyone feels better!
what is autism
What is Autism?
  • A Neuro developmental SPECTRUM disorder – everyone is affected differently
some statistics for autism spectrum disorders asd s
Some Statistics for Autism Spectrum Disorders (ASD’s)

Increase in incidence in population CDC 1/100 1/70 for boys.

Increase large in last 10 years.

More than can be accounted for by increase in knowledge or diagnostic capability.

Cause? Unknown. Suspected to be a combination of genetics & an environmental trigger.

Family hx of Bipolar Disorder, Depression, Anxiety –increased chances of having a child with an ASD.

diagnostic criteria for 299 00 autistic disorder
Diagnostic Criteria for 299.00 Autistic Disorder

I) A total of six (or more) items from (A), (B), and (C), with at least two from (A), and one each from (B) and (C)

(A) qualitative impairment in social interaction, as manifested by at least two of the following:

  • 1. marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction2. 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 ( note: in the description, it gives the following as examples: not actively participating in simple social play or games, preferring solitary activities, or involving others in activities only as tools or "mechanical" aids )
diagnostic criteria 299 00 continued
Diagnostic Criteria 299.00 continued
  • (B) qualitative impairments in communication as manifested by at least one of the following:
  • 1. delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)2. in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others3. stereotyped and repetitive use of language or idiosyncratic language4. lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level
diagnostic criteria 299 00 continued11
Diagnostic Criteria 299.00 continued
  • (C) restricted repetitive and stereotyped patterns of behavior, interests and activities, as manifested by at least two of the following:
  • 1. encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus2. apparently inflexible adherence to specific, nonfunctional routines or rituals3. 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
  • (II) Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: (A) social interaction(B) language as used in social communication(C) symbolic or imaginative play
diagnostic criteria 299 80 aspergers syndrome
Diagnostic Criteria 299.80 Aspergers Syndrome
  • (I) Qualitative impairment in social interaction, as manifested by at least two of the following: (A) marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction(B) failure to develop peer relationships appropriate to developmental level(C) a lack of spontaneous seeking to share enjoyment, interest or achievements with other people, (e.g.. by a lack of showing, bringing, or pointing out objects of interest to other people)(D) lack of social or emotional reciprocity
  • (II) Restricted repetitive & stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:(A) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus(B) apparently inflexible adherence to specific, nonfunctional routines or rituals(C) stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole-body movements)(D) persistent preoccupation with parts of objects
299 80 asperger s continued
299.80 Asperger’s Continued
  • (III) The disturbance causes clinically significant impairments in social, occupational, or other important areas of functioning.(IV) 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)(V) 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.(VI) Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia
pdd nos
PDD-NOS
  • Characterized by some, not all of the characteristics of Autism
what s different
What’s Different?
  • Neurotypical kids can usually by age 4 or 5:
  • Guess your emotions by your face or the situation
  • Name their own emotions
  • Self soothe with 1 or 2 simple strategies
  • Know what you are thinking/ Track what you know.
  • Converse with you on a topic of shared interest
  • Mindblindness
how are kids affected
How are kids affected?
  • Three primary areas:

- Sensory Challenges

- Social & Communication Impairment – Lack of friends, difficulty relating with adults and kids, difficulty communicating needs, questions, concerns

- Restricted patterns of interest- a high schooler who wants only to talk about Pokemon.

sensory challenges
Sensory Challenges:
  • The signals don’t come together!
  • Too loud, too bright, too fast, too tight– hyper or hypo sensitive
  • The mall at holiday time.
  • Challenges with normal bump & touch of a school setting. Or normal “background” noise.
  • Auditory processing
  • They work to hold it together, then melt down
how it might present
How it might present..
  • A student who is very bright, converses well with adults, but not with peers.
  • A student who “melts down” periodically, for unusual reasons, or no visible reason.
  • A “quirky” kid who excels academically, but will only work alone.
  • A child who invades the space of peers, but becomes quite agitated when touched or bumped.
  • A kid who looks “spoiled” and will tantrum or refuse to do certain work (like writing.)
challenges
Challenges
  • Dealing with loud noises (fire drill!)
  • Dealing with changes in routine
  • Asking for help
  • Negotiating with peers or others (what else is for lunch?)
  • Lack of understanding of situations due to
  • Lack of understanding of perspective of others “Mindblindness.”
  • Focusing on the details, can’t see the big picture
additional challenges who are you anyway
Additional Challenges: Who are you anyway?
  • Differences in part of brain that governs facial recognition
  • Identifying emotions on other’s faces
  • Reading nonverbal social cues
  • “J” 1:00-2:34
frequently co occurring
Frequently Co-occurring
  • Auditory processing challenges—You’re talking too much!
  • Language formation challenges, written or oral. --Inability to ask for help, even to formulate the question
  • “J”
tools for assessments
Tools for Assessments
  • Checklists:
  • Observation
  • Talk to peers
  • Double Interview
treatment challenges
Treatment Challenges
  • Most of us are “Neurotypical”
  • You don’t always know what you KNOW!
  • Its hard to see what these kids don’t know, and hard to tell what piece to teach them!
strengths
Strengths
  • Visual Mind
  • Detail oriented
  • Rule followers
  • Seeing a different picture
temple grandin
Temple Grandin

First 7 min or so of :

http://www.ted.com/talks/temple_grandin_the_world_needs_all_kinds_of_minds.html

what doesn t work
What doesn’t work
  • Basically, everything I was ever taught clinically
  • Insight oriented therapy
  • Role Play
  • Peer Modeling
  • Standard Non-Directive Play Therapy (supported play CAN work, with some careful thought.)
the big thing
THE BIG THING

MAKE IT AS

VISUAL

AS YOU CAN!

treatment needs to be
Treatment Needs to Be:
  • Concrete
  • Visual
  • Explicit
  • Repetition Repetition Repetition
  • Research Based
  • Structured
  • Supported
tools that do work a whirlwind tour
Tools that DO work: A whirlwind tour
  • Social Stories
  • Social Thinking/ I LAUGH model including Superflex and You are a Social Detective
  • Sixth Sense Curriculum
  • Video Social Stories: My school day, etc.
  • The Incredible 5 Point Scale
  • Comic Strip Conversations
  • Socially Curious and Curiously Social
  • 10 unwritten Rules of Social Relationships.
  • Videotaping –used carefully
social thinking vs social skills
Could you have had a successful conversation without thinking about the other person?

What information were you “tracking?”

Can you be taught to do something without understanding WHY?

“Social Thinking ® ” vs. Social Skills
social thinking is
“Social Thinking is….”
  • Thinking about others
  • and how they think about YOU
  • A model developed by Michelle Garcia Winner, MA-CC SLP
  • www.socialthinking.com
the i laugh model
The I-Laugh Model
  • I = Initiation of communication or action
  • L = Listening with eyes and brain
  • A = Abstract and Inferential
  • U = Understanding Perspective
  • G = Gestalt Perspective Getting the “big picture.”
  • H = Humor
key lessons
Key Lessons:
  • Expected & Unexpected Behavior
  • How we Make Impressions
  • Social Behavioral Map
  • Making “Smart Guesses”
behavior for a conference
Behavior for a Conference
  • Expected
  • Unexpected
making impressions
Making Impressions

Parts of an Impression—Begin with a visual, CLAY, etc

  • How You Look
  • What You Say (just your words)
  • What You Do
how your message gets across
How your message gets across
  • Is it the WORDS?
  • Or the WAY?
parts of an impression
Parts of an Impression
  • How you look…
    • A. Hygiene
    • B. Clothes you wear, hairstyle
  • What you Say…
    • A. Just the words you use
parts of an impression continued
Parts of an Impression, continued
  • What you do…
    • A. Body language & gestures
    • B. Facial expression
    • C. Tone of voice
    • D. Proximity
    • E. Loudness, pitch of voice, etc.
social stories slides courtesy of marci laurel ma cc slp
Social Stories* Slides courtesy of Marci Laurel, MA-CC-SLP
  • Social stories were developed by Carol Gray and are used to help students understand expected behaviors in situations that are challenging for them.
  • The goal of the story is to increase understanding, provide comfort and offer some appropriate responses.
  • Social stories can reduce problem behaviors, increase social awareness and/or teach new skills.
social stories
Social Stories
  • Language is based on the student’s ability to comprehend both vocabulary and abstract ideas.
  • The story is reviewed regularly in preparation for, but not during, the challenging event.
  • Cartoons and social scripts can also be used.
describe the situation
Describe the Situation
  • Address the “wh” questions: where does the situation take place, who is involved, what they are doing and why they may be doing it.
  • Helps the student recognize the situation when it happens…

“Sometimes our class sits on the carpet. We sit on the carpet to listen to stories and for group lessons.”

“The teacher wants the students to be quiet and still.”

provide the perspective of others
Provide the Perspective of Others

Give an idea about what might be in the minds of others in the story or provide details about the emotions and thoughts of others.

“My friends are trying hard to listen so they can enjoy the story or learn from the teacher. It can be hard for them to listen if someone is moving all around.”

student perspective
Student Perspective

Describe one or two of the student’s possible feelings or responses.

“It is hard for me to sit still. When the teacher tells me to sit still I might feel mad.”

give ideas about what to do
Give Ideas About What to Do

Suggest desired (expected) responses designed to be supportive to the specific student.

“When I want to jump around while the teacher is reading, I can do floor push ups, push and pull with my hands or walk to the back of the group.”

happy ending
Happy Ending
  • It can be helpful to create a happy ending that makes sense to an individual student.
  • Linking the ending to the beginning can bring the whole story full circle!

“My friends will be happy when I can remember to use my ideas to be still during carpet time!”

i can be a super friend
I Can Be a SUPER FRIEND!

Created by Lisa Grant & Rochelle Lentini

2002

slide50

I like talking and playing

with my friends

at school.

slide51

Sometimes, I want to play with what my friends are playing with.

When I play, I sometimes feel like taking toys, using mean words, or hitting and kicking.

My Friends get sad or mad when I hit, kick, use mean words, or take toys.

slide52

If I want to join in play, I need to join nicely or ask to play with my friends’ toys.

Can I play with you?

I can say, “Can I play with that toy?” or “Can I play with you?”.

slide53

First I stop, then I think about what a

Super Friend would do.

Super Friends use:

Use nice talking,

Gentle hands and feet,

Look with their eyes,

Listen with their ears, &

Take turns with toys.

taking turns

Taking Turns

Dr Jed Baker

Adapted by Megan Shanley

slide56

The Social Skills Picture Book, Dr. Jed Baker$39.95 To order go to www.futurehorizons-autism.com and click on book titles.

comic strip conversations
Comic Strip Conversations
  • Use of simple drawings to visually clarify the elements of social interactions and emotional relations.
  • Can be used to visually "work through" a problem situation and identify solutions.
things to consider
Things to consider
  • What will it take, how much support, to get the child to have the desired experience, produce the desired behavior?
  • --A list of questions? Studying a social story for several weeks before practicing? Rehearsing with the therapist before a friend? Peer support?
resource list pg 1
Resource List pg 1
  • The following can be purchased from www.Social Thinking.com, where you can also find articles, newsletters & a helpful blog:
  • Thinking About You Thinking About Me
  • Superflex: A Superhero Social Thinking Curriculum
  • You are a Social Detective
  • Think Social: A Social Thinking Curriculum for School-Age students
  • Worksheets! For Teaching Social Thinking & Related Skills
  • Inside Out: What Makes a Person with Social Cognitive Deficits Tick?
  • Socially Curious and Curiously Social
  • Many of these can also be borrowed from UNM-CDD library (next slide)
resource list part two
Resource List, part two

Other books:

  • Unwritten Rules of Social Relationships, Temple Grandin & Sean Barron
  • Ten Things Every Child with Autism Wishes You Knew, Ellen Notbohm
  • The New Social Story Book,The Sixth Sense, Comic Strip Conversations, all by Dr. Carol Gray
  • The Incredible 5 point Scale, Dunn Buron & Curtis
  • The Social Skills Picture Book, Dr. Jed Baker
  • The Hidden Curriculum, Brenda Smyth Myles
other helpful places
Other Helpful Places:
  • UNM-Center for Development & Disability (CDD)-Autism Programs [formerly Southwest Autism Network(SWAN)] Assessments, referrals to resources, a lending library.

cdd.unm.edu 272-1852 LINC library 272-0281

-NM Autism Society: Newsletter, email listserve, resources

http://nmautismsociety.org/

Autism Speaks Website: www.autismspeaks.org

www.socialthinking.com

other books for perspective an incomplete list
Other Books, for Perspective: (an incomplete list)
  • Pretending to be Normal, by Liane Holliday Willey.
  • Look me in the Eye, John Elder Robison.
  • Born on a Blue Day, Daniel Tammett.
  • Freaks, Geeks, & Aspergers Syndrome, Luke Jackson
  • Emergence, Labeled Autistic, Animals in Translation, The Way I See It, Thinking in Pictures, all by Temple Grandin
  • Rules, Cynthia Lord-fiction for young readers
  • The Curious Incident of the Dog in the Nighttime, Mark Haddon – also fiction
movies also an incomplete list
Movies- (also an incomplete list)
  • Adam (Neurotypical woman falls in love w/ young man w/ Aspergers.)
  • Temple Grandin (HBO movie).
  • The Horse Boy (Documentary about young son w/ AU & family’s struggles & quest for healing.)
  • Rain Man. (Not so typical, but familiar.)
  • “Normal People Scare Me.” Produced by Taylor Cross, a teen boy w/ AU. He interviews other teens in LA area.