ASD/Autism Spectrum Disorder

1. Developed by Louise Crock, Rob Meinberg, and Zena Johnston Piedmont College, Ed. S. Forsyth County Cohort, August 17, 2010 ASD/Autism Spectrum Disorder

2. AUTISM BRAINPOP

3. Autism’s most defining trait is that it is characterized by extraordinary variability. Like snowflakes, no two autistic people are alike. The term “autism” refers to a wide range of autism spectrum disorders, from a child with “classic” autism who is non-verbal and asocial, to a high-functioning child with idiosyncratic social skills, play, and language. What is Autism?

4. Autism is a developmental disability, generally evident before age three, that adversely affects a student's educational performance and significantly affects developmental rates and sequences, verbal and non-verbal communication and social interaction and participation. • Other characteristics often associated with autism are unusual responses to sensory experiences, engagement in repetitive activities and stereotypical movements and resistance to environmental change or change in daily routines. • Students with autism vary widely in their abilities and behavior. The term does not apply if a student's educational performance is adversely affected primarily because the student has an emotional and behavioral disorder. [refer to 34 CFR 300.7(c)(1)(i)] Accessed from the Georgia Department of Education Autism definition

5. The term of autism may also include students who have been diagnosed with Pervasive Developmental Disorder, Asperger’s Disorder, Rett’s Disorder, or Childhood Disintegrative Disorder provided the student’s educational performance is adversely affected and the student meets the eligibility and placement requirements. Autism may exist concurrently with other areas of disability. Definition continued

6. In the Diagnostic and Statistical Manual (DSM-IV), these diagnostic categories are outlined under the heading of “Pervasive Developmental Disorders (PDDs).” • In the DSM-IV, these disorders are defined by deficits in three core areas: social skills, communication, and behaviors and/or interests. Types of autism spectrum disorders, or PDDs, include: • Autistic Disorder • Asperger Syndrome • Childhood Disintegrative Disorder • Rett’s Disorder • Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) What is ASD?

8. Autism is characterized by what is clinically described as “deficits in social reciprocity.” In December 2009, the Centers for Disease Control and Prevention issued their ADDM autism prevalence report which concluded that the prevalence of autism had risen to 1 in every 110 births in the United States and almost 1 in 70 boys (much more common in boys than girls). About one in 500 people have autism. Siblings of a child with autism have a greater chance of being diagnosed with an autism spectrum disorder. WHO HAS Autism?

9. Manifests itself by the age of 3. Monitor your child’s developmental milestones. Hallmark Developmental Milestones “Learn the Signs. Act Early” - Centers for Disease Control and Prevention Lack of or delay in spoken language Repetitive use of language and/or motor mannerisms (e.g., hand-flapping, twirling objects) Little or no eye contact Lack of interest in peer relationships Lack of spontaneous or make-believe play Persistent fixation on parts of objects IDENTIFICATION OF AUTISM

10. Based on statistics from the U.S. Department of Education and other governmental agencies, autism is growing at a startling rate of 10-17% per year. • Forsyth County Special Education Data Forsyth County Schools R4 Dashboard – Student Profiles Demographics

11. http://www.cdc.gov/ncbddd/autism/index.html

12. Doctors don't know exactly what causes Autism, but it may be connected to differences in brainchemicals. Doctors usually diagnose autism at a young age, when a child is between 18 months to four years old. At this point there is no known cause or cure for autism. In 2000, the American Academy of Neurology, which was supported by the American Academy of Pediatrics, called for the routine screening of all children for autism. It is likely that both genetics and environment play a role. Possible Causes

13. We know that the once common belief that poor parenting practices cause ASDs is not true. There is some evidence that the critical period for developing ASDs occurs before birth. However, concerns about vaccines and infections have led researchers to consider risk factors before and after birth. To date, the studies continue to show that vaccines are not associated with ASDs. Possible Causes

14. The treatments tried are many and varied ranging from Applied Behavioral Analysis to Diet Therapy to Sensory Integration Therapy to Music Therapy to Medication. Treatment Approaches, from First Signs Autism Treatment Evaluation Checklist (ATEC), from the Autism Research Institute Treatments

15. Guidelines used by the Autism Society of America include the following questions parents can ask about potential treatments: • Will the treatment result in harm to my child? • How will failure of the treatment affect my child and family? • Has the treatment been validated scientifically? • Are there assessment procedures specified? • How will the treatment be integrated into my child’s current program? • Do not become so infatuated with a given treatment that functional curriculum, vocational life and social skills are ignored. GUIDELINES FOR TREATMENT

16. This program is for younger children with an autism spectrum disorder. It can be effective in some cases. ABA uses a one-on-one teaching approach that reinforces the practice of various skills. The goal is to get the child close to normal developmental functioning. • ABA programs are usually done in a child's home under the supervision of a behavioral psychologist. These programs can be very expensive and have not been widely adopted by school systems. Parents often must seek funding and staffing from other sources, which can be hard to find in many communities. Applied Behavior Analysis

17. The biomedical approach is not ‘alternative’ medicine; it’s a science-based, molecular-biological approach to treatment. Everyone agrees that psychotropic drugs do not treat the problem—they simply reduce or eliminate some of the symptoms. Our aim, in contrast, is to address the underlying health problems. The guiding principle is simple: remove what is causing harm, and add what is missing. Affected children often have an exaggerated response to toxins, foods, and airborne allergens. It is well documented that they often lack various nutrients, enzymes, anti-oxidants, and essential fatty acids, and that they require methylation support. (Less commonly, these health problems also occur in the non-autistic population; the medical approaches that are typically used are the same.) Diet Therapy or Biomedical Therapy

18. Many people with autism are also hypersensitive or under-sensitive to light, noise, and touch. Sensory integration therapy is essentially a form of occupational therapy, and it is generally offered by specially trained occupational therapists. It involves specific sensory activities (swinging, bouncing, brushing, and more) that are intended to help the patient regulate his or her sensory response. The outcome of these activities may be better focus, improved behavior, and even lowered anxiety. SensoryIntegrationTherapy

19. Research supports connections between speech and singing, rhythm and motor behavior, memory for song and memory for academic material, and overall ability of preferred music to enhance mood, attention, and behavior to optimize the student’s ability to learn and interact. Therefore, one of the purposes of music therapy for persons with autism is to provide the student with an initial assist using melodic and rhythmic strategies, followed by fading of musical cues to aid in generalization and transfer to other learning environments. OUTCOMES: *Increased attention *Improved behavior *Decreased self-stimulation *Enhanced auditory processing *Improved cognitive functioning *Decreased agitation *Increased socialization *Improved verbal skills *Successful & safe self-expression *Enhanced sensory-motor skills MusicTherapy

20. Medicines are often used to treat behavior or emotional problems that people with autism may have, including: Aggression Anxiety Attention problems Extreme compulsions that the child cannot stop Hyperactivity Impulsiveness Irritability Mood swings Outbursts Sleep difficulty Tantrums Medication

21. Different ways to accommodate students are: • amount of items, length of time required • extra support required • ways to present instruction • difficulty of work required • methods of showing mastery • type of participation • alternate assignments • substitution of the curriculum (Remember this as size, time, level of support, input, difficulty, output, participation, alternate, and substitute curriculum) Retrieved from the Autism Research Institute for Educators Teaching Strategies

22. Eligibility shall be based on assessment of the five characteristic areas associated with autism. The assessments shall minimally document that each of the characteristic areas of (1) developmental rates and sequences, (2) social interaction and participation and (3) verbal and non-verbal communication are significantly affected. The adverse effect on a student's educational performance shall be documented. SPECIAL Education eligibility & placement

23. Developmental rates and sequences. Social interaction and participation. Communication (verbal and/or nonverbal). Sensory processing. Repertoire of activities and interests. determination of deficits based on the following criteria:

24. Comprehensive psychological evaluation • Educational evaluation • Communication evaluation • Behavioral evaluations • Developmental history • A student may be diagnosed as a student with autism after age three if the characteristics of autism are met. evaluations and assessments utilized to determine the presence of autism

25. are often visual thinkers. • are usually good at drawing, art and computer programming. • may be sensitive to specific sounds. Try to muffle load sounds. • may have visual processing issues, getting on and off escalators or moving sidewalks would indicate this. • usually are seen as fussy or difficult. This is because generalization is difficult, teach each concept in many locations and in reference to many things. The child often uses small, non-relevant details to recognize objects. This may make a food or a bathroom unrecognizable and cause a temper tantrum. Autistic children…

26. Avoid florescent lighting, flicker causes problems. Use natural lighting or try Irlen colored glasses • Wearing a weighted vest, pressure is calming • Incorporate movement such as swinging or moving on a mat • Try music or whispering instead of speaking • Nonverbal children many be unable to process visual and auditory material at the same time, touch works well for older children • Place keyboard so it can be seen at the same time as the screen and the mouse can be difficult for some children to use • Flat panel TV and monitors may be easier to see because of reduced flickering • Allow child to type instead of write • Proximity of teacher/classroom seating • Stress ball • Notepad for questions and answers Accommodations in the classroom

27. Children with autism need to have a structured day, and teachers who know how to be firm but gentle. • Avoid many step instructions. • Sequencing is very difficult. Break every task into specific steps and teach each step. • Use fixations to motivate school work. • Use concrete visual methods to teach number concepts. • Hard consonants may be hard for the child to hear, listen for a child who uses primarily vowel sounds in speech. • Sticking to a clear schedule with as much forewarning of variances (such as field trips) as possible. What CAN TEACHERS DO?

28. Try varied methods for reading instruction ex: phonics, whole word • Flashcards with word and pictureon the same side • Photo is better than drawing • Closed captioning helps with reading • Use colored overlays for reading printed materials Reading

29. Children with autism have difficulty understanding social rules and interpreting the feelings and emotions of others. Physical space and/or contactwithothers may cause anxiety. • Actively teach social behaviors through role play and presentation. • Have clear consequences for inappropriate social behavior. • Rehearse social rules in different settings. • Reinforce the use of appropriate verbal or facial expressions of feelings and emotions. Socially

30. Solve any medical or sleep problems Increase supervision and structure Establish set daily care routines Have set places where activities always occur Establish a reward system Work on simple directions - following them everyday Increase your efforts to “catch them being good” Use picture schedules - if helpful Use of stop sign/universal no symbol Allow plenty of time (exercise patience) Pick your battles and follow through Increase consistency between care givers (work together) Be consistent and firm (not 100%) May need “down time” following school/daycare Have a set community outing each week that occurs just for “teaching” and practicing good behavior Discipline Strategies

31. Ignore/redirect Guided compliance (small steps) Time-out (use sparingly) It’s okay to say, “No” Give specific directions for compliance Teach an acceptable alternative behavior Reactive Strategies

32. Jason McElwainAutistic Basketball Player

33. Google Health – Autism https://health.google.com/health/ref/Autism National Institute of Neurological Disorders and Stroke – Autism Fact Sheet http://www.ninds.nih.gov/disorders/autism/detail_autism.htm CDC – Autism Spectrum Disorders http://www.cdc.gov/ncbddd/autism/index.html First Signs – Autism Spectrum Disorders http://www.firstsigns.org/delays_disorders/asd.htm Autism Society http://www.autism-society.org/site/PageServer Pinning Down Autism http://www.pinningdownautism.com/autism.html References

34. National Institute of Mental Health booklet on ASD http://www.nimh.nih.gov/health/publications/autism/nimhautis spectrum.pdf Autism Research Institute http://www.autism.com/index.asp American Music Therapy Association http://www.musictherapy.org/factsheets/bib_autism.pdf BrainPop http://www.brainpop.com/health Hallmark Milestones http://www.firstsigns.org/healthydev/milestones.htm Forsyth County Dashboard/Special Education Student Profiles http://r4dashboard.forsyth.k12.ga.us/html/StudProf_SpEd.html Autism Video links http://www.autismspeaks.org/video/index.php References continued