Ms. Vanessa Lewis | Clinical Psychologist | LD Clinic | KEM Hospital

1. Understanding & Dealing With Autism •••••••••••••••••••••••••••••••••• Ms. Vanessa Lewis |Clinical Psychologist |LD Clinic |KEM Hospital

2. Autism Assessment (CARS2) • Standard Version Rating Booklet (CARS2-ST) Equivalent to the original CARS; for use with individuals younger than 6 years of age and those with communication difficulties or below-average estimated IQs. • High-Functioning Version Rating Booklet (CARS2-HF) An alternative for assessing verbally fluent individuals, 6 years of age and older, with IQ scores above 80. • Questionnaire for Parents or Caregivers (CARS2-QPC) An unscored scale that gathers information for use in making CARS2-ST and CARS2-HF ratings.

3. CARS2 Standard & High Functioning Forms CARS2-ST and CARS2-HF each include 15 items addressing the following functional areas: • Relating to People. • Imitation (ST); Social-Emotional Understanding (HF). • Emotional Response (ST); Emotional Expression and Regulation of Emotions (HF). • Body Use. • Object Use (ST); Object Use in Play (HF). • Adaptation to Change (ST); Adaptation to Change/Restricted Interests (HF). • Visual Response. • Listening Response.

4. CARS2 Standard & High Functioning Forms • Taste, Smell, and Touch Response and Use. • Fear or Nervousness (ST); Fear or Anxiety (HF). • Verbal Communication. • Nonverbal Communication. • Activity Level (ST); Thinking/Cognitive Integration Skills (HF). • Level and Consistency of Intellectual Response. • General Impressions.

5. Classroom Strategies Talking to a child with autism: • Attention: make sure you get the child’s attention before talking to them. • Unnecessary Language: be short and to the point (For example, instead of saying, You need to come and sit in your seat like all the other children until it’s time to go outside,” point to the chair and say, “Sit please.” • Do vs. Don’t: Tell the child what you want him/her to do instead of what not to do. Avoid using don’t because a child with autism may not understand or catch the reversed meaning of the statement beginning with don’t. (Crissey, 2005, p. 3)

6. Classroom Strategies • Visual Schedules. • Social Stories. • Comic Strip Conversations/Cartooning. • Power Cards.

7. Visual Schedules Providing a daily schedule in a visual format will make the day predictable, ease transitions, and reduce stress. • full day, may break the day into sections, or display only a part of the day at a time. • may use photos, line drawings, picture symbols or words. (Crissey, 2005, p. 3).

8. Visual Schedules Art Class Bathroom Spelling Lunch Recess Reading Activity Computer Lab Math

9. Social Stories Social Stories present appropriate social behaviour in the form of a book and include: • relevant social cues that a child might miss if not directly taught. • specific behaviours/actions the child is to expect in a given situation. • details for the child to know what is expected of him. Social stories may be used to: • address many different behaviours from fear, aggression, obsession, etc. • teach routines and changes in routines. • help teach students to understand their behaviours and the behaviours of others. • give step-by-step directions for completing a task. • tell how to respond to a given situation.

10. Comic Strip Conversations/Cartooning Comic Strip Conversations (aka: Cartooning) are visual systems used to enhance the ability of children and youth with social-cognitive challenges to understand their environment, including the hidden curriculum. Steps for creating/using comic strip conversations: • Drawing: Begin by drawing the drawing the comic strip conversation. This can be done by you or the student. Either way, artistic ability is not required; stick figures work fine.

11. Comic Strip Conversations/Cartooning Steps for creating/using comic strip conversations: • Guide with questions: The adult guides the student’s drawing or what needs to be drawn by asking a series of questions: • Where are you? • Who else is there? • What did you do? • What did others do? (Myles, Trautman, & Schelvan, 2004, p. 28-29)

12. Comic Strip Conversations (Example)

13. Power Cards The power card strategy is a visual aid that incorporates the child’s special interest in teaching appropriate social interactions including: • routines. • behaviour expectations. • the meaning of language. The Power Card Strategy consists of presenting on a single sheet or in booklet form a short scenario, written in the first person, describing how the child’s hero solves a problem and a small card, the POWER CARD, which recaps how the child can use the same strategy to solve a similar problem himself. (Gagnon, 2001, p. 19)

14. Where Can the Power Card Strategy Be Used? Power Cards are appropriate for behaviour's/situations in which the student: • lacks understanding of what she/he is to do. • does not understand that he has choices. • has difficulty understanding that there is a cause-and-effect relationship between a specific behaviour and its consequence. • has difficulty remembering what to do without a prompt. • does not understand the perspective of others. • knows what to do when calm but cannot follow a give routine under stress. • needs a visual reminder to recall the behavioural expectation for the situation. • has difficulty generalizing. • is difficult to motivate and may be motivated only by the special interest. • has difficulty accepting directions from an adult.

15. Power Cards (Example) Student Description: Arun has been acting out in class and seeking attention from his peers by saying or blurting out inappropriate comments in class. He likes the attention he gets from his peers for doing this and he thinks he’s being accepted when his peers laugh at him for doing this. Arun’s special interest is in cars and he especially likes racing car driver, Michael Schumacher. Power Card Story: “Michael Schumacher and His Fans” Michael Schumacher loves being a race car driver, but sometimes it is difficult for him to think before he speaks. At the end of a long day sometimes all he wants to do is make others laugh. Sometimes Michael blurts things out when his boss is talking. But Michael has learned to think before he speaks.

16. Power Cards (Example) Michael has learned it is important not to talk when his boss is talking and not to say things to try and make others laugh when his boss is trying to talk to his pit crew and teach them the latest racing rules and regulations. Michael has learned to stop and think about the comments he makes before speaking. Just like Michael, it is important for Arun to think before he speaks. It would make Michael proud to know that Arun is like him and that he thinks before he speaks and doesn’t interrupt his teachers in class. It is important for Arun to remember to do the following: • Think before he speaks. Say it in your head first before saying it out loud. If it’s not related to what the teacher is teaching then Arun shouldn’t say out loud in class. • If Arun can’t think of something to say about the teacher’s lesson, it’s better for him not to say anything at all. • Always follow the classroom rules and raise your hand before you speak.

17. Power Cards (Example) 1. Think before he speaks. Say it in your head first before saying it out loud. If it’s not related to what the teacher is teaching then Arun shouldn’t say out loud in class. 2. If Arun can’t think of something to say about the teacher’s lesson, it’s better for him not to say anything at all. 3. Always follow the classroom rules and raise your hand before you speak.

18. How to Handle a Meltdown Don’t: • Loud voices. • Negative statements/threats (e.g. “You had your chance”, “You made your choice, now you need to leave class”). • Taking away preferred or comforting materials or activities. • Angry tone or body language. • Punishments (e.g., “You just lost your sticker on your behaviour chart).

19. How to Handle a Meltdown Do: One of the most important skills a teacher can have is the ability to be clam and comforting in a crisis or “meltdown” situation. A comforting teacher may: • talk softly and share encouraging words. • repeat a calming phrase. • or simply keep one’s own body relaxed. (Kluth) “The more you try to control the situation, the less control you will have!”

20. Things to Consider It’s important to consider the following things: • Fight or Flight. • Ask previous teachers and/or parents what typically occurs when the child has a meltdown (does he/she throw things, hit, kick, etc.). • Find out if there are triggers or warning signs that a meltdown might occur and if so what are those triggers or warning signs. • Talk with teachers, parents, administrators, etc. and discuss the best way to de-escalate the situation. • Determine when you should call for additional support.

21. Questions?

22. Thank you for your attention! •••••••••••••••••••••••••••••••••• Ms. Vanessa Lewis |Clinical Psychologist |LD Clinic |KEM Hospital