Including Students with ASD

1. Including Students with ASD TCHE2610 – Issues in Special Education Course Coordinator – Dr Anna Bortoli

2. An Introduction to Autism Early Development The Culture of Autism The diagnosis and what is involved

3. 10 Tips to Understanding Students on the Spectrum (Bortoli & Enright, 2009) • ASD students don't have to look at you all the time. Reason: They find looking and listening at the same time confusing. • Give them time to answer any of your questions. Reason: They have slower processing time. Sometimes it can take them up to a minute to formulate the answer in the correct sequence. • If they feel pressured they will answer with ‘standard’ answers. Reason: They know it will get them out of trouble quickly. This may include: "I don't know", "yes“ and "maybe“. Often this isn't their true answer! • They often don't "generalise" information between people and places. Reason: Their rigidity in thought and need for consistency. • They find organisation of their school equipment very difficult. Reason: They are best with one folder with everything inside. Limit the number of pencils, pens etc.

4. Limit their choices and be very specific with choices. Reason: They find choices overwhelming and are often concerned with making wrong the choice due to their difficulty with problem solving. • Be as clear, concise and concrete as possible. Reason: People with ASD have difficulty with abstract thinking. • Avoid verbal overload. Reason: They are visual learners and verbal information takes them longer to process and retain. • Avoid verbal arguments by redirecting them to what they should be doing. E.g. "Start your work". Reason: They often enjoy verbal arguments. • Students on the spectrum need positive feedback to know they are on the right track. Reason: Because of their fear of failure, and it takes longer to undo mistakes

5. Triad of Impairments Dyad of Impairments

6. DSM-V Criteria • Clinically significant, persistent deficits in social communication and interactions. • Deficits in social-emotional reciprocity (i.e.: failure to initiate or respond to social interactions) • Deficits in nonverbal and verbal communication used for social interaction; • Deficits in developing, maintaining and understanding relationships Two of: • Restricted, repetitive patterns of behavior, interests, and activities • Stereotyped or repetitive motor movements, use of objects, or speech • Insistence of sameness, inflexible adherence to routines and ritualized patterns of verbal or non-verbal behavior • Highly restricted, fixated interests of abnormal intensity or focus • Hypo- or hyper-reactivity to sensory stimuli, or unusual sensory behaviors

7. Video: Early Signs of Autism Early Red Flags • A lack of joint attention, imitation, pretend play and interest in and play with peers are four developmental milestones that might be critical early signs of autism or other developmental delays • Joint attention • refers to nonverbal behaviours we use to request, comment show or share affect. Joint attention is both communicative and social; we use joint attention to share attention to an object, event or person • Imitation • Vocal and motor imitation are important early social communication skills and mechanisms for learning. Infants begin imitating their caregivers’ vocalisations and motor actions with objects • Pretend play • During the toddler years, children spend less time manipulating and exploring toys and more time functionally using toys. Infants might mouth, shake or look at objects, toddlers will begin to use objects as they are meant to be used, eventually children will start using toys or objects as if they were something else this type of play is referred to as symbolic or pretend play • Interest in peers • By 24 months children begin to show increasing interest in playing alongside their peers with similar toys. For example, toddlers might be playing with the same train set, pushing trains along the track and occasionally looking at what their peer is doing. Conversely, the child with autism might be playing with one train, spinning the wheels and rarely glancing at others near them (Barton and Harn, 2012)

8. Culture of Autism(Pittman, 2008) • Autism is a neurological developmental disability which affects the way the student interacts with their world and managing essential daily living and social skills • Mesibov et al. (2004) uses the term “culture” as the predictable patterns of thinking and behavior are unique to this group, but these core characteristics manifest differently with each individual • There is a saying: YOU’VE SEEN ONE PERSON WITH ASD, YOU’VE SEEN ONE PERSON WITH ASD

9. Uneven Learning Profile/Splintered Development • Students with ASD sometimes present with a splintered learning profile, being able to function in some areas higher than their overall level of functioning • This means that they may be massively skilled in one or several small parts of their life, but may have massive skills gaps in other areas. • In some instances the area of strength may be limited in how it is used and often cannot be applied functionally • For example a 7 year old student may be able to read material that is several levels above their age group, but comprehension skills are significantly below or: • An adolescent may be able to calculate complex equations, but is unable to work out change while shopping with his parents

10. An example of an Uneven Profile Knowledgeable about white goods Knows which stores sells certain models Knows operating system of white goods Difficulty talking to people Struggles with personal hygiene Can’t budget his pocket money

11. Difficulty generalizing skills and knowledge There is a tendency to become prompt dependent Many display “stimulus over-selectivity” Difficulty relating appropriately to others Present with a wide range of language and communication disorders and peculiarities Difficulty following and mastering an unmodified curriculum Insistence on sameness Interpret things literally Atypical and difficult-to-understand behaviour Irregular patterns of development Difficulty attending to relevant and multiple cues Receptive and expressive language can be problematic Impairment in social cognition Like predictability and routine Working memory is affected Poor planners and organisers Strengths in rote memory and recall, but difficulty with encoding Major strength is in the visuospatial areas, so they are primarily visual learners Strong rule followers Presentation in the school environment

12. Social interaction style 1. They often have difficulty establishing relationships 2. Difficulty in reciprocal social interaction 3. There is often an impairment in the ability to read, understand and respond to social situations. This is characterised by: - Attending to relevant social situations - In ability to process and interpret non-verbal communication - An impairment in the use of non-verbal behaviours and gestures to regulate social interaction 4. They are impaired in those interactions that require knowledge of other people 5. There is a tendency to play with toys and objects in unusual ways 6. Some may engage in excessive or inappropriate laughing or giggling 7. Their play may lack imaginative qualities 8. The quality and quantity of play of social interaction is on a continuum (Aloof, Passive, Active) 9. Preference for solitude as socialising is mentally and emotionally exhausting Implications for instruction: • Social skill development is an essential curricular area for students with autism. • Students with autism do not learn and acquire social skills incidentally by observation. • It is generally necessary to target specific skills and provide explicit instruction.

13. Think about these… • If a student does not like people praising him because of the eye contact and interaction involved, try saying to other people how well he/she is working • Use visual ways to help them express their feelings • Match mentors/friends who understand their idiosyncracies • 10 minutes of socialising needs 10 minutes of solitude • A good way of socialising can be helping people complete tasks e.g. gardening • Ask permission to hug first and the type of hug

14. Impairment in nonverbal communication Delay in or lack of expressive language skills May display differences in pitch, intonation, rate, rhythm or stress Speech may also include repetitive and idiosyncratic language Echolalia is common (delayed or immediate) May have a restricted vocabulary that is dominated by nouns and communicative functions There is a tendency to perseverate on a topic Difficulty with pragmatics Inability to extract social information from a social context Difficulty in the comprehension of verbal information, following long verbal instructions and remembering a sequence of instructions Implications for instruction: A comprehensive assessment by a speech pathologist is essential The assessment will assist in the identification of goals, objectives and strategies for facilitating development It is important to create opportunities and to teach in context Recognize the learning style and program accordingly Provide activities which promote social communication development Communication style

15. Think about these… • Always use the name of the student and give clear precise instructions • If repeating a specific and well constructed instruction, try using the same words again rather than rewording it • As students with autism have difficulties processing questions and formulating their reply, try to reduce questions and instead use statements. For example, “What is the man doing in the picture? V The man in the picture is …… and pause for a reply • Use of certain words/mannerisms are code for early stages of stress (Pittman, 2008)

16. A restricted range of interests with a preoccupation with one area Inflexible Stereotypic and repetitive mannerisms Preoccupation with parts of objects A fascination with movement An insistence on sameness and resistance to change Unusual responses to sensory stimuli Problems are related to stress and anxiety Triggered by environmental stressors Stress may manifest as withdrawal, reliance on special interests, inattention, hyperactivity, aggressive behaviour Implications for Instruction: May be due to other factors such as their hyper/hypo sensitivities Teach to manage their repetitive mannerisms Consider environmentaland curriculum adaptations Increase use of visual strategies Behaviour & Interests

17. Everyday is a stressful day..…. You might observe some of the following: • The student having special interests and/or objects. Often referred to as their obsessions • Phobias • Sensory driven memories • Difficulty with transition • Fear of the unknown, try using calendars, diaries, schedules • The need for a sanctuary to be a haven from socialising • Solitude is the need to be alone, not being lonely • Repetitive questions • Sign of stress, way of coping, maintaining an interaction, reassurance and their way of predicting the answer • The degree of stress is often proportional to the number of people around them

18. Sensory Processing and Learning • Sensory processing impacts on the manner which the individual reacts to the world, and on how they take in, process and learn from information within their environment (Machin, 2003) • Sensation, that is what we see, hear, feel, smell and taste gives us information about the environment around us and ourselves. Our interpretation of the world is individual, and so we all react differently (Smith-Myles et al. 2000) • Many individuals with ASD do not remember verbally but sensorially (Willey, 1999) • Memories of sensory experiences may evoke physiological responses • Sensorial memory is not an efficient carrier of all information particularly that which requires interpretation • The brain-behaviour connection is very strong. Because the child with Sensory Processing Disorder has a disorganised brain, many aspects of their behaviour is disorganised. Their overall development is disorderly and their participation in childhood experiences is spotty, reluctant or inept. For the out-of-sync child, performing ordinary tasks and responding to everyday events can be enormously challenging (Kranowitz, 2005) For the out-of-sync child their central nervous system is wired differently to most typically developing children. As a result how their senses respond to the environment will often be atypical

19. Video: Marion Joiner, Living with Autism Near & Far Senses (Smith-Myles et al., 2000)

20. Neurological Threshold Continuum (Smith-Myles et al., 2000) HIGH LOW

21. “Learning how each individual autistic person’s senses function is one crucial key to understanding that person”(O’Neill in Bogdashina, 2004) • An Occupational Therapist can assess the student in order to establish a sensory profile and then to develop a sensory diet • The aim is to reduce stress and anxiety in the classroom • To support their learning and to bring a sense of order and organisation, it will be helpful to arrange the environmental variables to as act as cognitive organisers (Scheuermann & Webber, 2002) • It is recommended to construct a visually organised room, that is free from clutter and that it will communicate learning and behavioural expectations • Structure in the classroom together with knowledge of the student’s sensory needs will make for a better learning during the day • Differentiate the environment and the curriculum knowing the student’s sensory profile

22. Document and Share your Knowledge about the Student with ASD This Photo by Unknown Author is licensed under CC BY-NC-ND