Part I - Autism Spectrum Disorder Part II - Tyler – Case Study #3

1. Part I - Autism Spectrum Disorder Part II - Tyler – Case Study #3 Suzanne Stear EDEX 650 SSI June 29, 2011

2. Part I - Definition Autism Spectrum Disorder is defined by the Autism Society of America (ASA) as: A complex developmental disability that typically appears during the first 3 years of life and is the result of a neurological disorder that affects the normal functioning of the brain, impacting development in the areas of social interaction and communication skills. Both children and adults with autism typically show difficulties in verbal and non-verbal communication, social interactions, and leisure or play activities.

3. Range of Symptoms The variability range is from mild to severe and is demonstrated in combination with the intellectual capability of the individual that helps define their strengths and weaknesses in the areas of: • Hyperactivity • Short attention spans • Impulsiveness • Aggressiveness • Self-injury behavior

4. Statistics • 1 in 110 births result in some form of Autism • Autism is 4 times more likely to occur in boys than girls • Despite their deficits persons with autism can lead productive lives

5. PDD/Statistics • Autism is one of five disorders that falls under the umbrella of Pervasive Developmental Disorders (PDD), a category of neurological disorders characterized by “severe and pervasive impairment in several areas of development” • Autism is the fastest growing developmental disability – more common than Down Syndrome

6. Other Types of Autism • Asperger's Disorder – • Language barriers • General very intelligent • Struggle with social interactions • Fixate on a certain object or subject • Retts Disorder – • Similar to Autism - only occur in girls • They develop on target, but then begin losing some communication abilities • Symptoms of Retts begin to occur between ages 1 and 4

7. Characteristics • No fear of danger • Over or under sensitivity to pain • May avoid eye contact • May prefer to be by him/herself • Has difficulty expressing what they want or need - may then try to use gestures • May echo words or phrases • May have inappropriate attachments to objects • May spin his/herself or objects • Prolonged repetitive play • May insist on things/routines always being the same • May exhibit inappropriate laughing (laughing when not appropriate to the situation) • May display tantrums for no apparent reason • May avoid cuddling • May exhibit self injurious behavior when upset i.e. biting self or banging head • An overall difficulty interacting with others

8. Determining Symptoms • Consult with the child’s Doctor • Consult with a Psychologist or a Speech Therapist • They have specific training in Autism and other developmental disorders and will have a better understanding of Autism and how to treat it.

9. Possible Causes of Autism • Research indicates that the cause of Autism is likely biological, but this may not be the only cause • Autism tends to run in families, pointing to a possible genetic cause • Autopsies of the brain have shown deficits in various parts of the brain (i.e. cerebellum, frontal lobes, brain stem) • Scientists have also found abnormal levels of neurotransmitters in the brain, such as Serotonin

10. Appropriate Intervention • Accurate diagnosis is important in order for a person to receive appropriate intervention and gain access to special educational services • Intervention must be customized for each student - taking into consideration: • Developmental status, behavior, and psychosocial needs • Cognitive and functioning levels of mild, moderate, or severe Autism • 10% of persons with Autism have special skills in Math, Reading, and Art

11. Instructional Approaches Applied Behavior Analysis (ABA) – * It is an intensive, structured teaching program that uses a variety of behavior modification techniques – it can be used for all students, not just Autistic students * Considered the most popular method for instructing and managing Autistic students * Learning is shaped by reinforcement * Helps to improve cognitive, social, and language skills

12. Early Intervention Individual Family Service Plan (IFSP) – • Needs of social skills • Functional skills – (dressing, toilet training, self feeding, communication, and behavior) • No one program is applicable to all students with Autism • Strengths and needs of each child must be considered per individual

13. Considerations of Instruction in the Classroom 1. Ensure that the student is in good health, free from pain and irritation, and in a safe, stimulating and pleasurable setting. 2. Provide clear guidelines regarding expectations for appropriate and inappropriate behavior. 3. Provide tools, such as written or picture schedules, to ensure that the flow of activities. 4. Base the curriculum on the student's needs, not on the label of autism. 5. Focus on developing skills for their future life in school, home, and community. 6. Carefully plan transitions to new placements in school. 7. Encourage parents and other family members to participate in the educational process (teaching life skills).

14. Part II Tyler with Autism – Case Study #3

15. Birth through the first year • Language/Communication and Social development there are some concerns – • He only vocalized “eee” sounds • Did not point to objects • Many times cried and screamed to have needs met • Resisted with assertiveness at times

16. Investigation of concerns • Talked with Pediatrician and researched about: • Language develop for his age • Assertiveness in resisting requests • Strategies: • Attend a daycare to interact with other children his age • Use flash cards/pictures to encourage speech • Continue to read, talk, sing • Teach signs and use gestures

17. 24 – 30 Months of Age Characteristics: • Scans pages of a book for hours • Sits quietly and loves music • Often screams to have his needs met • Loud sounds send him into a screaming fit (car horn, bells, keys clanging, and construction) • Does not like to make eye contact • Likes to spin himself and spin objects • Developing some language skills

18. 24 – 30 Months of Age Concerns: • Very concerned about Tyler not meeting milestones at his age in speech • Socially feel that something is wrong with certain behaviors but cannot pin point the situation • An free evaluation was set up with an Early Intervention Specialist (EIS)

19. Pre-School Years Diagnosis: The Early Intervention Agency evaluates and diagnosis Tyler with Autism. The Speech Therapist confirm Tyler’s language and social skills are delayed. They recommend pre-school to help with speech/language therapy and increase his social skills. Research/Discovery - Found a church-run preschool that would work with Tyler and his needs – nurturing, patient, and kind environment that was accepting of Tyler’s disability.

20. Pre-School Years • During Pre-school years – Tyler’s interest in others increased • Vocabulary increased – but still has difficulty expressing what he wants and needs – no spontaneous speech • Continued to have terrible tantrums when routines or schedules changed

21. Pre-School Years Behavior decisions at this age with tantrums: • Use of a timer • Try to calm him down • Try to redirect to a different task • Informing that tantrums are not acceptable • Withhold privileges from him just as a typical child • Reward for good behavior and engaging in activities with others

22. Additional Information concerning communication/language skills • 25% of all children with Autism may never develop verbal language skills • The goal may be to acquire gesture communication, such as sign language or the use of a symbol system with pictures to convey thoughts • Symbol systems can range from picture boards or cards to electronic devices that generate speech through buttons

23. Voice Output Communication Aids

24. High Tech Augmentative or Alternative Communication Aid

25. Elementary School Years • Meeting is arranged at Tyler’s Elementary School to discuss his needs • School suggested to see a Developmental Pediatrician • Kindergarten was challenging – • The teacher had a difficult time with Tyler’s behavior • Upset when routines changed • Would talk out often in class and run around the room – would not comply when asked to stop

26. Elementary School Years • First Grade – • IEP was developed • Second Grade – • Same behaviors continued to occur • School suggested to place Tyler in a more structured environment to receive intense instruction • Decisions: • Overwhelmed as a parent with all the decisions • Desire to keep Tyler in the regular classroom as much as possible – due to improved social skills with classmates and improved language skills

27. Elementary School Years • Third and Fourth Grade – • Tyler was placed in a more structured environment to establish following rules/routines, and taking turns • Inclusion was used as much as possible • Reading and Math still produced meltdowns • Language improved but from a narrow perspective • Fifth Grade – • Social awkwardness and emotional delays took a toll

28. Middle School/Adolescence • Strengths – • Learned to change classes and understand multiple instruction styles from teachers • Loves to read and has become an expert in anything about the Solar System • Difficulties – • Teased when flapping hands when anxious • Easily victimized to say inappropriate things to others • Struggles with understanding and expressing emotions

29. Future Concern/Challenges • Can Tyler acquire the skills he needs to have a job and be on his own someday or intermittent support on an as needed basis • Can Tyler be employed someday with the help of community support groups for employment • Continue to provide the best quality of life with learning so that Tyler does not regress • Future living arrangements when we’re elderly

30. References http://www.definitionofautism.com/ Gargiulo, Richard M. (2012). Special Education in Contemporary Society. Chapter 9 http://www.ericdigests.org/2000-3/autism.htm http://www.eiskids.com/services/htm. Early Intervention website http://www.webanswers.com/relationships/parenting-kids

31. References http://www.youtube.com/watch?v=vVVD63KgY3U&feature=mfu_in_order&list=UL http://www.youtube.com/watch?v=xsoasg1Rlmc