Autism Spectrum Disorder

1. Autism Spectrum Disorder

2. What is Autism? • https://www.youtube.com/watch?v=1sQsEwTNzpo

3. 0.7% Oregon 2nd highest in Nation 1 in 82 students, & increasing 0.8% U.S. Department of Education Autism Rates for children ages 6-17 (graphic from www.latimes.com)

4. Autism Spectrum Disorders • Autistic disorder, Asperger’s syndrome, childhood disintegrative disorder, & PDD-NOS • Deficits in the areas of • Social communication & social interaction • Restricted, repetitive patterns of behaviors, interests, or activities • Present in early childhood • Limit and impair everyday functioning (http://www.dsm5.org)

5. Autism Spectrum Disorders, cont’d • The autism spectrum encompasses a wide range of behaviors • Some have been coined “autistic behaviors” • E.g., “self-stimulatory” behavior • Assumes function • The utility of labeling behaviors in this manner is questionable • PBIS grounded in Applied Behavior Analysis (ABA) • Human behavior, regardless of a diagnosis still serve the same functions

6. Often a student with ASD experiencesthe world as chaotic, unpredictable and disadvantageous….. produces high anxiety not available to learn not able to respond appropriately

7. ASD & Challenging Behavior Changing Perspectives Challenging behaviors are not “part of autism” Challenging behaviors: 1) are maladaptive ways of responding to inadequacies in the environment; 2) occur due to lack of socially-adaptive skills for controlling environment Children with autism are at high risk for developing challenging behaviors due to difficulties with learning, communication, and perception

8. Young child w/ autism • http://www.youtube.com/watch?v=9w5nTegfToQ • Early signs of autism • http://www.youtube.com/watch?v=FuWWie1DlJY • Asperger’s: All Grown Up • http://www.youtube.com/watch?v=MaMa0pbxnIY&feature=em-share_video_user

9. Who are students with autism? • In many respects, they are just like everyone else---heterogeneous group of people • From every part of society • Every ethnic and racial group • All socioeconomic levels • All faiths

10. CONTINUUM OF SCHOOL-WIDE POSITIVE BEHAVIOR SUPPORT Tertiary Prevention: FBABSP for Students with High-Risk Behavior ~5% Secondary Prevention: Specialized Group Systems for Students with At-Risk Behavior ~15% Primary Prevention: School/Classroom- Wide Systems for All Students, Staff, & Settings DISCUSSION: What do you think Autism Spectrum Disorder has to do with the 3 Tier Continuum? ~80% of Students

11. SWPBIS & Autism • The goal of SWPBIS for students with ASD is to PREVENT and reduce the occurrence of challenging behaviors through the use of evidence based practices. (Neitzel, 2010) • Students with autism should move through the 3 tiers just as any other student • Do Not assume that all students with autism require intensive supports • DO anticipate skill deficits and FOCUS on PREVENTION

12. Supporting Students with Autism in a SWPBIS Framework: Tier I • Focused on system-wide practices that support all children and prevent the likelihood of challenging behaviors • For students with ASD, effective universal supports can help to mitigate the need for secondary or tertiary level supports

13. Challenging Behavior Intervention involves PREVENTING problem behaviors from developing or occurring by: Arranging the environment so that challenging behaviors are unnecessary (and desired behaviors are encouraged) Teaching skills needed to navigate and control social environment

14. Purpose • Why a session on ASD & PBIS? • Inclusion with typically developing peers is a key to long-term success • These experiences must be intentionally and systematically designed to ensure success (Odom & Wolery, 2003) • Evidence-based practices for students with ASD have been identified • Improvements need to be made on how to incorporate these interventions at the systems level • Tremendous variability in skill sets • What is appropriate for 1 student with ASD may be inappropriate for another

15. Evidenced-based Practices

16. Positive Supports • Visuals, structure and routines throughout the day and across all environments • Communication supports are needed for ALL students with ASD • Behavior is communication—what is the person communicating through their behavior? • Sensory and emotional regulation supports

17. Visual Supports • VISUAL SUPPORTS • Evidence-based practice supporting • SOCIAL, • COMMUNICATION • and BEHAVIOR • Short Written Words • Pictures • Photographs • Line drawings/Icons • Video models

18. Structure and Supports Caution - students with ASD are often very literal Example Non-Example Zip Your Lip Quiet Mouth Put Trash in the Green Can Good Citizens Pick Up

19. Morning Checklist My Morning Schedule

20. Seat Work Seat Work 1. Stay on task 2. Finish your work 3. Stay in seat until you have permission to be up 4. Quietly move to next work

21. Reinforcement for Seat Work • Contingent Activities Can be as simple as First, Then • Make sure it is a choice • Must be honored First Then Finish Work Read quietly

22. Tier 1 – Tips in teaching • Make it visual (short video clip & review) • Make it literal, model and practice • Teach in the natural environment • Increase the teaching, reminders and practice opportunities • Use posters, gestures to prompt visually, moving toward self-prompting • Individualize the reinforcement

23. Contingency Maps

26. ASD & Tier I: Environmental Modifications • Designing effective environments • Post daily classroom schedule • Increases predictability, can help support successful transitions across more/less preferred activities • Salient, eye level, consider adding visuals • Provide organized learning centers • Explicitly teach students how to transition in an organized fashion • Consider the order in which students are called • Have materials located in areas where they are typically used • Provide organizational supports to increase academic engagement and task completion (e.g., color-coded materials)

27. Communication • Communication skills must be explicitly taught and supported • If the student does not have the means to communicate what he wants and needs at that moment, he WILL often use Problem Behavior Reminder Card Raise Hand Talk when teacher responds Use # 2 voice Talk once then listen

28. Sensory/Biological • Breaks - depending on the needs of the student • Movement • Tasks that require moving

29. Added Benefit – You will find that LOTS of students will benefit, not just those with ASD Gould, 2012

30. Supporting Students with Autism in a SWPBIS Framework: Tier II • Secondary supports focus on preventing skill deficits or challenging behavior from becoming significant or chronic • Interventions should be: • Embedded in the general curriculum • Directly linked to school-wide expectations • Feasible for the general educator • Minimally invasive for student with ASD • Minimally disruptive to other students

31. ASD & Tier II: Skill Building Interventions • Small group interventions targeting specific skill deficits(direct, explicit instruction) • Behavioral expectations • Increased opportunities to physically practice the behavior and receive feedback across settings • Precorrection • Small group social skills, academic instruction, CICO • Peer-mediated interventions • Peer tutoring • Peer “buddy” for the day • Scripts • Play, social interaction, requesting help, etc. • Video modeling

32. ASD & Tier II: Environmental Modifications • Additional prompts • Increased opportunities for choice-making • Transition warnings • Precorrections • Visual cues/reminders • Advanced organizers • Highlighted text • Individual visual or written schedules • Increase predictability • Increase on-task behavior

33. Tier 2 Tips and Tweaks • Social Narratives including Social Stories TM • Video modeling • Self-regulation strategies

34. Working At The Computer I am in 10th grade. We have a computer in our room. Sometimes I get to watch other kids work on the computer. I like to watch kids working on the computer. Some kids ask me to work with them. Some kids like to work alone. I will try to let them work alone. I can work with them if they ask me to. Social StoryTM Sample: Carol Gray

37. Taylor and Her Fans by Cassie Jones Taylor Swift loves being a star, but sometimes it is difficult for her to be nice to everyone. At the end of a long day in the studio or after a concert, she is often tired and it is difficult for her to be nice to her fans and friends. Taylor has learned that it is important to smile at people she meets and say nice things to everyone, even when she is tired. She has learned that if she can’t say something nice, it is better to just smile and say nothing. She stops and thinks about comments she makes before she says anything. Just like Taylor, it is important for young people to think before they talk. It makes Taylor proud when preteens and teenagers remember to do the following: 1. Think before you say anything. Say it in your head first before you say it out loud. 2. If you can’t think of something nice to say, smile and don’t say anything. 3. You do not have to say every thought that you think out loud.

38. 1. Think before you say anything. Say it in your head first before you say it out loud. 2. If you can’t think of something nice to say, smile and don’t say anything. 3. You do not to say every thought that you think out loud.

40. Sensory/Biological • Teach replacement behaviors • Teach and maintain sensory regulation

41. CHECK OUT Buron, K. D. (2008). Check in poster. Shawnee Mission, KS: AAPC. www.asperger.net. Used with permission.

42. Stress Thermometer Stress Signals ___________ ___________ ___________ _________________________________ _________________________________ Relaxation Techniques ___________ ___________ ___________ _________________________________ _________________________________ 10 5 1

43. My Calming Sequence • Squeeze my hands • Three deep slow breaths • Close my eyes • Think happy thoughts Adapted from Buron, K.D. 2006 When My Worries Get Too Big

44. Coping Cards Take 2 deep breaths with your eyes closed Press your hands together and count to 10 slowly

45. Tier 2 Tips and Tweaks Peer-Based Support (can be academic or social) • Peers must be taught about unique communication and routines • Use Peers as social and behavior “interpreters” • Video-Modeling

46. Social Translator • Pair the student with ASD with a “Social Expert” • Observe areas and social situations that have caused misunderstandings or where non-desired behavior is occurring • “Social Expert” student acts as “social translator” to translate the situation and discuss options for more positive reaction and behavior

47. Visual and Video Modeling • ‘Visual models’ using real or • TV/video examples of social situations http://www.youtube.com/watch?v=zT6ITDwPi0w

48. Another thing - Generalization cannot be assumed Students with ASD often have trouble generalizing = = PE GYM New room = New activity Different font = Different word

49. Tertiary Supports • Intensive Positive Behavior Support Team • Conduct FBA • Use Person-Centered Planning • Design Function-Based Supports • Wraparound Interventions • Connecting Home, School, & Community Supports

50. ASD & Tier III: Preventive Strategies • Consider setting events • Alter the effectiveness of a consequence • Alter the frequency/probability of the behavior affected by the consequence • E.g., not eating breakfast, missing morning medication • Neutralizing routines • Use when you can reliably predict an increase in problem behavior • E.g., provide snack upon arrival to school, arrange with parent for student to take medication at school