Understanding and Living with ASD Prepared by the 2003-2004 Autism Team
Parenting children with autism spectrum disorders requires flexibility, creativity, and a willingness to change.
Autism is referred to as a spectrum disorder to signify similarities among a group of individuals who share a common diagnosis, but who differ in how core characteristics are manifested, and in the number and severity of specific characteristics.
Spectrum Disorder • Because of broad variability in: • Measured Cognitive Ability • Social-Emotional Development • Communication Ability • Motor Skills: Both Fine and Gross • Sensory Processing
Causes of Autism Spectrum Disorders • No Specific Known Cause • Neurobiological Disorder • Genetic Component • Perhaps Multiple Causal Factors • Subtypes Based on Predicted Time of Onset
Pervasive Developmental Disorders (PDD) • Autism • Pervasive Developmental Disorder Not Otherwise Specified • Asperger’s Syndrome • Rett’s Syndrome • Childhood Disintegrative Disorder
Autism • Characterized by difficulties in communication, social interaction, and imaginative play, and the presence of restricted interests and activities prior to the age of 3.
PDD NOS • Atypical autism presentations that do meet the criteria for Autistic Disorder because of late age at onset, atypical symptomatology or subthreshold symptomatology.
Asperger’s Syndrome • The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning. • There is no clinically significant general delay in language (e.g., single words by age 2 years, communicative phrases used by 3 years).
Rett’s Disorder • A genetic disorder, that only occurs in girls. • Normal development for the first 5 months. Head growth ceases between 5-48 months with loss of previously acquired skills. • Results in difficulties in expressive and receptive communication, poorly coordinated gait and trunk movements, and cognitive disabilities.
Childhood Disintegrative Disorder • Extremely rare. • Develop normally for at least the first 2 years and then display significant regression in communication, motor, and social interaction skills.
Characteristics of Children with Autism Spectrum Disorders • Social Difficulties • Expressive and Receptive Communication Difficulties • Restricted Repertoire • Additional Considerations • Sensory Processing Difficulties • Theory of Mind • Executive Functioning
Social Pragmatics Obsessive Interests Black/White Thinking Rigidity Sensory Attention Motivation Motor Executive Functioning Emotional Regulation Hidden Social Rules Areas of Difficulty Handwriting
Behavioral Characteristics • Obsessions/Rituals • Compulsive Mannerisms • Self-Stimulatory Behavior • Refusal • Withdrawal • Self-Injury/Abuse • Aggression
Sensory Processing Difficulties • Each of us have various sensory systems which process information and assist us in making sense of the world. • People with autism spectrum disorders have difficulty processing and using sensory input in a meaningful and relevant way. • Some individuals are over sensitive and others are under sensitive to sensory input.
Sensory Processing Difficulties • Visual • Auditory • Tactile • Vestibular • Olfactory • Gustatory (taste) • Proprioceptive
As a result of these sensory difficulties, individuals may experience sensory overloads and or meltdowns.
Unstructured times Bus Before/after school Transitions Lunch Physical education Sensory Crowds Space Noise Academic Understanding what to do & how to do it Breaking down tasks Writing Organization Social Novel Events Changes Common Stressors at School
Sensory food haircuts dentists medical clothing showers Completing routines getting ready for school doing homework chores Family activities Adjusting “their” agenda/interests with family plans Common Stressors at Home
Lower Expectations • Temporarily, be flexible • This is not the time to teach new skills! • Adreon & Gitlitz, 1998
Increase Environmental Supports • Make the environment as predictable as possible • Provide consistency • Prepare the individual for any unavoidable changes • If a change is unavoidable, further reduce expectations/demands following the change • Adreon & Gitlitz, 1998
Remove/Reduce Stressors • Remove/decrease disliked activities • Remove/decrease difficult activities • Simplify work • Reduce writing assignments • Simplify all tasks involving organizing, planning & sequencing • Eliminate discussions on feelings • Adreon & Gitlitz, 1998
1. Operate on “Their Time” • Twice as Much Time, Half as Much Done = A Successful Day • Avoid Rushing!
2. Balance the Agenda • Assess the demands for the student when planning the schedule. • Incorporate a balance of LOW-STRESS, HIGH-PLEASURE activities for the individual. • Include “stress-free” time in the schedule.
Balance the Agenda (con’t) • Conserve energy • Assess the upcoming demands on the student for the day. • Remove any stressful tasks/activities that are not essential. • Do not remove tasks that the student enjoys.
3. Manage the Environment • Provide consistency in the environment. • Avoid sudden changes. • Adapt the environment when there are changes.
4. Set the Tone • Speak in a calm, relaxed voice. • Give facts in an unemotional tone of voice. • Model positive acceptance.
5. Share the Agenda • Live Out Loud • Let the student know the sequence of upcoming events. • Provide information about time periods.
Arrange schedules from top to bottom or left to right - allow way to check off or remove task when done
6. Simplify Language • Keep your language concise and simple. • Tell the student specifically what to do. • Break down tasks into components.
Giving the child checklists is particularly helpful when they has to complete short series of related activities or when they need to organize a group of materials. For a chore at home they might need a checklist for completing the steps necessary to clean their room.
7. Manage Change of Plans Field Trip to Science Museum Cancelled • Handle changes PROACTIVELY! • Incorporate “back-up” plans for which you can control the variables.
8. Provide Reassurance • The student with AS NEVER KNOWS WHAT IS COMING NEXT! • Reassure the child about the sequence of events. • Utilize “check-ins”
9. Be Generous with Praise • Find opportunities to build-up/compliment the student. Thanks for asking! Thanks for holding the door open!
Access to preferred peers/adults Allow individual work Schedule for activities individual enjoys computer reading drawing Adreon & Gitlitz, 1998 10. Increase Opportunities to Engage in Activities of High Interests and/or Strengths
11. Listen to the WORDS • Words convey the meaning for children with AS. • Listen to what the child is saying. • Interpret what the child is saying literally! • “Probe” for further information • Encourage clarification
Students might also be able to communicate more effectively if given some structure to help talk about their day.
12. Recognize “Teachable Moments” • Orchestrate positive exchanges • Provide direct feedback • Capitalize on your child’s strengths/interests! Ooops!
13. Be Realistic! • You’re only human! • Do the best you can! • Be patient with yourself! • Remember, the child is doing the best he/she can!
14. Increase Social Supports • Utilize Your Community • Increase Reassurance • Increase Clarity of Feedback • Increase Access to People They Like • Protect from Teasing/Bullying • Schedule “Support Talk” • D. Adreon, 1998
15. Set up System for Monitoring • Often difficult to recognize signs of stress & anxiety • Need to carefully monitor how the student is doing in various social situations (through observation/interviews) • Carefully monitor whether schoolwork is being completed and turned it • DON’T LET PROBLEMS BUILD UP!
Stabilization Strategies The goal is to help the individual survive each day successfully • Lower expectations • Do not teach new tasks at this time • Increase supports • Reduce stressors
Five Steps to Remember to Help Stabilize when Problems Occur • Gather information from a number of sources to assess the student’s emotional state. • Determine the stressors that exist in the environment. • Decrease the stressors by modifying the requirement for disliked and/or difficult tasks and temporarily eliminating any emphasis on teaching new skills (con’t)
Stabilization (con’t) • Make the environment more predictable and increase the use of home base. • Balance stressors and learning.
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