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Autism, Education & Behavior Consulting Austin, Texas 2015 Supporting Students with Autism Spectrum Disorder

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WHO ARE YOU? Find Your Hobby Partners Name Experience youve had with autism in your professional, volunteer or personal lives

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Learning Objectives Participants will: Identify the areas of impairment associated with ASD Identify 3 learning characteristics of children with ASD Use the information about learning characteristics to identify how the participant will work, interact and advocate for students with ASD

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TODAYS AGENDA Autism Diagnosis Characteristics Strategies, Curriculum and Materials Family/Child in Crisis Additional Resources

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It is sometimes said that if you know one person with autism, you know one person with autism.

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What is ASD? Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013) Autism spectrum disorder (ASD) and autism are both general terms for a group of complex disorders of brain development Neurodevelopmental Disorder A diagnosis of ASD now includes several conditions that used to be diagnosed separately: autistic disorder, pervasive developmental disorder not otherwise specified (PDD-NOS), and Asperger syndrome. THESE CONDITIONS ARE NOW ALL CALLED AUTISM SPECTRUM DISORDER.

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DIAGNOSIS No medical test Doctors look at the childs behavior and development to make a diagnosis ASD can sometimes be detected at 18 months or younger By age 2, a diagnosis by an experienced professional can be considered very reliable Many do not receive a final diagnosis until much older https://www.youtube.com/watch?v=qb_pX7n3ZRI Early Signs @ 24 months 1.23 minutes

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DIAGNOSIS The diagnosis of autism spectrum disorder is based on analysis of Social communication & social interaction Restricted, repetitive patterns of behavior, interests, or activities Severity of symptoms

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DIAGNOSIS A.Persistent deficits in social communication & social interaction across contexts not accounted for by general developmental delays; 3/3 symptoms A1Deficits in social-emotional reciprocity A2Deficits in nonverbal communicative behaviors used for social interaction A3Deficits in developing, maintaining & understanding relationships B.Deficits in restricted, repetitive patterns of behavior, interests, or activities; 2/4 symptoms B1Stereotyped or repetitive speech, motor movements or use of objects B2Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change B3Highly restricted, fixated interests that are abnormal in intensity or focus B4Hyper or hypo-reactivity to sensory input or unusual interest in sensory aspects of the environment See Dr. Laura Carpenter, Ph.D. 2/2013 Handout, DSM-5 Autism Spectrum Disorder

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DIAGNOSIS Symptoms can be currently present or reported in past history In addition to the diagnosis, each person evaluated will also be described in terms of any known genetic cause (e.g. Fragile X syndrome, Rett syndrome) level of language intellectual disability presence of medical conditions such as seizures, anxiety, depression and/or gastrointestinal (GI) problems

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DIAGNOSIS-DSM-5 NEW CATEGORY Social Communication Disorder (SCD) Diagnosis for disabilities in social communication, without the presence of repetitive behavior More research and information is needed There are currently few guidelines for the treatment of SCD Utilize autism-specific interventions

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WHO PROVIDES DIAGNOSIS? Developmental Pediatrician Neurologist Psychiatrist Team of Specialists (audiologist, speech & language therapist occupational therapist) A Multi-Disciplinary Evaluation is important for diagnosing autism and other challenges that often accompany autism, such as delays in motor skills. DID YOU KNOW The co-occurrence of one or more non-ASD developmental diagnoses is 83%. The co-occurrence of one or more psychiatric diagnoses is 10% DID YOU KNOW The co-occurrence of one or more non-ASD developmental diagnoses is 83%. The co-occurrence of one or more psychiatric diagnoses is 10%

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PREVALENCE Centers for Disease Control (CDC) In March 2014, the Centers for Disease Control and Prevention issued their ADDM autism prevalence reportADDM autism prevalence report Prevalence of autism: 1 in every 68 births in the United States nearly twice as great as the 2004 rate of 1 in 125 Almost 1 in 42 Boys 1 in 189 Girls

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http://www.cdc.gov/ncbddd/autism/data.html

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PREVALENCE Autism Speaks, 2012 No longer a low incidence disability Almost half (46%) of children identified with ASD have average to above average intellectual ability.

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Causes and Risk Factors We do not know all of the causes of ASD. We do know there may be many factors that make a child more likely to have ASD.

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Causes and Risk Factors RISK FACTOR 1 Genetic predisposition-Research has identified more than 100 autism risk genes. RISK FACTOR 2 Children who have a sibling with ASD are at a higher risk of also having ASD. 5-10 5-10 RISK FACTOR 3 ASD tends to occur more often in people who have certain genetic or chromosomal conditions, such as fragile Xfragile X syndromesyndrome or tuberous sclerosis. 11-14tuberous sclerosis 11-14

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Causes and Risk Factors RISK FACTOR 4 When taken during pregnancy, the prescription drugs valproic acid (Depakote) and thalidomide have been linked with a higher risk of ASD. 15-16 15-16 RISK FACTOR 5 There is some evidence that the critical period for developing ASD occurs before, during, and immediately after birth. 17 17 RISK FACTOR 6 Children born to older parents are at greater risk

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Causes and Risk Factors CDC currently working on one of the largest U.S. studies to date, called Study to Explore Early Development (SEED).Study to Explore Early Development (SEED) SEED is looking at many possible risk factors for ASD, including genetic, environmental, pregnancy, and behavioral factors.

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LONG TERM Researchers estimated the lifetime cost of caring for a child with autism is as great as $2.4 million Researchers estimated Spending on special education, housing during adulthood, & indirect costs like lost productivity were the biggest contributors to the million-dollar price tag

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D.J. Svobodo Artist, Motivational Speaker, Author, Artist

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Susan Boyle, Singer, Performer

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Dan Akroyd, Actor, Producer, Writer

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STRATEGY 1 Visual supports are a way of making auditory information visual.

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STRATEGY 2 Structured and consistent schedules, agendas, & plans

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STRATEGY 3 Prepare for Transition https://www.youtube.com/user/timetimer Time: 2.03 minutes

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Linear Clock or Wait Strip A different, linear concept of a visual timer that features a concrete visual representation of time, amount of steps to be completed, number of minutes to work, math problems to be completed using a series of dots as a visual guide. 54321 Linear Clock

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STRATEGY 4 Create a Break Area Teach how to request a Break Teach what to do in the Break Area Provide Breaks and a Home Base

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Supportive Space Non-punitive Scheduled/unscheduled Safe Break Area Overview of changes in day/schedule Escape from stress of current environment Provide Breaks and a Home Base

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STRATEGY 5 ALL students need SENSORY SUPPORTS https://vimeo.com/52193530 Time: 2.23 minutes

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Sensory Supports Matrix Student: _________ TimeActivityLocationSkill DevelopmentSensory Supports Needed 8:00 8:15Opening/Calendar Time ClassroomPoint to color of the weekKoosh ball that is bounced on his body for reinforcer

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Examples of sensory overload 12 signs of Sensory Overload 1.Loss of Balance/coordination 2.Skin flushes/goes pale 3.Child is verbalizing STOP! 4.Child refuses activities 5.Racing heartbeat 6.Hysteria/crying 7.Stomach Distress/nausea/vomiting, cramps 8.Sweating 9.Child becomes Angry/Agitated 10.Child begins repeating 11.Self-stimulatory behaviors occur 12.Child lashes out

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STRATEGY 6 SUPPORTING SOCIAL INTERACTIONS Direct Instruction Social Narratives Cartooning Power Card Strategy Incredible 5-Point Scale 34

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DIRECT INSTRUCTION Levels of Learning Acquisition Fluency Generalization Maintenance 35 GENERALIZATION Teach in a group and in the real setting Teach REAL skills Practice DAILY 3X3X3

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SOCIAL NARRATIVES/SOCIAL STORIES Social Narratives are stories developed to provide learners with insight into social situations. Emphasizes the significant social cues of given social situations The story provides the learner with examples of appropriate social responses Allows educators to pre-teach social situations and provide learners with strategies to respond to those situations The narrative must be individualized to the learners needs and interests http://www.kansasasd.com/socialnarratives.php SOCIAL NARRATIVES

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CARTOONING 37 Promotes social understanding Use conversation and thought bubbles Use comic strip format Facilitates understanding of social situations Arwood, E. & Brown, M. M. (1999) A guide to cartooning and flowcharting: See the ideas. Portland, OR: Apricot

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POWER CARD STRATEGY Power Card Strategy involves including special interests with visual aids to teach and reinforce academic, behavioral and social skills to individuals with Autism Spectrum Disorder. https://www.youtube.com/watch?v=kKDQIC5Hv0U Time: 1.46 minutes

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40 The Incredible 5-Point Scale Autism Asperger Publishing Company

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https://www.socialthinking.com/

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VIDEO 5 Things Teachers Should Know About Students With High-Functioning Autism https://www.youtube.com/watch?v=txx8G6_FsaU 3.28 minutes

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STRATEGY 7 Channel Their Strengths Dr. Temple Grandin, Professor of Animal Sciences James, Durbin, American Idol Finalist, Musician David Byrne, Oscar Winner Musician

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ACTIVITY Pair up or break into small groups Discuss 1 characteristic and a matching strategy that you will use with a student

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FAMILY STRESSORS In the homeOutside the home Sleep issues Behavioral/Communication Issues Marital differences Medication issues Homework issues Sibling issues Insurance limitations Finding a doctor, hairdresser, dentist, etc. Medication issues Community isolation No friends Recreation leisure limitations Faith based issues

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Services & Supports for High Functioning ASD No single or best treatment CBT helpful for teens/adults in learning social skills and self- control of emotions, obsessions and repetitive behaviors. Educational and social support programs that focus on social and adaptive skills utilizing a step by step highly structured activities. The instructor may repeat important ideas or instructions to help reinforce more adaptive behaviors. Parent training/Support Group social skill development programs SLP, OT, PT Early interventions Behavioral interventions Medications such as selective serotonin reuptake inhibitors (SSRIs), antipsychotics and stimulants to treat associated problems such as anxiety, depression and hyperactivity and ADHD.

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Autism Addendum is MANDATORY for Students with ASD Review and update addendum at ANNUAL ARD Consider all 11 elements of the supplement We are NOT required to provide all of the services in each of the 11 components We are required TO CONSIDER all 11 components

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Components of the Autism Addendum 1. Extended educational programming 2. Daily schedule with minimal unstructured time 3. In-home/community training 4. Positive behavior support strategies 5. Transition planning 6. Parent/family training support 7. Staff to student ratio 8. Communication interventions 9. Social skills supports 10. Professional educator/staff support needed 11. Research based strategies

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In-Home/Community Training and Viable Alternatives The ARD committee has considered information about daily schedule reflecting IN-HOME / COMMUNITY TRAINING or VIABLE ALTERNATIVES for acquisition of social / behavioral skills in new contexts and determined:

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Purpose of in-home and community based training: Helps Ss reach acquisition of social/behavioral skills Promotes maintenance & generalization of skills across school, home, community The district provides an in-home trainer Requires in-home training needs assessment Goals/objectives for in-home training are developed from assessment TAC 89.1055(e)(3) In-home/community-based training is an option an ARD committee may choose for a student with autism in order for the student to learn or reinforce social skills in a variety of settings. TAC 89.1055(e)(3) In-Home/Community Training and Viable Alternatives

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Parent/Family Training The ARD committee has considered information about PARENT / FAMILY TRAINING and determined: An ARD committee should address fading strategies when parent training is discussed.

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Parent/family training and support, provided by qualified personnel with experience in Autism Spectrum Disorders (ASD) Provides a family with skills necessary for a child to succeed in the home &/or community setting Includes information regarding resources (Ex. parent support groups, workshops, videos, conferences, and materials designed to increase parent knowledge of specific teaching/management techniques related to the child's curriculum) Facilitates parental carryover of in-home training (Ex. strategies for behavior management and developing structured home environments and/or communication training so that parents are active participants in promoting the continuity of interventions across all settings Parent/Family Training

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COMMUNITY RESOURCES Austin Travis County Integral Carehttp://www.integralcare.org/http://www.integralcare.org/ Growing Rootshttp://growingrootsaustin.com/http://growingrootsaustin.com/ Spectrum Serviceshttp://www.spectrumsocial.net/http://www.spectrumsocial.net/ Easter Seals Central Texashttp://www.easterseals.com/centraltx/http://www.easterseals.com/centraltx/ Any Baby Canhttp://www.anybabycan.org/http://www.anybabycan.org/ Blue Sky Abilitieshttp://www.blueskyabilities.com/index.htmlhttp://www.blueskyabilities.com/index.html Austin ISD FASST Teamhttp://eparentsupport.org/page.php?2http://eparentsupport.org/page.php?2 Texas Child Study Center https://www.dellchildrens.net/services_and_programs/texas_child_study_center__mental_health_services/ https://www.dellchildrens.net/services_and_programs/texas_child_study_center__mental_health_services/ DARS Autism Program http://www.dars.state.tx.us/autism/ContractorsProvidingServices.shtml http://www.dars.state.tx.us/autism/ContractorsProvidingServices.shtml

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RESOURCES Autism Society of Central Texas http://www.austinautismsociety.org/ Autism Speaks http://www.autismspeaks.org/ Region 13 Autism Supports http://www4.esc13.net/autism Autism Society of America http://www.autism-society.org/ Austin ISD Behavior Specialists Website https://sites.google.com/site/aisdbehavior/home

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Remember, that we are All teachers https://www.youtube.com/watch?v=JnylM 1hI2jc https://www.youtube.com/watch?v=JnylM 1hI2jc