autism spectrum disorder rethinking the glass house rule...indicative of adhd. • difficulty with...
TRANSCRIPT
Autism Spectrum Disorder
Rethinking the Glass House Rule
Living with ASDMetro Parent Conference
April 7, 2017
Complexity
• Perhaps student profiles and behaviors are becoming more complex
The Real Question • What is your professional and ethical
responsibility?
Understanding Asperger - Research
• Break in the brain• Cannot figure it out• Cognitive ability does not = social skill
development• Not holding back on social skills
Activity: Conversation without looking at the person’s eyes
Aspergers – Seeking guidance from someone who probably knows what to do is usually not a first or even a second thought. The student with Aspergers might be sitting next to someone who could obviously help but appears blinkered and determined to solve the problem by himself.Atwood, 2007
Fat lady in the grocery store
Student with Aspergers remarks in his usual tone of voice and volume, “That lady is fat and needs to go on a diet” The child’s opinion is that she should be grateful for the observation and advice, the likelihood that his mother will be embarrassed or the woman would be offended at such a rude comment is not part of the thinking process.
Atwood, 2007
“People expect cognition and social functioning to be equally developed. When kids with Asperger’s Syndrome experience difficulty they [public] wrongly assume it is deliberate misconduct.”(A. Klin and F. Volkmar, 1997)
Making Associations –Right or Wrong
Create rigid rule structures to make order in ambiguity
• Playing with toys for young children and the child molester
• “NO LEFT TURNS!”• Men go to bars and women are maids• “Jocks”, “People that don’t make good
decisions” and “friends”• Pass four red cars and it’s a good day• Blue gel pen = good assignment• Grocery Store Scenario• Exchanging Christmas presents
Cerebellum
Limbic System
Cerebrum
Amygdala
Progression of Etiological Theories
BRAIN research . . . Looking at brain differences
CorpusCollosum
Cerebellum • Balance & coordination
• Modulating sensory input
• Integrating motor & sensory information
• Smaller or sudden overgrowth that decreases
Purkinje Neurons
“Inability to rapidly or accurately
shift attention”
Limbic System
Amygdala-Brain’s Fear Center
• November 22, 2006: Study (Davidson, Univ. of Wisconsin) confirms reduced size of amygdala in most socially withdrawn individuals with ASD.– Starts hyperactive and enlarged– Shrinks over time (toxic adaptation) which
correlates with length of eye contact and general fear of, withdrawal from, people.
Amygdala, Cont.
• Small amygdala: significantly slower in identification of happy, angry, sad facial expressions.– Spent least amount of time looking at eyes relative
to other facial regions.• Smallest amygdala: 40% longer to recognize
emotional expressions.• Largest amygdala: looked at eyes 4 times
longer than smaller amydgalae.
Theory of Mind: Perspective Taking and Reciprocity
• “Mind reading” ability is located in the orbito-frontal cortex-superior temportal sulcus-amygdala area of the brain.
• Winning/losing concept difficult• Difficult to engage in manipulation• Difficult to understand concept of apology• Difficult to engage in lying
Theory of Mind
Cerebrum (Cerebral Cortex)Executive Functions examples:• Reasoning• Planning• Problem
solving• Judgment• Organization
• Studies have suggested at least 75% of children with Aspergers also have a profile indicative of ADHD.
• Difficulty with four aspects of attention:– Ability to sustain attention– Attention to relevant information– Shifting attention– Storing/encoding information
(episodic vs. semantic memory)
Attention
Attwood, 2007
Executive FunctioningResearch confirms that some children, but especially
adolescents and adults with AS, have impaired executive functioning.
Elementary:Difficulty with:• Inhibition (age 8)• working memory• using new strategies
Middle School and older:Additional difficulties with:• organization and planning• self-reflection and self-
monitoring (mental conversations)
• time management and prioritizing
• understanding abstract concepts
• weak central coherenceAttwood, 2007
Neurons• Mirror Neurons:
A study by UCLA neuroscientists (Dapretto et al)featuring functional MRI suggests that
mirror neurons help people understand the intentions of others –a key component to social interaction.
Faulty?Not cued into them?
• Cell-Adhesion Molecules: Help brain cells connect (Hakonarson, 2009, Center for Applied Genomics at Children’s Hospital of Philadelphia)
Nature Neuroscience, Hahamy et al
Resting-state brain studies are important because that is when patterns emerge spontaneously, allowing us to see how
various brain areas naturally connect and synchronize their activity
• From a young age, the average, typical person's brain networks get molded by shared experiences that could make synchronization patterns more similar to each other
• It is possible that in ASD, as interactions with the environment are disrupted, each one develops a more uniquely individualistic brain organization pattern
Yawning Study
Current results suggest that contagious yawning is impaired in ASD, which may relate to their impairment in empathy. It supports the claim that contagious yawning is based on the capacity for empathy.
Senju, et al, 2007
Cognitive Differences• Cognitive development
typically ranges from average to very superior IQ.
• Difficulties may include:– Difficulty shifting attention– Difficulty processing two
cognitive tasks simultaneously– Generalizing information– Retrieving information on
demand– Developing problem-specific
solutions– Difficulty with sense of time
SOLUTION SOLUTION
SOLUTION
PROBLEM
J.Janzen, Understanding the Nature of Autism
PROBLEM PROBLEM
PROBLEM
SOLUTION
J.Janzen, Understanding the Nature of Autism
Activity: Executive Functioning
O T T F F S S
Cognitive Inflexibility• Difficulty with change• Insistence on sameness• Rule-governed• Routines/rituals• Concrete thinking• Difficulty letting go of thought and ideas• Over-focus on details (weak central
coherence)
Cognitive Inflexibility• Difficulty with change• Insistence on sameness• Rule-governed• Routines/rituals• Concrete thinking• Difficulty letting go of thought and ideas• Over-focus on details (weak central
coherence)
Cognitive Strengths• Processing whole chunks of information
quickly• Good rote memory• Good long-term memory• Process visual information meaningfully• Understand and use context-free
information and rules
Learning Characteristics of ASDUneven skill development
Tends to resist change in learning environment
Difficulty generalizing skills/information
Difficulty with abstract concepts
Relies on cues and learned routines
May tend to function more reliably with consistency and structure within activities and environments
Learning Characteristics of ASDOrganizational issues
Focus on unimportant information
Difficulties processing multiple sensory input under certain conditions
Difficulty seeing the “big picture”
Over-selectivity
Good long-term and rote memory
Prefers sequences and routines
May demonstrate desirable persistence with a task if motivated
Tendency toward literalness – difficulty with multiple meaning words
Theory of Mind(ToM) means the ability to recognize andunderstand thoughts, beliefs, desires andintentions of other people in order tomake sense of their behaviour and predict what they are going to do. (Atwood, The Complete Guide to Aspergers Syndrome, 2007)
Experts on people
Experts on things
birth
Normal
ASD
Developmental Trajectories
Theory of Mind: Perspective Taking and Reciprocity
• “Mind reading” ability is located in the orbito-frontal cortex-superior temportal sulcus-amygdala area of the brain.
• Winning/losing concept difficult• Difficult to engage in manipulation• Difficult to understand concept of apology• Difficult to engage in lying
Sub Class Swearing Homework 1st Hour
Comm Art Room E 108 Hanthorne
Y N
Y N
2nd Hour Biology Erikson
Y N
Y N
3rd Hour World History
Y N
Y N
4th Hour Algebra
Y N
Y N
5th Hour English
Y N
Y N
6th Hour Media Assistant
Y N
Teacher Internal Script
StudentInternal Script
Social Contract
Younger Students with ASD
Strategy Must Fit Within the Autism Spectrum Disorder
Angry Birds Feeling Scale Elabortory Daily Chart
Schedule
Older Students with ASD
As the Student with ASD gets Older, Because of Previous Experiences, the Window of ASD GetsMore Narrow. Strategy Must Fit within the ASD.
MaturationThe ability to understand the value of deception and recognize when it might be expected occurs later in the development of the student with Aspergers, sometimes as late as early teens.
This can cause confusion to parents and teachers, as the previously honest, (perhaps to a fault) child recognizes that one can deceive people and avoid anticipated consequences. However the type of deception can be immature and the deceit easily identified by an adult. Atwood, 2007
Travis and Lying
Travis is 18 Years OldDrives and attends a typical high school
Driving to school his check engine light came on
Communicated in the best way he knew howDid not get any response
Got a response Is this Lying
Background Information
• Staff explained they could not believe what Travis said anymore He was constantly lying.
• Used white board invited Travis into the meeting
• Put the word liar on the white board• Travis said – “Everyone thinks I am a Liar”
• What was discovered by the facilitator and staff?
Travis’s Take on Things• “Telling the truth is not good enough for the
people”• Translation – I need help and the staff does
not help me• “The wrecker is better because my car blew
up”• Translation – Ms. Black responded to the
wrecker is coming because my car blew up but did not respond to my check engine light coming on
PROBLEM PROBLEM
PROBLEM
SOLUTION
J.Janzen, Understanding the Nature of Autism
Maturation• Lying and Asperger Syndrome• Due to the impaired or delayed ToM abilities,
the person with Aspergers may not realize that the other person is likely to be more offended by the lie than by any apparent misdemeanor
• He may consider that a lie can be a way of avoiding consequences or a quick solution to a social problem
• Maintaining self esteem should he have an arrogant self image whereby the making of mistakes is unthinkable. Atwood, 2007
Typical children, especially after the age of five years, are remarkably astute at perceiving and understanding social cues that indicate thoughts and feelings. (Michelle Garcia Winner, 11-08)• Parents nor educators teach these skills• Parent and educators only notice when these
skills are not present• The lack of these skills makes students and
adults uncomfortable• Zero productive social skills curriculum
developed
It is as though their mind prioritizes social cues above other information in their environment and they have a mental theory as to what the social cues mean and how to respond. (Michelle Garcia Winner, 11-08)• Minds of typically developing students work
differently• Lack of the prioritization of social skills• Lack of a mental theory • Eric example• Resulting response? How does this manifest
in a student you know?
This ability dominates the perception of typical people to such a degree that we become anthropomorphic and projecthuman social behaviour on animals andeven objects. (Michelle Garcia Winner, 11-08)
• Anthropomorphic - Attribution of human motivation, characteristics, or behavior to inanimate objects, animals, or natural phenomena.
• Factual or predictable information dominates the Asperger’s Population
S.A.T. Study – Aspergers• Significant differences• Typical
– Chasing, entrapping, and playing– Frightened, elated or frustrated
• Aspergers: Different terms to explain movement of shapes– Bouncing or oscillating vs. bravery or elation– Narratives – shorter with less elaborate plots– Fewer, more simplistic personality attributions– Focus on physical aspects of objects
Attribution Theory• Every day we must guess how people will
act, often from small shreds of evidence.• We do this through a form of social
cognition called attribution. • As we observe others, we make
inferences about them. We attribute people’s behavior to various causes.
• Whether we are right or wrong about the causes of their behavior, our conclusions affect how WE act.
Attribution• In 2005, in the aftermath of hurricane
Katrina, many celebrities went to New Orleans to help hurricane victims. As you watched these events, did you:
Attribute the celebrities’ actions to selfless concern for the suffering in New Orleans?
ORWere the celebrities motivated by a selfish desire to hog the limelight?
Attribution Theory
Two people enter a restaurant and order different meals. Nell tastes her food, then salts it. Bert salts his food before he tastes it. How would you explain their behavior?
Introduction to Psychology: Gateways to Mind and Behavior: Twelfth Edition, 2010 Cengage Learning, Inc.
Fundamental Attribution Error(It IS human nature!)
• Attribution Theory• Erroneous cognitive tendency• Over-value dispositional-based explanation for
behaviors of others• Under-value potentiality of situational
explanations for behavioral motives of others
We predominantly presume that the actions of others are indicative of the "kind" of person they are, rather than the
kind of situations that compel their behavior.
An attribution is an inference about why an event occurred. More generally, "attribution is a process that begins with social perception, progresses through a causal judgment and social inference, and ends with behavioral consequences."
(Crittenden 1983)
Professional Responsibility
Path A Path B
??
Attribution• Going to have prejudices/attribution errors • Lack of social skills – negates any viable
opportunities • Oddity about social characteristics• Physical appearance• Perceived cognitive ability• Are we going to be embarrassed?• Is she going to embarrass herself?• Make people uncomfortable
What made you change what you attribute her behavior to?
She Started SingingStrengths Outweighed Public
Perception
Susan Boyle: Behavior Didn’t Change
• Walks off stage without results• Doesn’t understand she won by reactions• Wake up call• Shut down the cynicism in the audience
• We are going to make attributions and attribution errors
Doesn’t Change Issues• Required Hospitalization• Continued Difficulty with Social Situations• Support Person – Britain’s Got Talent• Greater Societal Understanding –
Because of TalentWhat would have happened to her without
discovery of her talent?
Continued sneers and judgment of her lack of social understanding
Students with AspergersHave Strengths and Talents
How will we respond?
Will we give them a chance and overcome our own attribution errors?
Will we be judgmental and attribute their behaviors to their own control?
Option A Option B Option C
Keep doing what
you’re doing
Magic Fix
Put strategies in
place & support the student with lens of AS
Michigan Definition to Determine Eligibility for ASD
• Qualitative Impairments in Reciprocal Social Interactions: 2 of 4 areas
• Qualitative Impairments in Communication: 1 of 4 areas
• Restricted, Repetitive and Stereotyped Behaviors: 1 of 4 areas
What Do You Attribute the Student’s Focus and/or Intensity of Interest Area To?
• Pick Student: To what to you attribute focus and/or intensity of interest area?
• Worksheet
• Collin – Dinosaurs
Fundamental Attribution ErrorCollin - Outcomes
Path A Path BLikely outcomes for Collin if his behavior is attributed to Aspergers and the situational context??
Likely outcomes for Collin if my attribution is dispositional based??
Cut the projector screen and leaf on plant;Pulled down his pants to show peers his underwear
Fundamental Attribution ErrorCollin - Outcomes
Path A Path B
Showing DinosaurDinosaur Scissors
Sexual HarassmentProperty Destruction
Cut the projector screen and leaf on plant;Pulled down his pants to show peers his underwear
An attribution is an inference about why an event occurred. More generally, "attribution is a process that begins with social perception, progresses through a causal judgment and social inference, and ends with behavioral consequences"
(Crittenden 1983)
Focus and/or Intensity of Interest Area
The special interest has several functions:a. To overcome anxietyb. To provide pleasurec. To provide relaxationd. To ensure great predictability and
certainty in lifee. To help understand the physical worldf. To create an alternative worldg. To create a sense of identityh. To occupy time, facilitate conversation
and indicate intellectual ability (Atwood, 2007)
Not No Where and When
Intense Interests
• What About Us?– Do you ever feel like something is missing?– What do you do?– How do you handle it?
– Where is YOUR CELL PHONE right now?
Group Discussion
Intense Interests
This is hard!!!
Co-workers will say that you are giving into the Autism
Spectrum Disorder
Professional ResponsibilityStudent’s Focus and/or Intensity of Interest
Your Own Student
Path A Path B
? ?
NO
WHERE WHENAND
Option A Option B Option C
Keep doing what
you’re doing
Magic Fix
Put strategies in
place & support the student with lens of AS
Michigan Definition to Determine Eligibility for ASD
• Qualitative Impairments in Reciprocal Social Interactions: 2 of 4 areas
• Qualitative Impairments in Communication: 1 of 4 areas
• Restricted, Repetitive and Stereotyped Behaviors: 1 or 4 areas
What Do You Attribute the Student’s Communication Issues To?
• Pick Student: To what to you attribute communication difficulties?
• Worksheet
• Matthew – Doughnuts and Police
Fundamental Attribution ErrorMatthew - Outcomes
Path A Path BLikely outcomes for Matthew if his behavior is attributed to Aspergers and the situational context??
Likely outcomes for Matthew if my attribution is dispositional based??
Asked the Police Officer in an assembly if he likeddoughnuts
Fundamental Attribution ErrorMatthew - Outcomes
Path A Path B•Intense questioning about police officers and doughnuts•Questions all police officers if they like doughnuts based on urban legend•Lack of understanding
•Making Fun of Police Officers•Disrespectful in an Assembly•Physical Management•10 Days Suspension
Asked the Police Officer if he liked doughnuts
An attribution is an inference about why an event occurred. More generally, "attribution is a process that begins with social perception, progresses through a causal judgment and social inference, and ends with behavioral consequences"
(Crittenden 1983, p. 426).
Pragmatic Language (Social Communication)
• Pedantic, formal– In this economy – Calculate my percentage – When in a rare conflict
• Difficulty with relinquishing conversational turn--prompts
• Limited understanding of conversational partner (interest, cues, topic appropriateness)
• Tone of voice (often perceived as disrespectful)• Literal use of Language
– Blow Your Socks Off– Stinker– What’s Up
Whenever a Student with ASD is Struggling Stop Talking
Think Visual Strategies and Supports
Pragmatic Language (Social Communication)
• Pedantic, formal– In this economy – Calculate my percentage – When in a rare conflict
• Difficulty with relinquishing conversational turn--prompts
• Limited understanding of conversational partner (interest, cues, topic appropriateness)
• Tone of voice (often perceived as disrespectful)• Literal use of Language
– Blow Your Socks Off– Stinker– What’s Up
We have a young man in our middle school who has autism (we actually have many young people with autism....however this story just focuses on one specific young man) and has been rather challenging so far this year. Well, today he decided that he didn't want to participate in class.....after losing all his tokens he was taken to "time-away". Of course, this didn't go as planned and MK had to assist the parapro in moving him to his designated timeout area. Once he was safely escorted to his time-away...he served his "time", completed his compliance task and immediately bolted for the bathroom. Of course, all the individuals working with him at this time were female and thus could not enter the bathroom.....so I was called. I entered the bathroom to find him just standing there....really doing nothing. The moment I enter...he runs into one of the stalls and attempts to slam the door shut. I quickly grab the door and walk in. At this point....he backs himself into a corner and in his deepest most convincing pirate voice....says " "You'll never get anything out of me...you lousy no good scum-sucker". I start laughing...tell him that is a great line and ask him what class he needs to be in? He says "room 104" At this point, we walk out of the bathroom, I hand him over to his parapro and they head down the hall to room 104. When they arrive...they walk into Mrs. Redker's class as she is teaching sex ed. The young man hears the topic......takes one look at his para and yells "I'm not ready for this" and bolts out of the room!!! Hey..Mr. Caine, do you think this is a "pragmatic" issue? Gotta love our jobs! Hope each of you are having a great day!
Liam raised his hand and asked a question about what he was supposed to do. The task was identifying a vocabulary word that had a similar meaning to two stimulus words. Mrs. K helped him with one item, told him to do a “process of elimination,” and walked away.
Liam said, “I don’t know!” Mrs. K replied, “Well, you’ve got to go through the words. Just skip the ones you don’t know.”
Liam said, “I’ll skip the whole thing.” He began laughing to himself again.
Mrs. K. said, “Do you need Mrs. C to remind you about being appropriate?” Liam said, “No, I need Mrs. C to remind me about how to do this!”
Pragmatic Language (Social Communication)
• Pedantic, formal– In this economy – Calculate my percentage – When in a rare conflict
• Difficulty with relinquishing conversational turn--prompts
• Limited understanding of conversational partner (interest, cues, topic appropriateness)
• Tone of voice (often perceived as disrespectful)• Literal use of Language
– Blow Your Socks Off– Stinker– What’s Up
Ordering/ReOrderingSecretaries Name
• Baiba• Bunny• Bev• Blanche• June
• What is wrong with this place?• Get a normal name• At least they could all start with the same letter
Option A Option B Option C
Keep doing what
you’re doing
Magic Fix
Put strategies in
place & support the student with lens of AS
Professional ResponsibilityStudent’s Communication
Your Own Student
Path A Path B
? ?
Michigan Definition to Determine Eligibility for ASD
• Qualitative Impairments in Reciprocal Social Interactions: 2 of 4 areas
• Qualitative Impairments in Communication:1 of 4 areas
• Restricted, Repetitive and Stereotyped Behaviors: 1 or 4 areas
What Do You Attribute the Student’s Social Skill Differences To?
• Pick Student: To what to you attribute the social mistakes?
• Worksheet
• Jacob – Student attention
Fundamental Attribution ErrorJacob - Outcomes
Path A Path BLikely outcomes for Jacob if his behavior is attributed to Aspergers and the situational context??
Likely outcomes for Jacob if my attribution is dispositional based??
Tickled peers on the back of the neck
Fundamental Attribution ErrorJacob - Outcomes
Path A Path B•Desperately wanted to •Interact with Kids•Tickle Back of Necks•Trying to Fit In•Incompatible Response•Tried Even Harder
•Targeting Students•Aggressive Toward Peers•Change of Classroom•Feared by Others•Threat of 10 Days Suspension
Tickled peers on the back of the neck
Card QuestionsQuestion Answer
1 How many cars make up the chase for the race? 122 C.O.T.in 2007 stood for what? Car of Tomorrow3 C.O.T. in 2008 stands for what? Car of Today4 How many road races are run each year? 25 How many point races are in a season? 366 What's the biggest race of the year? Daytona7 What was Jr's old number? 88 What is Jr's new number? 889 What was Jr's old sponsor? Budwiser
10 What is Jr's new sponsor? AMP/Mt. Dew11 What team does Jr. race for now? Hendrick
12 Who are Jr's new teammates?24- Jeff Gordon; 48 Jimmy Johnson; 5 Casey Mears
13 Who drove the #5 car last year? Kyle Bush14 What team does Kyle Bush drive for this year? Joe Gibbs Racing15 What is Kyle Bush's new number? 1816 What kind of car does Jr. drive? Chevy Impala17 What new car manufacture started in cup series in O7? Toyota
18 What team did Jr start his career with? D.E.I./Dale Earnhart Inc19 What kind of tires does NASCAR use? Goodyear20 What kind of car did the Chevy teams use last year? Monte Carlo SS21 Who is Jeff Gordon's sponsor? Dupont22 who is Jimmy Johnson's sponsor? Lowe's