Learning about Autism

What is it really like?

Definition of Autism

• According to DSM-5 Autism/autistic disorder, Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified are listed in the same category. ASD is characterized by two things:

• 1) deficits in social communication and social interaction and• 2) restricted repetitive behaviors, interests, and activities

(RRSs)• Because BOTH components are required for diagnosis of ASD,

social communication disorder is diagnosed if no RRBs are present.

American Psychiatric Association (2013)

Common Social Skills Deficits

Social interactions involve:• verbal communication • non-verbal communication• personal space • social engagement • social reciprocity• topic flow• eye contact• humor Scholastic Intervention Solutions (2014)

Common Social Skills Deficits

• Unwilling to make direct eye contact with people • May not respond when name is called or when spoken

to• Finds it difficult to understand other people. May not

be able to read facial expressions or body language.• Unaware of social conventions/appropriate social

behavior such as the importance of taking turns during a conversation.

• Extremely directive and controlling or overly passive. Research Autism (2013)

Common Social Skills Deficits

• Conflict presents a problem. They may not understand the difference in being assertive and being aggressive.

• Indifferent or aversive to physical contact and affection. They may not like being touched or hugged.

• Objects such as toys are not shared and emotions are not shared with other people.

• Express inappropriate emotions (such as laughing or smiling at the wrong time and place.)

• Prefer solitary activities and does not try to make friends or would like to make friends but is unsuccessful.

Research Autism (2013)

Social Deficits

• Communication• Initiation of communication• Reciprocity• Cognition• Since children on the spectrum do not desire

social interaction they must be encouraged to participate. Lack of the ability to communicate will be very frustrating. Being unable to initiate a conversation will lead to loneliness.

Social Deficits

• Reciprocity in communication and interaction just requires a back and forth reaction in carrying on a conversation. But ASD students need to learn this process. It does not come naturally to them.

Examples of Social Communication

• Kindergarteners playing with blocks, taking turns stacking them while building a tower. While building they say, “Don’t knock it down,” “Build it higher,” “No, don’t make it fall” They both laugh when it does tilt over.

• Girls playing in the kitchen center. “Let’s cook breakfast.” “I want pancakes.” “Do you want some pancakes?” “Yes, I want two.”

Examples of Social Reciprocity

• When infants interact with caregivers by imitating vocalizations; using objects in turn-taking, such as shaking a rattle; and playing games like peek-a-boo.

• “cool,” “right on,” and “uh-huh” are responses for the not so talkative in instances when nothing substantial is needed along with eye contact or gestures.

Hall (2013)

Examples of Social Cognition

• When children play they automatically know what to do when someone says, “Ready, set, go,” or “Tag, you’re it”

• When a child says, “ I am feeling sick” and the child next to him raises his hand to tell the teacher.

Hall (2013)

Example of Social Initiation

• Hey, look” or “Look at this,” is an appropriate conversation starter for preschoolers. They would then continue with the conversation.• Joint eye gaze (catching one’s eye) and asking

an appropriate question, “What’s that?” or “What are you doing?”

Hall (2013)

Suggested Assessments of Social Skills

• Preschool Language Scale (PLS-4). Zimmerman, Steinek, & Pond, 2002.• Clinical Evaluation of Language Fundamentals–Preschool (CELF-P). Semel, Wiig, &

Secord, 2003.• Clinical Evaluation of Language Fundamentals (CELF-4) (4th ed.). Semel, Wiig, &

Secord, 1992.• Peabody Picture Vocabulary Test (PPVT). Dunn, Dunn, Robertson, & Eisenberg,

1981.• Comprehensive Assessment of Spoken Language (CASL). Carrow-Woolfolk, 1999.• Oral and Written Language Scales (OWLS). Carrow-Woolfolk, 1995.• Goldman Fristoe Test of Articulation. Goldman, & Fristoe, 2000.• Social Communication Questionnaire. Rutter, Bailey, & Lord, 2003.• Do, Watch, Listen, Say: Social and communication intervention for children with

autism. Quill, 2000. Boutot & Myles (2011)

• Screening Tool for Autism in Toddlers and Young Children (STAT)• Autism Diagnostic Interview–Revised (ADI-R)• Autism Diagnostic Observation Schedule (ADOS), a

standardized, protocol for observing the communicative and social behavior of toddlers to adults.

• The Mullen Scales of Early Learning measures cognitive functioning

• Autism Screening Instrument for Educational Planning (ASIEP-2)

Assessment Process• Consult parents for permission to test• Explain your reasoning and suspicions • Once permission is obtained - set up appointment with system

testing personnel or secure the testing documents for yourself• Seek training for the tests before beginning as this secures accuracy• Administer testing - this will be completed over a period of time

depending on the age of the participant• If testing personnel is conducting the process the results will come

with a narrative explaining the results which can be shared with the parents

• From there a curriculum can be designed for meeting his needs• The Individual Education Plan ( IEP) will reflect this

Techniques to assist the Autistic

• Social scripting-a scripted sentence is run through a card reader and the ASD student repeats it and performs the social direction. When successful, fading (leaving words off of the end of the sentence until the students hears only the first word) is started but the child still knows and performs the social direction.

• Video modeling-people playing with toys correctly. People behaving correctly at the mall or shopping and at the dentist. (Hall,2013)

Techniques (cont.)

• Social Problem-solving Strategies-an Integrated Play Group with the goal of the ASD student sharing a toy with a peer.

• Natural reinforcement- when a student asked to play on the see-saw he was allowed to do that (goal being to point to or verbalize his desires). (Hall, 2013)

Techniques compared

• Social scripting• Video Modeling • Social Problem-solving Each strategy:• Fulfills a need for the ASD student. • Provides a variety of methods • Assists many students on the spectrum (Hall,2013)

Techniques compared

• Video Modeling is the least stressful of the three during training.

• Social Problem Solving would be the most interesting to some kids and scary to others.

• Social Problem Solving is both functional and structural. Functional-teaching behaviors they should know. Structural-teaching cognitive skills/to know when to use the skills.

Technique Examples

Examples of Social Problem Solving Strategies - Peer Mediation - Cooperative Learning Groups - Group Counseling SettingsSocial Scripting, Video Modeling, and Social Problem Solving can address any topic. Kaser, (2007)

Interventions

• Design lessons using the assessment data• Interventions should be personal, meaningful and

opportunities to participate should flourish • Interventions should be practical, natural

communication.• Lessons should offer social skills instruction in the

setting that the child will likely be in.• Staying involved in serious intervention with many

learning opportunities is crucial. Boutot & Myles (2011)

Interventions

• Interventions serve various purposes from behavioral to pragmatic

• Behavioral Interventions: Discrete trial instruction and verbal behavior are teacher directed to illicit appropriate responses

• Naturalistic Interventions: Picture Exchange Communication System (PECS) and Pivotal Response Training (PRT)

Boutot & Myles (2011)

Interventions: A small sampling

• Social Pragmatic Interventions: Social Communication Emotional Regulation Transactional Supports (SCERTS) which is a framework for designing an intervention plan

Boutot & Myles (2011

Prompting• Prompts may be verbal or a gesture (pointing)• Give prompt from behind the student especially when using

picture reading so they do not become as dependent on the prompt

• If child is a reader the pictures will later be changed to words• Prompting the child to read the schedule is started as needed

when skill is gained the prompts are faded.• This can be used in many social situations:• Saying “Hi” to peer or adult• Saying “Thank you” to peer and adult• Student asking to go to the bathroom• Reminding to put name on paper

Self-Monitoring• Self-monitoring and self-recording go hand in hand• recognizing the behavior must come first• student must be aware when he acts a certain way in

order to off-set that behavior • discuss what the behavior looks like and feels like • A role play situation is a good idea to let the child see the

aspects of his behavior that need improving. • The student must understand how to replace the negative

behavior so choices need to be presented and acted out. Then he will know the correct behavior that he is supposed to use. Hall, (2013)

To Increase Social Interaction

• Use activity schedule with student• Pairing buddies for incidental classwork• Group project• Project pairing• play for a purpose - build a tower with a peer• Group play at school (free-play)• Play with a peer(free-play)• Lunch buddy• Bus buddy• Room leaders (pair)

Social Skills Interaction Supportsfor Faculty and Staff

• Physical Environment Modifications seating, learning space, and space for relaxation.• Major Sensory Considerations Lighting, sounds, smells, and temperature• Safety Considerations Home/school – arranging furniture, storing supplies, cover outlets, etc., as needed. Boutot, (2011)]

Social Skills Interaction Supports

• Visual Supports objects, photographs, pictures, symbols, signs, and written words.• Visual schedules, visual organization or choice

boards.• Boundary markers, maps and labeling.• Areas for work, play, reading/quiet, relaxation. (Boutot, 2011)

ReferenceAmerican Psychiatric Association (2013). Highlights of changes from DSM-4-TR to DSM-5. Retrieved

from: http://www.psychiatry.org/dsm5 Click on changes from DSM-4-TR to DSM-5 (direct link)

Boutot, E. Myles, A. (2011). Autism Spectrum Disorders: Foundations, Characteristics and Effective Strategies. Pearson. Upper Saddle River, NJ.

Grusec, J. (1992). Social learning theory and developmental psychology: The legacies of Robert Sears and Albert Bandura. American Psychological Association, Inc.

Frankel, F. and Wood, J. (2011). Social skills success for children with Autism and Asperger’s. Jossey-Bass, San Fransco, CA.

Hall, L. (2013). Autism Spectrum Disorders: From theory to practice. Pearson. Upper Saddle River, NJ.Huitt, W. and Dawson, C. (2011) Social development: Why it is important and how to impact it.

Educational Psychology Interactive. Valdosta, GA: Valdosta State University. Retrieved from http://www.edpsycinteractive.org/papers/socdev.pdf

Kaser, C. (2007). Series on highly effective practices social problem solving. Retrieved from: http://education.odu.edu/esse/research/series/social.shtml Research Autism. (2013). Social skills and autism. Retrieved from: http://researchautism.net/autism_issues_challenges_problems.ikml?print&ra=3&infolevel=4

Reference• Scholastic Intervention Solutions(2014). Recognizing Autism: Overview of social skills functioning

and programming. Retrieved from: http://www.scholasticinterventions.org/2011/07/13/recognizing-autism-overview-of-social-skills-functioning-and-programming