Introduction to Autism z Deborah Hammer Autism & Low Incidence Specialist Arlington Public Schools [email protected] 2021 What is an z Autism Spectrum Disorder (ASD)? • A neurobiological developmental disability • *Believed to effect 1 in 54 people • Ranges from very mild symptoms to very severe - a ”spectrum disorder” • 4 out of 5 people diagnosed with autism are male • Treatable but not curable “*Prevalence of Autism Spectrum Disorders- CDC Surveillance Summaries / March 27, 2020 / 69(4);1–12 ; Study of 8-year-olds at 11 sites across the United States. Common Characteristics of Autism Two primary symptoms identified in DSM-5; ALL people with ASD must have both 1. Impairments in Language, Communication, and Social Interaction 2. Restrictive and Repetitive Behaviors Impairments in z Language and Communication § Speech might sound like a script from a movie or TV show § Speech sounds strange, too loud or soft § Difficulty with speaking- might talk too much, not enough, or not at all § Difficulty understanding directions and might misunderstand you § Doesn’t understand idioms, metaphors, sarcasm, and abstract language § Repeats certain words or phrases – or really dislikes other words and phrases Impairments in Social Interaction Skills § Hard to make and keep friends § Understanding how and when to act a certain way § Difficulty with conversations § Understanding other points of view (Theory of Mind) § Acting “Cool” § Turn-taking § The “unwritten rules” Restricted and Repetitive Behaviors • “Stereotypic” behaviors, such as rocking, humming, hand flapping, and twirling • Unusual or limited interests • Need to place items in a particular order • Strong need to do a certain behavior • Need to do the same thing, in the same way, over and over again • Perseverative thoughts Additional Common Characteristics of ASD: : • Difficulty with change • Avoiding eye contact • Good at some skills, but not others • Motor skill deficits • Sensory differences • Hyperlexia • Eloping/wandering ASD and Sensory Issues • Unusual responses to sensory stimuli. • Hyper (over) or hypo (under) sensitive to one or more senses. Affected senses include: Auditory (Hearing) Olfactory (Smell) Tactile (Touch) Visual (Seeing) Vestibular (Balance) Gustatory (Taste) Proprioceptive (Gross motor) What it Means To Be On the Autism “Spectrum” Safety and Medical Issues Some people with ASD may be diagnosed with additional medical and psychological problems, including: • Seizures • Poor muscle control • Gastro-intestinal problems • Ear infections • Sleep problems • Anxiety disorder • Pica (eating non-edible objects) • Abnormal pain tolerance • Depression Some students with ASD are not aware of or afraid of dangerous situations, such as traffic, water, and fire Receiving a Medical z Diagnosis of ASD § Given only by a doctor or psychologist § According to the DSM-5, the individual must have: § Problems reciprocating social or emotional interaction, problems with non-verbal language, and problems maintaining relationships AND § At least 2 of the following symptoms § Stereotyped or repetitive speech, motor movements or use of objects. § Excessive adherence to routines, ritualized patters of verbal or nonverbal behavior, or excessive resistance to change. § Highly restricted interests that are abnormal in intensity or focus. § Hyper or hypo reactivity to sensory input or unusual interest in sensory aspects of the environment Receivingz an Educational Label of Autism Spectrum Disorder § Given by an IEP team during an eligibility process § Does NOT require a medical diagnosis or rely on the DSM-5 § Must have deficits in the areas of communication and social skills and repetitive and restrictive behaviors § Deficits must have an impact on the student’s ability to access general education Shades of the Autism Spectrum: z Associated Terms • Levels 1, 2, 3 • Asperger’s Syndrome • Aspie • On the Spectrum • 2E- Twice Exceptional • Autistic • Person with Autism • Otaku • Neurodiversity Illustration by Cindy Chung, Verywell What Causes Autism Spectrum Disorders? There is no single form of autism. Most types of ASD are linked to genetics. It could be heredity, certain gene mutations, and genetic disorders. Other connections to autism: • Specific genes most linked to autism are: CHD8, NlGN3, PTEN, and SCN2A • Infections, seizures, and other medical problems before or at birth may increase likelihood or level of autism • *Vaccines do NOT cause ASD People with ASD have many neurological differences from neuro-typical people Potential Challenges in the Classroom and Workplace § Difficult understanding and following directions § Distractibility § “Inappropriate” behavior § Difficulty getting along with peers § Difficulty with changes in routine or schedule Potential Challenges in zthe Community: § Haven’t mastered “unwritten rules” for the setting § Behaviors that are unexpected for the person’s age or setting § Problems adjusting to sensory stimuli and unfamiliar setting Good Things About Having ASD/ Being Autistic § Able to see and remember details § Can stay focused on something you enjoy for a long time § Solve problems in a new and creative way § People with ASD can be REALLY good at things they enjoy § Honest and direct communicators § Friends with ASD are loyal and interesting! Many people diagnosed with or thought to have ASD have achieved great success Susan Boyle Heather Kuznich Temple Grandin David Byrne Albert Einstein Stephen Wiltshire Steven Satoshi Tajiri Spielberg Bill Gates Clay Marzo Shigeru Miyamoto Daryl Hannah Strategies for Success z § IEPs and 504 Plans • Adaptations § Sensory Diet • Social Skill Training § Clear Expectations • Environmental Modifications § Behavior Intervention • Visual Supports § Task Analysis z IEPs and 504 Plans § Many students with ASD have documents created by an educational team that state what type of modifications, related services, and specialized instruction they require. § All staff working with a student with ASD should be familiar with all of a student’s relevant paperwork Sensory “Diet” Squeezy balls and hand fidgets Backpacks, headbands, weighted blankets Sunglasses or soft lights Breaks to walk and move Headphones Chewy objects or gum Music Aromatherapy Modifying the Environment • Use lamps instead of fluorescent lights • Tape to delineate student’s area • Label and organize items in room • Calming areas • Reduce distractions • Remove clutter • Bins instead of dresser § Slant boards z Adaptations § Multi-modality instruction § Modified assignments § Assistive technology (laptops, iPhones, software) § Audio books (AIM) § Allow breaks or designate quiet areas § Extra help from an aide, teacher, or friend Clear Expectations z § Use pictures and writing, not just words § Explain what materials are needed, and when the project is finished. § Some things might have to be repeated § Avoid idioms, sarcasm, and metaphors § Avoid using ambiguous phrases (“put that away”) § People with ASD have difficulty generalizing: § Each assignment or direction may need to be explained, in multiple locations Organizational Assistancez § Folder for completed assignments § Left to right organization § Use and check agenda book, Smart phone, or visual schedule § Assist with organizing desk, notebook, book bag or locker, or room § Teach what is clutter and what is important z Visual Supports § Picture Communication Symbols § Visual Schedule “I raise my hand when I have § Photographs and Videos something to say” § Highlighters § Reading Windows § Illustrations § Stickers Why We Use Visual Supports § To attract and hold attention § To remind student of rules and expectations § To reduce anxiety § To make abstract concepts more concrete § To help students clearly express their thoughts/needs Examples of visual supports z Reinforcer Menu Calming menu z Visual Cues More examples of visual supports Calendars Choice Boards But… aren’t they z too old for visual supports??? Visual Schedules • Daily or for an activity • Include items needed for class • Color-coding may help • Visual (photos, icons, maps) Checklist Visual Schedules: Additional Tips • Use “First, Then” statements or pictures to let child know sequence of event: first a task, then a reward • Emphasize a clear beginning and end Social Skills Help • Peer mentors • Facilitate student inclusion in group activities and projects by using their talents and strengths • Ensure student with ASD is not being bullied • Social skills lessons and groups Social Narratives • Describe a social situation from the individual perspective in a story format • Provide relevant social cues and script desired responses • Serve as a visual clue • Are personalized and motivating • Target one behavior for improvement • Teach perspective taking Task Analysis 1. Decide what task you want your student to perform 2. Determine what steps are needed to get to the end result 3. 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