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Responding to the Needs of Students with Autism Spectrum Disorders

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Title: Responding to the Needs of Students with Autism Spectrum Disorders


1
Responding to the Needs of Students with Autism
Spectrum Disorders
2
The Center for Autism and Related Disabilities
  • CARD- Albany is a university-affiliated resource
    center that brings research and practice together
    in community settings.
  • CARD- Albany provides evidence-based training
    and support to families and professionals and,
    through ongoing research, contributes knowledge
    to the field of autism spectrum disorders

3
Objectives
  • Participants will become familiar with the
    definition, characteristics, and other related
    information regarding autism spectrum disorders
  • Participants will be able to recognize evidence-
    based practices in assessing students with ASD
  • Participants will be able to recognize components
    for developing an effective educational program
    for students with ASD
  • Participants will understand the importance of
    effective collaboration, resources, and supports
    for students with autism spectrum disorders

4
Definition of Autism Spectrum Disorders
  • Question What are some of the common
    characteristics that you see in each of the
    children portrayed in the video?

5
IDEA and Part 200Definition of ASD
  • Autism means a developmental disability
    significantly affecting verbal and nonverbal
    communication and social interaction, generally
    evident before age three, that adversely affects
    a child's educational performance. Other
    characteristics often associated with autism are
    engagement in repetitive activities and
    stereotyped movements, resistance to
    environmental change or change in daily routines,
    and unusual responses to sensory experiences.

6
Eligibility for Special Education Services from
Part 200
  • Areas of need
  • Academic achievement, functional performance,
    learning characteristics
  • Social development
  • Physical development
  • Management needs

7
Who Is Affected By Autism?
  • CDC currently estimates that 1 in 150 individuals
    have autism spectrum disorder based on study that
    looked at 8 year-old children across 14 states
  • CDC study expanded the definition of autism to
    include the diagnosis of PDD-NOS and Aspergers
    Syndrome
  • Boys are 4 times more likely to be diagnosed but
    girls are more severely affected
  • http//www.cdc.gov/ncbddd/autism/faq_prevalence.ht
    m

8
NYS Children and Youth with Disabilities
Receiving Special Education Programs and Services
  • School age students (4-21) with autism
  • 1996 - Total 3,416
  • 1997 - Total 4,104
  • 1998 - Total 5,142
  • 1999 - Total 5,659
  • 2000 - Total 6,752
  • 2001 - Total 7,918
  • 2002 - Total 9,141
  • 2003 - Total 10,617
  • 2004 - Total 12,162
  • 2005 - Total 13,622
  • 2006 - Total 15,471
  • 2007 Total 17,505

513 INCREASE
Source NYS Department of Education
9
When Does It Occur?
  • Children are born with the disorder and never
    outgrow or are cured of their autism
  • Usually diagnosed in early childhood (18 months
    2 years) when a child fails to meet developmental
    milestones
  • www.cdc.gov/ncbddd/autism/actearly/interactive/ind
    ex.html
  • http//www.autismspeaks.org/video/glossary.php

10
What Causes Autism?
  • Genes
  • Monozygotic vs. dizygotic twin studies have shown
    that if 1 identical twin has autism, the chance
    that the other twin has autism is 10 times higher
    than that of fraternal twins
  • Multiple genes are now being studied for their
    possible role

11
What Causes Autism?
  • Brain structure is different
  • Cause of autism is currently unknown

http//www.nimh.nih.gov
12
What Causes Autism?
  • Other Theories
  • Heavy metals
  • Pollutants
  • Toxins
  • Vaccines
  • Chemicals
  • Pesticides
  • Gastrointestinal issues
  • none of these have been empirically proven to
    cause autism

13
DSM-IV Diagnostic Criteria(American Psychiatric
Association, 2000)
  • Communication
  • Delay in, or complete lack of, verbal
    communication
  • Difficulty in initiating or sustaining
    conversations
  • Stereotyped or idiosyncratic use of language
    (echolalia, jargon)
  • Inability to engage in spontaneous, make-
    believe, or imitative play at the appropriate
    developmental level

14
DSM-IV Diagnostic Criteria
  • Socialization
  • Difficulty developing peer relationships
    appropriate to developmental level
  • Impaired use of nonverbal behaviors (e.g., eye
    contact, facial expressions, and gestures)
  • Lack of spontaneous seeking to share enjoyment,
    interests, or achievements with other people
    (joint attention)
  • Lack of social or emotional reciprocity

15
DSM-IV Diagnostic Criteria
  • Behavior
  • Preoccupation with an activity or interest that
    is abnormal either in intensity or focus
  • Inflexible adherence to nonfunctional routines or
    rituals
  • Repetitive or stereotyped movements (e.g., hand
    flapping)
  • Persistent preoccupation with parts of objects

16
Pervasive Developmental Disorders (PDD) Autism
Spectrum Disorders (ASD)
Lower Functioning Below Average IQ, Mental
Retardation, little or no verbal language
IQ lt 70
Retts Disorder
Childhood Disintegrative Disorder
Autism
PDD -NOS
Aspergers Syndrome
Higher Functioning Average/Above Average IQ,
verbal language, etc.
17
Retts Disorder
  • Early typical development followed by period of
    stagnation or regression
  • Motor and cognitive delays
  • Loss of purposeful hand movements
  • Rare 110,000 females not found in males
  • Occurs around 6-18 months of age
  • Genetically based (MECP2)
  • International Rett Syndrome Foundation
  • http//www.rettsyndrome.org

18
Childhood Disintegrative Disorder
  • A developmental disorder characterized by a
    relatively longer period of typical development
    (compared to Retts and Autism) followed by a
    marked regression in communication,
    socialization, and cognitive skills
  • Around 1 in 1500 births - more common in boys
  • Symptom onset between 2 to 4 years of age but
    before 10 years of age
  • Cause unknown
  • Yale Developmental Disabilities Clinic
  • http//info.med.yale.edu/chldstdy/autism

19
PDD-NOSPervasive Developmental Disorder Not
Otherwise Specified
  • Individual exhibits many of the behaviors and
    characteristics of autism but not enough to meet
    the full criteria of autism
  • Not the same has high functioning autism or
    Aspergers Syndrome
  • Individuals can range from high to low
    functioning

20
Aspergers Syndrome
  • Distinguished from Autism and PPD-NOS by the lack
    of language delay
  • Normal to above-average intelligence
  • Social interest present but understanding and
    skills are lacking
  • Often verbose but may use language in different
    ways and lack pragmatics
  • Patterns of speech may be unusual
  • Often motor skill delays and appear physically
    awkward, clumsy
  • Autism Society of America , www.autism-society.org

21
3 Core Deficits Across the Spectrum
Diagnostic Overlap
Diagnostic Overlap
Adapted from Christine Peterson
Autism
PDD-NOS
Aspergers Disorder
Verbal/lacks pragmatic Aspects of communcation
Communication
Non-Verbal/ Echolaic
Scripts/lacking Functionality
Parallel Play/lacks Age appropriate skills
Appears unaware/ no interest
Interest/lack of social understanding
Socialization
Physical rocking/ Head banging
Preoccupation with parts/ Spinning objects
Repetitive Patterns of Behavior
Over focus on topic
22
Implications for the ClassroomCommunication
  • Wide range of communicative ability
  • Non-verbal to verbose but lacking in pragmatics
  • Often more behavioral communication than
    intentional, social, or verbal communication
  • Receptive language difficulties - expectations,
    directions, comments need to be clear, concrete,
    simple, direct, and visual
  • Expressive language difficulties even highly
    intelligent students may struggle to speak up or
    become frustrated trying to share thoughts,
    feelings, and ideas
  • Written communication difficulties from the
    mechanics of writing to organizing thoughts and
    getting them to paper

23
Video Social Difficulties in Aspergers Syndrome
24
Implications for the ClassroomSocial Deficits
  • Social imitation (academic non-academic) is
    lacking explicit instruction required
  • Perception and interpretation of body language
    and social cues lacking watch for social
    misunderstandings
  • Subtle and arbitrary social rules not recognized,
    understood, or valued may need to explain or
    explicitly instruct rules should be functional
    to make sense
  • Will need significant assistance with
    establishing and maintaining social
    relationships self-advocacy, and integration
    into the school community
  • Often victims of bullying be aware
  • Lack Theory of Mind doesnt realize others
    may think and feel differently

25
Theory of Mind
26
The Sally Ann Test
27
Implications for the ClassroomRepetitive
Behavior and Interests
  • Adherence to inflexible routine or rules common
    striking a balance of structure and teaching
    flexibility key
  • Often preoccupied with activity or particular
    interest can you turn activity or opportunity
    to discuss interest into a reinforcer for
    pro-social and good work habits?
  • May engage in odd repetitive behavior behavior
    extinction not always the best approach

28
Related CharacteristicsSensory Issues
  • Processing sensory information
  • Over or under-sensitivity to noises, lighting,
    odors, tastes, textures, pain
  • Sensory over-selectivity
  • Failure to respond
  • Hidden senses
  • vestibular (movement and balance)
  • proprioceptive (feedback on how much force or
    pressure to apply when picking up something or
    holding an item)

29
Video Clip of sensory sensitivities leading to
repetitive behaviors
30
Related CharacteristicsCognitive Issues
  • Difficulty drawing conclusions
  • Difficulty with incidental learning
  • Often excellent rote memory
  • Slower at retrieving information
  • Slower processing speed
  • Problems with working memory
  • Trouble predicting outcomes (e.g., peoples
    reactions)
  • Often do not see cause-effect

31
Related CharacteristicsCognitive Issues
  • Problems with executive function
  • Issues with shift moving freely from one
    activity/situation to another, transitions,
    flexible problem solving
  • Issues with initiation cant begin tasks
  • Issues with planning, organizing, sequencing,
    setting goals/objectives
  • Issues with seeing big picture or main idea
  • Issues with evaluating activity pace,
    completion,
  • Issues with modulating emotional response
  • Issues with controlling impulses

32
Evidence-Based Instructional Methods/Interventions
33
What is Evidence-Based Practice?
  • NCLB (2002)
  • Effective education practices
  • Scientifically based research
  • Rigorous peer review
  • Positive results
  • Review and synthesis completed by Simpson, et. al
    (2005)
  • Scientifically-based possess significant and
    convincing empirical efficacy and support
  • Promising programs that have emerged as having
    efficacy and utility with individuals with ASD

34
Why Do Students with ASD Require Special Learning
Environments?
  • Core symptoms associated features challenge
    students to learn from more typical environments,
    so they often require
  • Structured learning environments that include
    social communication training and behavior
    supports
  • Structure and enhancement of relevant stimuli to
    increase attending
  • Scope and sequence of skills
  • Repeated learning trials
  • Specific intervention for generalization
  • Continuous opportunities to learn and apply
    skills across multiple contexts
  • Magyar, C., (2008, November). Developing a system
    of support for students with autism spectrum
    disorders A classroom model. Presentation given
    at the 7th Annual Conference sponsored by
    CARD-Albany, Albany, NY.

35
Focus of Assessment
  • Specific learning challenges
  • Cognitive ability and profile
  • Academic ability and profile
  • Ecological Assessment
  • Instructional context
  • Interaction between learning context/environment
    and student learning behavior (FBA)
  • Assessment of other skills related to learning
  • Adaptive
  • Social
  • Language
  • Emotional-behavioral
  • Magyar, C., (2008, November). Developing a system
    of support for students with autism spectrum
    disorders A classroom model. Presentation given
    at the 7th Annual Conference sponsored by
    CARD-Albany, Albany, NY.

36
Linking Assessment to Intervention
  • Determine the students ability profile
  • Determine the contextual support elements to
    maximize learning
  • Know the curriculum/lessons and align content
    difficulty level with student ability, THEN
    select best instructional methods, activities,
    and format
  • Differentiate instruction differentially
    reinforce
  • Evaluate progress and performance (continuous)
  • Problem solve
  • Revise
  • Re-assess
  • Magyar, C., (2008, November). Developing a system
    of support for students with autism spectrum
    disorders A classroom model. Presentation given
    at the 7th Annual Conference sponsored by
    CARD-Albany, Albany, NY.

37
Continuous Assessment
Revise, Modify, Enhance Education Plan
Response to Plan/Intervention
Initial/Continuous Assessment and Educational Plan
Magyar, C., (2008, November). Developing a system
of support for students with autism spectrum
disorders A classroom model. Presentation given
at the 7th Annual Conference sponsored by
CARD-Albany, Albany, NY
38
Effective Components for Educational Practices
  • Current research supports the following should be
    present in a quality educational programs for
    students with ASD
  • Individualized supports and services
  • Systematic instruction
  • Comprehensible and structured learning
    environments
  • Specialized curriculum focus
  • Functional approach to problem behavior
  • Family involvement
  • Iovannone, R. Dunlap, G. Huber, H. and
    Kincaid, D. (2003). Effective educational
    practices for students with autism spectrum
    disorders. Focus on Autism and Other
    Developmental Disabilities,18, 150-165

39
Effective Components for Educational Practices
  • Individualized Supports and Services
  • Students with ASD are heterogeneous in
    presentation of behaviors
  • Unique interests, preferences, learning styles
  • No one program, support, or service is likely to
    meet the population as a whole
  • Flexible placement and support options are needed
  • Match specific practices, supports, services with
    each students unique profile and individual
    family differences

From Iovannone, R. Dunlap, G. Huber, H. and
Kincaid, D. (2003). Effective educational
practices for students with autism spectrum
disorders. Focus on Autism and Other
Developmental Disabilities,18, 150-165
40
Evidence-Based Practice
  • Applied Behavior Analysis
  • Not a specific intervention, but rather a
    theoretical framework
  • Based on work of behaviorists (Skinner, etc.)
  • Desired behaviors are identified, taught, and
    reinforced
  • Programs are highly individualized
  • http//www.abainternational.org

41
Effective Components for Educational Practices
  • Systematic Instruction
  • Identification of valid educational goals
  • Careful outlining of instructional procedures and
    their implementation
  • Evaluation of effectiveness
  • Adjustment of instruction based on data

42
Evidence-Based Practice
  • Discrete Trial Training (DTT)
  • Trial single teaching unit
  • Instruction, child response, consequence
  • Break down tasks into discrete behaviors
  • Each correct behavior is positively reinforced
  • Data is collected to drive instructional goals

43
Evidence-Based Practice
  • Pivotal response training
  • Based on principles of ABA
  • Targets pivotal behaviors to increase important
    language, play, and social behaviors(naturalistic
    approach)
  • Motivation responsivity to multiple cues
  • Utilizes natural reinforcers
  • Data is collected to drive instructional goals
  • http//psy3.ucsd.edu/autism/prttraining.html

Koegel et al., 1987
44
Promising Practice
  • Incidental teaching
  • Instruction during typical activities based on
    student interest and motivation
  • Learning environment organized around preplanned
    objectives and student preference
  • Advantages
  • Skill generalization
  • Social initiations
  • Daily routines
  • http//www.autismnetwork.org/modules/academic/inci
    dental/index.html

45
Effective Components for Educational Practices
  • Comprehensible/Structured Learning Environments
  • Curriculum needs to be clear to both students and
    educational personnel
  • Allows student to predict whats going to happen
    next
  • Provide a schedule of activities
  • Plan and provide choice-making
  • Provide behavior support
  • Define areas of classroom and school
  • Provide temporal relations
  • Facilitate transitions, flexibility, change

46
Promising Practice
  • TEACCH Treatment and Education of Autistic and
    related Communication Handicapped Children-
    Structured Teaching
  • Modifying environment to accommodate needs of
    individuals with ASD
  • Physical organization
  • Work schedules
  • Work systems
  • Task organization

http//www.teacch.com
47
Effective Components for Educational Practices
  • Specialized Curriculum Focus
  • Focus on development of social reciprocity and
    communication
  • Systematic instruction in
  • Social engagement skills (initiating
    responding)
  • Appropriate recreational or leisure skills
  • Language comprehension and communication

48
Evidence-Based Practice
  • LEAP Learning Experiences An Alternative
    Program for Preschoolers and Parents
  • Early childhood social development
  • Inclusive setting (home, school, community)
  • Peer mediated interventions
  • Behavior management
  • Educational approach with individualized
    objectives
  • http//prekese.dadeschools.net/docs/leap/LEAPinfof
    lyer.pdf

Kohler Strain, 1999
49
Promising Practice
  • Picture Exchange Communication System (PECS)
  • At most basic level it allows individuals to
    exchange picture for an item
  • Based on functional nature of communication
  • http//www.pecs.com

Frost Bondy, 1994
50
Promising Practice
  • Social Stories
  • Individualized cognitive intervention that
    describes social cues and appropriate responses
  • Teaching routines and academic material
    addressing behavior problems
  • http//www.thegraycenter.org/
  • http//www.polyxo.com/socialstories/

51
Promising Practice
  • SCERTS
  • SC - Social Communication
  • ER - Emotion Regulation
  • TS - Transactional Support
  • Developmental framework
  • Incorporates evidence-based practices

http//www.scerts.com
52
Effective Components for Educational Practices
  • Functional Approach to Problem Behavior
  • Positive Behavior Support
  • Goal is to enhance the students quality of life
    by expanding his/her behaviors and adjusting the
    learning environment and by making dysfunctional
    behavior irrelevant ineffective
  • Functional behavior assessment
  • Identification of variables that reliably predict
    and maintain problem behavior by collecting data
    directly and indirectly
  • Behavior Intervention Plan
  • Plan for teaching new equally effective
    pro-social behavior
  • Outlines adjustments to the environment to
    support pro-social behavior
  • Identifies responses to behavior from educational
    personnel and others that will support and
    reinforce the new, desired behavior

53
Evidence-Based Practice
  • Positive Behavior Support
  • Research-based strategies used to increase
    quality of life and decrease problem behavior
  • Teaching new skills changing environment
  • http//www.pbis.org/
  • http//www.apbs.org/

54
Hierarchy of Behavior Supports
55
Classes of Challenging Behavior
56
Functional Behavior Assessments
  • Should be conducted if the challenging behavior
  • Significantly impacts the students
    academic/social performance
  • Places the child at risk of a more restrictive
    placement
  • Has produced a series of disciplinary actions by
    administration (suspensions, etc.)

57
Behavior Intervention Plans
  • The goals of the behavior intervention plan (BIP)
    are to
  • Prevent the behavior from occurring, when
    possible and appropriate
  • Teach new behaviors to take the place of the
    challenging behavior
  • Change adult/peer responses to the behavior so
    the behavior is no longer reinforced

58
Effective Components for Educational Practices
  • Family Involvement
  • Most stable, valuable, influential people in
    childs environment
  • Determine optimal level of participation based on
    family characteristics, stressors, needs of
    family
  • Viewing parents as active partners
  • Teach parents to implement strategies
  • Parents contribute to effectiveness particularly
    when it comes to implementing strategies across
    multiple environments

59
Effective Collaboration, Support and Resources
  • Global nature of ASD requires a multidisciplinary
    approach including involvement of parents or
    guardians
  • Explicit need to generalize learning across
    multiple environments requires trained
    professionals in districts and schools
    collaborate to train others within the education
    setting and to assist parents in understanding
    students educational needs
  • Supporting families through knowledge of and
    referral to community agencies and supports is
    essential for families to manage stress of
    raising a child with ASD
  • Building partnerships with community agencies
    will lead to more effective transition plan
    outcomes for students with ASD
  • Utilizing community resources to prepare students
    with ASD to enter the day treatment/training,
    workforce, or higher education following
    graduation

60
Remember
  • Always take into consideration the
    characteristics of autism and how they impact the
    individual
  • Develop realistic goals for the individual
  • Use teams input in ANY assessment
  • Staff are MUCH more likely to use strategies and
    supports if they have a say in what is used
  • Use MULTIPLE tools to assess
  • Link the assessment to the intervention and
    CONTINUE ASSESSING

61
Regional Centers for Autism Spectrum Disorders
62
The Center for Autism and Related Disabilities
  • Contact Us
  • Phone (518) 442-2574
  • Email card_at_albany.edu
  • Website http//www.albany.edu/psy/autism
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