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AAC and ASD: Engineering Perspective-Taking and Emotional Regulation

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AAC and ASD: Engineering Perspective-Taking and Emotional Regulation Marcia Weber-Olsen, Ph.D., CCC-SP Monterey County SELPA Verjene Kalashian, M.A., – PowerPoint PPT presentation

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Title: AAC and ASD: Engineering Perspective-Taking and Emotional Regulation


1
AAC and ASD Engineering Perspective-Taking and
Emotional Regulation
  • Marcia Weber-Olsen, Ph.D., CCC-SP
  • Monterey County SELPA
  • Verjene Kalashian, M.A.,
  • CCC-SP
  • San Lorenzo Valley USD

2
THE BIG PICTUREour vision for the future
  • Engaging Learning Environments that promote
  • communicative, social, and cognitive growth
  • for learners with Social Learning Disabilities
  • Strong receptive base to support comprehension
  • Behavior management to support student engagement
  • Frequent expressive AAC use to support social
    interactive communication
  • Strong language and literacy training to support
    learning

3
Agenda
  • Social Cognitive Learning (SCL) Deficits
  • Perspective-taking and mind blindness in SCLD
  • Different pathways to SCLDs
  • Developmental prerequisites for
    perspective-taking
  • Social Communication, Executive functioning and
    Emotional Regulation Challenges in students with
    SCLDs
  • AAC as a framework to support perspective-taking,
    emotional regulation and social-communication

4
Agenda- continued
  • Engineering AAC supports for
  • Social Communication
  • Social Scripting Partner Focused Questions
  • Small Talk
  • Sharing the Day/Visual Bridges (Hodgson)
  • Perspective-Taking
  • Social Stories
  • Comic Strip Conversations
  • Video Social Review
  • Emotional Regulation
  • Identifying/Recognizing Emotions
  • Grading of emotions
  • Cognitive Behavior Therapy Behavior guides,
    Calming Strategies
  • Contingency Maps

5
Language comprehension perspective-taking
deficits .at the root of social learning
difficulties (Mirenda Beukelman,2000)
  • Comprehension drives language sense-making
  • Perspective-taking drives our thoughts about
    others thoughts, beliefs, knowledge, intentions
    desires
  • Mindblindness Deficits in mentalizing about
    others (Baron-Cohen, 1995)

6
What Do We Mean By.Perspective Taking?
  • Perceptual perspective ability to visualize what
    others can see or hear
  • Conceptual perspective ability to know what
    others are thinking and keep track of what others
    know

7
PERSPECTIVE-TAKING a range of complex social
scenarios
Source Carol Gray.
8
  • Theory of the Mind .a system for inferring and
    predicting a full range of mental states from
    anothers behavior - Baron-Cohen, 1995
  • ToM a social executive function
  • Understanding ones own and others emotions,
    thoughts, beliefs, prior experiences, motives,
    and intentions and inferring plausible causal
    factors for these states (Rubin Laurent,2001)
  • Inner language executive functions assist
    perspective-taking
  • Without ToM the world is an unpredictable
    place

9
Mindblindness deficits in mentalizing about
others (Baron-Cohen,1995)
  • Difficulty establishing shared knowledge for
    learner to process ongoing social interaction, or
    account for what others know
  • Difficulty understanding and predicting others
    intentions, actions or intended meanings
  • Inability to understand misunderstandings
  • Difficulty anticipating what others think of
    ones actions
  • Difficulty understanding deception, or being
    deceptive

10
Empathy Perspective-taking
  • Difficulty reading others emotional states
    comprehending others feelings
  • Insensitivity to others feelings

11
Pragmatic symptoms and Perspective-Taking
  • Poor ability to share topics obsessive,
    circumscribed interests, sticky topics
    problems linking to new topics (R. Paul, 2008)
  • Poor ability to infer what others already know
    what they need to know in running conversation
    (pre-suppositional knowledge)

12
Different Pathways to SCLDs
  • Students with social-learning difficulties
  • High Functioning Autism
  • Asperger Syndrome
  • PDD-Not Otherwise Specified Atypical Autism

13
  • AUTISM SPECTRUM DISORDERS

Asperger Syndrome
High functioning
Autism
Pervasive Developmental Disorder-NOS
Source Wetherby Prizant, 2000
14
Behavior Social-Cognitive Characteristics in
Autism Spectrum Disorders
  • Inflexible learning style
  • Do not accommodate well to change or novelty
  • Strongly desire routine in their environment
    respond best with predictability and structure
    (Rubin Lennon, 2004)
  • Sensory processing and behavioral modulation
    difficulties (Wetherby Prizant, 2001)
  • Unique perspective-taking difficulty predicting
    or correctly inferring what others feel or
    think
  • Genuine inability to understand others beliefs
    and emotions (Baron-Cohen,95)
  • May expect others to know their thoughts,
    experiences, opinions

15
Other groups at risk for Social-Cognitive
Learning challenges
  • Attention Deficit Disorder both hyperactive and
    inattentive types
  • Traumatically Brain Injured
  • Emotionally Disabled
  • Schizotypal affective disorder
  • Bipolar disorder
  • Genetic syndromes Fragile X Syndrome 33 of
    children with this genetically inherited
    condition also have a co-morbid ASD and
    associated social-cognitive deficits (Hagerman,
    U.C.Davis M.I.N.D. Institute)
  • The quirky kid

16
Students with Social Cognitive Learning
Challenges
  • Desire social contact, but have limited social
    pragmatic skills to establish and maintain
    friendships
  • May appear indifferent to peer pressure
  • Unaware of unwritten social rules (hidden
    curriculum)
  • May lack intuitive empathy insensitivity to
    others feelings
  • Often victims of bullying by middle school
    because of pronounced social learning problems
  • Significantly at risk for mood disorders
    (Anxiety, depression)
  • Sources Twachtman-Cullen, 2000 Atwood, 2003)

17
Developmental Prerequisites between 9-18 mos.
  • Joint Attention social communicative behavior in
    which two people share attentional focus on an
    object or event
  • Joint Attn Child responds to anothers
    attentional directive or initiates shared
    attention with another
  • Most massive deficits in autism are evident in
    shared referencing/joint attention (Curcio,1975)
  • Eye gaze three-way gaze shifts
  • Pointing gestures
  • Other declarative gestures (showing, or showing
    offinviting interaction from others)

18
Joint or Shared Attention in Autism
  • Initially ASD children use pointing/showing
    gestures to get what they want in an instrumental
    way, not to share attention with social
    partners
  • Discrepancy in use of early pragmatic functions
  • Requesting Commenting functions (to share
    topics/
  • invite interaction) do not develop concurrently
    as in typically developing children - Wetherby et
    al., 1998
  • Disrupted joint auditory attention some ASD
    children speak too loudly, or too softly, or with
    little modulation (Frith, 1989)

19
Social Language features in Autism Spectrum
Disorders (ASDs)
  • Pragmatics social communication are core areas
    of deficit
  • Conversational and pragmatic skills such as,
  • Staying topic-focused, turn-taking in
    conversation establishing and following the
    conversational focus of their social partners
  • Reading non-verbal cues
  • Social Communication Skills include
  • Pragmatic skills Paralinguistics prosody,
    gaze, gestures, proximity - R. Paul, 2008
  • AND.Social Behaviors include
  • Conventional gestures
  • Facial expression and body language
  • Avoiding socially unacceptable behaviors

20
Language Features in Asperger Syndrome
  • Grammatical syntactic expression is on par with
    age often fluent, syntactically mature
    utterances
  • Speech may be lengthy say too much-
  • Intense and narrow restricted interests drive
    conversational topics
  • Overly formal (pedantic) vocabulary
  • Caveat superficial verbal skills often mask
    cavernous weaknesses in comprehension
    (Twachtman-Cullen, 2000)
  • Prosody shows high rates of impairment in ASDs
  • Atypical intonation flat pitch contour, robotic
  • Poorly modulated volume overly loud or too soft
  • Speech rate hyperverbal
  • Difficulty with figurative language humor and/or
    abstract verbal concepts

21
The Invisible Disabilityqualitatively assessing
social pragmatic skills
  • SLPs standardized assessments measure basic
    technical language skillsdo not capture if
    student shows communicative competence in these
    skills.
  • For students with social pragmatic deficits, the
    optimal assessment is a qualitative one
  • Observe student across environments and contexts
  • Compare social functioning to the level of their
    peers
  • Incorporate pragmatic language samples into the
    assessment battery
  • No assessment of a student with AS can be valid
    if it is completely based on standardized tools
    (this is also true for all child-based
    assessments to include psychological and
    educational)

22
Social Cognitive Assessment
  • Emotional Intelligence Protocol. Source/author
    (VK) 2003, Thinking Publications
  • The Social Thinking Dynamic Assessment Protocol-
    Garcia Winner, M. in Thinking about you thinking
    about me. 2nd edition.2007

23
Behavioral Social-Cognitive Characteristics in
ASDs
  • Difficulty with
  • Emotional regulation ability to self-regulate
    ones arousal and emotional state, or seek
    assistance from others (mutual regulation) for
    availability and for social engagement (Rubin
    Lennon, 2004)
  • ER is another CORE developmental challenge in all
    students with ASDs
  • Developmental progression from more basic
    physiological/biological need states (e.g.,
    sucking thumb, averting gaze when stressed) to
    sophisticated behavioral strategies and the use
    of language meta-cognition to self-regulate
    arousal levels
  • ASD learners demonstrate idiosyncratic motor
    strategies used to self-regulate (to increase
    or decrease their arousal level) (e.g. flapping,
    toe walking crashing into someone) that are
    misinterpreted as socially deviant behavior
  • Social partners often isolate themselves from
    such individuals

24
Supporting dysregulation in a Middle school
student
25
Emotions Stress
  • Neurotypicals
  • Mildly/moderately stressful situations activate
    frontal
  • lobe functions use cognitive rehearsal
    language to
  • verbally mediate/modulate their emotions
  • Autistic Individuals
  • Get neurologically stuck in an attempt to
    manage a rigid set of expectations or to avoid
    novel ambiguous events (Corbett,2003)
  • Sensory or processing overload, anxiety/fear,
    increased novelty (change) or ambiguity elicits
    unregulated emotional reactivity (Levine
    Wiener,1989)
  • Frontal lobe activity shuts down amygdala
    activates ignites a cerebral fire storm
  • Explosive meltdowns
  • Aggressive and/or panic behaviors- flight/fight
    response
  • Escape behaviors
  • Withdrawal
  • Sensory shutting down (plugging ears, shutting
    eyes)
  • Significantly elevated stress circuits (limbic
    system-cortisol levels) compared to neurotypicals
    when stressed (Corbett,2004)

26
Executive Functions, Emotions and the brain.
  • FRONTAL LOBE AREA
  • Office manager judgment, planning,
    organization, shifting attention, initiating,
    task completion
  • Mental flexibility
  • Not consistently related to intellectual
    functioning or language skills, which may be
    quite high (Samuelson, 2004)
  • Theory of the Mind (perspective-taking) driven by
    exec.functioning in autism this reflects as
    mind-blindness (thinking about you thinking
    about me)
  • Behavioral self-regulation inhibition, impulse
    control
  • Executive Function Deficits occur singly
    co-occur in ADHD, Aperger Syndrome, ASDs,
    Fragile X, brain injuries, auditory processing
    disorder
  • fMRI studies show decreased frontal lobe activity
    in individuals in autism

27
  • Structurally denser neurons in autistic brains
    Medial temporal lobe
  • Amygdala almond-shaped structure
  • aggression emotion
  • interpretation of facial recognition and
    non-verbal social cues
  • Hippocampus sea-horse shaped structure
  • memory functions

28
Designing AAC Intervention Strategies
29
Range of Skills to become competent
communicators- Light, J. Bilger, C, 1998
  • Linguistic Skills
  • Receptive and expressive skills
  • Linguistic code
  • Operational Skills
  • Form signs or gestures correctly
  • Social Skills
  • Skills to initiate, maintain, develop, and
    terminate interactions
  • Skills to develop positive relationships and
    interactions
  • Skills to express range of communication
    functions (e.g., comments,requests,
    protests,etc.)
  • Skills to develop perspective taking
  • Prerequisite turn-taking skill
  • Strategic Skills
  • Compensatory strategies

30
Augmented OutputMay either supplement speech or
act as a primary communication mode
  • GESTURES
  • Natural Gestures
  • Sign Systems
  • Sign Language
  • GRAPHICS
  • Traditional Orthography
  • Photographs
  • Line Drawings

Augmented InputCan play an important role in
producing and/or comprehending speech
Visual Language Systems successfully used for
students with autism, etc. to visually augment
language input and output
31
Core to all intervention strategies
  • present a combination of visual and verbal cueing

32
Middle School SDC Program
33
AAC Visual Supports Enhance Receptive and
Expressive Communication
  • Prompt joint attention
  • Enhance attention to, and understanding of social
    messages and behavior
  • Establish conversational referents
  • Promote memory recall
  • Increase comprehension of language concepts
  • Facilitate social initiation and communicative
    intent
  • Johnston, S., Nelson, C., Evans, J., and
    Palasolo, K (2003).

34
Aided Language Stimulation
  • A legitimate second language involving a
    paradigm shiftvisual language is a real language
    and must be available as an essential aspect of
    each life activity
  • Infuses the environment with visual language to
    assist in the receptive and expressive processing
    for students with autism
  • Goosens et al., 1992 and Cafiero, 1998

35
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36
Encourages and Organizes Facilitators
Input Systematic AAC Intervention which provides
child with multiple models and opportunities to
make meaningful connections
  • Pool of Response Options a scaffold that
    organizes adult input for
  • Modeling
  • Recasting
  • Slower delivery rate
  • Repetition
  • Concentrated versus diluted message pool

37
Pool of Response Optionsa scaffold that aids the
students
  • Repeated exposure to input-comprehension
  • Initiation of communication
  • Expression
  • Retention/memory
  • Communicative functions beyond requesting
  • Expansion of syntax words into complete
    sentences
  • Segmentation breaking sentences into individual
    parts

38
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39
How Many Symbols?
  • ALS is appropriate for students with autism who
    can process many picture symbols compared to
    those who are at the one-to-three symbol level.
  • Students with joint attention and able to point
    can handle up to 50 symbols on a language board.
  • Students not yet able to establish joint
    attention can use 2 to 6 symbol language boards
  • Because ALS is initially receptive language
    training, more symbols are used than student can
    verbalize or understand
  • Students with autism who are speakers also
    benefit from ALS as a means to stimulate more
    complex receptive and expressive language skills.
    Words can be used in place of symbols for those
    with literacy skills.
  • Cafiero 1998

40

Engineering AAC supports forSocial Communication
  • Social Scripting
  • Vocabulary for turn taking
  • Sequence of a social script
  • Partner focused questions
  • Small Talk
  • Sharing the Day Visual Bridges (Hodgon,1998)

41
Vocabulary to Support Participation in Social
Interactions
  • social vocabulary can be used to take a turn in
    the conversation and participate more frequently.
  • focus on turns that are quick to produce
  • communicates to the partner that the AAC user is
    involved and interested in the conversation

42
Vocabulary to Facilitate Turn Taking
Yeah! Awesome Fat chance!
No way! Poor thing. Get a life!
Really? Okay. Youre kidding?
Cool. Wow! Hurray!
Gross! Gimme a break. Yes!
I doubt it. Whatever! Yea!
Says who? Thats great. Head nod.
Uh huh. Alright! Thumbs up sign.
Get out of here. Oh no! Thumbs down sign.
Neat! Yuck! Me, too.
43
Turn Taking
  • Turns include spoken messages, sign or gestures,
    messages on a communication board or
    speech-generating device.
  • Obligatory turns follow a partners question
  • What are you doing?
  • Nonobligatory turns follow a partners comment or
    statement or they can be turns that extend or
    change a conversational topic Cool! I have
    another idea

44
Anatomy of a Sequenced Social Script
  • Attention Getters
  • Hi there!
  • Theres Nancy!
  • Starters
  • Whats up?
  • Did you see Lost last night?
  • Maintainers, Holders and Interjectionsadd
    interest to story and prompts listener to make a
    comment.
  • It was awesome!
  • Ill give you a clue.
  • Turn Transfers(partner focused questions)
  • What did you see?
  • How about you?
  • Closing

45
PATHS to Starting a Conversation
  • P Prepare ahead keep fact files with
    important facts about people you know
  • Birth datefamily membersfavorite food, color,
    school subjectinterestsreading computer games
  • Later on keep invisible files
  • A Ask your self what you are going to say and
    how you are going to day it before you day it
  • Conversation starters
  • T Time is right
  • H Hello
  • S Signals - smile, gaze, body

Source J. McAffee, 2002
46
Social CoachingSmall Talk
47
Determine the Content of the Introduction Message
  • Attention-getting message
  • Excuse me.
  • Greeting(s)
  • Hi, hello
  • The individuals name
  • Full name for formal situations
  • Nickname for informal situations
  • The purpose of the interaction
  • Id like to introduce myself.
  • Id like to place an order.

48
Partner-Focused Questions
  • Those questions an individual ask his or her
    communication partners about their thoughts,
    feelings, and experiences
  • How are you?
  • Whats up?
  • Whats new?
  • What did you do this weekend?
  • What do you think?
  • How about you?
  • Whats wrong?
  • Howd you do?
  • Shows partners they are interested in them
  • Fosters social closeness and enhances interaction

49
How are you? What are you doing this weekend? Where are you going on vacation?
Whats up? What are you doing? How was your vacation?
What do you want to do How are you doing? Whats the matter?
How was your weekend? How do you like? What are you doing tonight?
How was yours? What did you do last night? Do you have plans for the weekend?
How about you? What do you think? How was your birthday?
What do you think about? When is your vacation?
Whats wrong?

50
Social Scripts to Promote Social Interaction
  • Scripts used for joke-telling, sharing life
    stories and general conversations
  • Scripts help AAC users move beyond wants and
    needs
  • Support students in learning to claim, start, and
    maintain turns in a conversation
  • Pre-programmed turns on speech-generating devices
    (SGDs)

51
Sharing the day Visual bridges
Hodgson,1998
52
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53
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54
Where you may never have gone before in therapy
  • Perspective training Social Skills Instruction
  • Social Scripts Social Stories (C. Gray,1995)
  • Comic Strip Conversations (C. Gray, 1996)
  • Video Modeling
  • Emotional Regulation Training
  • Recognizing/labeling feelings
  • Grading of Emotions
  • Teaching calming coping strategies
  • Contingency Maps (Mirenda, 2005)

55
Designing Tools for Perspective-Taking and Social
Success
  • 3 Goals
  • Improving the understanding and consideration
    others have of the unique perspective of the
    person with ASD
  • 2. Providing accurate social information,
    including Assistance in predicting,
    understanding and reading social situations
  • 3 Supporting the individual in making more
    effective responses to social situations
  • Source Carol Gray,1996

56
Sample goals-attentional focus, perspective and
intentions of others
State Standard L/S Interpret speakers verbal
and nonverbal messages, purposes, and
perspectives (5.1.2)
  • Sample Student Goals
  • Shares internal thoughts or mental plans with a
    partner
  • Modifies language based on what partner has
    seen or heard
  • Sample Partner Goals
  • Shares emotions, internal states, and mental
    plans with student
  • Uses AAC supports to foster understanding of
    language behavior

Source Prizant, B. et al. 2006 The SCERTS Model
57
Social Stories
  • provide scripted events of social situations
    that challenge the student
  • provide a positive statement of what the student
    can do
  • are written from the students perspective 

58
Whats a Social Story?
  • Social stories help the student understand why
  • Social Stories answer questions that students
    dont ask or dont ask well
  • Expected outcome increase in participation in a
    novel routine when the student has reviewed the
    Social Story
  • Also hoping for a decrease in resistance to change

59
3 purposes for Social Stories
  • Describe a situation and appropriate behavior
  • Explain fictional qualities realistic
    interactions with people
  • When the principal wears a funny hat, it usually
    means theres a special event at school
  • Explain the environmentindicate location or
    environmental surroundings where events happen
  • At church, my family usually sits in the back
    row of pews
  • At a restaurant, a waiter/waitress hands me a
    menu
  • Teach new routines and anticipated actions
  • Help student to translate a goal
  • I will try to stay calm when the fire alarm
    rings
  • I can ask for a break when my work is finished
  • (Ivey, Heflin, Juane, Alberto , 2004)

60
  • I sit at my desk until my work is finished.
  • I know that I am finished because I have answered
    all of the questions on my page.
  • When Im finished, I can take a break.

61
Social Stories
  • are perspective driven try to correct what
    the child is misperceiving, or give additional
    information the child needs to respond
    appropriately in a given situation
  • teach social understanding over rote compliance
    (Gray, 2003)
  • Goal is to describe the target situation, not to
    direct the childs behavior

62
  • Show electronic ALS social stories
  • Playing Fair - AT activity
  • My Social Stories Book (Gray White, Aided
    Language Supports)
  • Can incorporate into lyrics of stories or songs
  • Some students respond to stories written on a
    single page, while others respond to book style
    stories with one concept and a picture or icon on
    each page

63
Problem
  • How do we get the student to retrieve the
    script on the fly?
  • A visual support that travels with the student?
  • A visual support that starts the video-tape
    rolling?
  • Show Find a Friend Who
  • Give students models and scaffolds upon which to
    build their oral cognitive communication and
    writing.
  • Thinking Feeling Writing Prompts

64
 
Comic Strip Conversations
  • A Social Story on the fly
  • Goal to assist students who struggle to
    understand the quick exchange of information in
    conversation
  • Instant replay of the Who (was present), What
    (they were doing), Words (spoken),
    Thoughts/Beliefs (of those interacting)  

65
Comic Strip Conversations
  • Illustrate social situations abstract or
    non-verbal conversational concepts (e.g.,
    interruptions)
  • Visually scaffold dialogue exchanges (speech
    bubbles)
  • Convey emotional content/motivation through use
    of color coding
  • Target from the students perspective  

66
Where you may never have gone before in therapy!
  • Perspective training Emotional Regulation
    Instruction
  • Social Stories (C. Gray,1995)
  • Comic Strip Conversations (C. Gray, 1996)
  • Video Modeling
  • Emotional Regulation Training
  • Recognizing feelings
  • Grading of Emotions
  • Calming coping strategies
  • Behavior Guides Contingency Maps

67
Video Modeling(NIKOPOULOS KEENAN, 2003)
  • Video modeling utilizes medium of
    television/video to teach a variety of skills
    (Corbett, 2003)
  • Teaches social referencing
  • Attention selectively focusing childs behavior
    on relevant stimuli (tone of voice, proximity,
    loudness, verbal content, facial expression)
  • Retention maintaining learned social l through
    video review
  • Use video clips from TV shows to exemplify
    interactions
  • Rehearse with written scripts first
  • Verbal rehearsal - example asking a girl out on
    a date
  • Paraphrase rehearsal
  • Re-enact the scene with clinician
  • Re-enact the scene with peer
  • Use VM and role-play to become aware of listener
    cues
  • Yawning, taking a breath
  • Swirming in a chair
  • Looking toward door looking at watch

68
Where you may never have gone before in therapy!
  • Perspective training Emotional Regulation
    Instruction
  • Social Stories (C. Gray,1995)
  • Comic Strip Conversations (C. Gray, 1996)
  • Video Review
  • Emotional Regulation Training
  • Recognizing labeling feelings
  • Grading of Emotions
  • Calming coping strategies
  • Contingency Map (Pat Mirenda, 2005)

69
Emotional Regulation
  • Child must have emotional regulatory capacities
    to
  • Avoid a state of too high or too low based on
    expectations of a social situation
    (Self-Regulation)
  • Seek assistance and/ or respond to others
    attempts to provide support when faced with
    stressful, overly stimulating, or distressful
    circumstances (Mutual Regulation)
  • Recover from being pushed over the edge into
    states of emotional dysregulation or attentional
    shutdown through self-regulation and/or mutual
    regulation strategies.
  • Source E. Rubin. Addressing Social
    communication in Students with HFA and AS.
    Monterey SELPA. Feb. 2005

70
Ways to teach emotional regulation
  • Teach a continuum of emotional vocabulary
    happy, content, excited, thrilled (How
    Do You Feel? posters, Mood Swings)
  • Grading of emotions identify salient cues for
    a particular level of emotion (tone of voice,
    body language, facial expression, muscle tension,
    breathing)
  • Teach mutual regulation Requesting
  • assistance from others - seeking
    comfort/sympathy (Rubin Lennon,2004)
  • Regardless of language level, the student may be
  • unable to adequately express himself in
    stressful/highly charged situations
  • Provide an escape plan
  • Walk and no talk (Atwood,2004 McAffee, 2002)
  • Provide distracting pleasurable activities(
    Atwood, 2004)

71
Grading of Emotions
72
Emotional Key Rings
73
Recognizing Feelings Stress Activities
  • Happy and Sad
  • The Stress Thermometer (McAffee,2002) and Social
    Story When I have stress

74
Software that Supports Concept Development
  • IntelliTools Classroom Suitesuite of programs
  • IntelliTalk
  • IntelliPics Studio
  • IntelliMathics
  • Concept development is supported with graphic,
    text, and/or animation
  • Very useful for students with ASD in particular
    due to the programs visual and auditory supports

75
COGNITIVE BEHAVIOR THERAPY to Manage Emotional
Regulation Atwood, 2004
  • Affective Education Component
  • Teach why we have emotions
  • Explore one emotion at a time, starting with
    happiness progressing to others anxiety,
    anger, etc.
  • Teach a continuum of emotional vocabulary
    happy, content, excited, thrilled
  • Teach Grading of emotions in response to
    stress-inducing situations

76
Additional Tools to Address ER Atwood, 2004
  • Record enjoyable activities photo and
    communication scrapbooks
  • Sensory tools
  • Pleasures box
  • Sensory Calming areas
  • Special interest tools solitude a devoted
    interest in a topic can be calming (example
    interest in Japanese culture tea ceremony)
  • Drama
  • Autobiographies of adolescents/adults with HFA/AS
  • Mood diaries
  • Medication

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Pleasures Box
  • A form of cognitive distraction/redirection
  • Refocuses student on calming things
  • Sensory calming tools
  • Photographs pet, family members, favorite toy,
    favorite vacations or locations
  • Stories,music or calming sequences

78
REMEMBER TRANSITIONS!
  • The single most challenging part of every
    students and teachers day they cant be avoided

79
  • WHY ARE TRANSITIONS SO DIFFICULT?
  • The student
  • doesnt want to or is unable to stop a preferred
    activity/give up a reinforcer
  • doesnt like change
  • doesnt like losing control
  • protests to avoid activities he perceives as
    too hard or frustrating
  • Source L. Hogdgon. Solving Behavior Problems in
    Autism.

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Increasing flexibility at transitions
  • Make transitions part of the daily routine ask
    students to prep materials for the next day
  • Verbally announce natural endings (only 2
    problems left, then we will be done)
  • Refer back to the visual schedule
  • Behavior self-monitoring guides

81
Modify the length of instructional periods...
  • Short instructional intervals
  • Intermittent breaks, or alternate work and
    break intervals
  • Show student the duration of an activity

Time Timer www.Timetimer.com
82
  • Teach meaning of gestures or facial expressions
    commonly used with oral language
  • Photos of students making gestures or facial
    expressions in IntelliPics Studio with a label
    description of what the gesture or facial
    expression communicates then an interactive
    quiz
  • Theory of MindIntelliPics Studio demonstrating
    relationship between behavior and thoughts (a
    person who is sad may cry, have down-turned
    mouth, downcast eyes, little talking) then a
    quiz
  • Basic social rulesIntelliPics Studio to create
    activities that give instructions for appropriate
    behaviors when initiating conversations, waiting
    for conversation partner, taking turns, changing
    topic and finishing a conversation
  • Functional skillsIntelliTalk or IntelliPics
  • Name of clothes, order of dressing, how to wash
    clothes, clothes to wear in different weather
    conditions, how to put clothes away, how to
    compliment someone on their clothes
  • Food preparation
  • Develop literacy skillsIntelliTalk with its
    visual supports for text helps reinforce the
    understanding of both the original text and the
    reading comprehension activity.

83
Cognitive Restructuring Component to Manage
Emotional Regulation Atwood, 2004
  • Correct distorted conceptualizations of an event,
    situation, or person
  • Challenge false beliefs or assumptions
  • Example being deliberately hit by someone vs.
    considering the context nice guy who was
    running, tripped accidentally bumped into me
  • Building an Emotional Toolbox to repair
    restructure feelings and beliefs
  • Physical Tools for self regulation (tools to
    release emotional energy)
  • Relaxation Tools for self-regulation
  • Social Tools for mutual regulation using other
    people as a means to manage feelings
  • Thinking Tools for self-regulation self-talk,
    reality checks using logic/facts

84
Where you may never have gone before in therapy!
  • Perspective training Emotional Regulation
    Instruction
  • Social Stories (C. Gray,1995)
  • Comic Strip Conversations (C. Gray, 1996)
  • Video Self-Review
  • Emotional Regulation Training
  • Recognizing labeling feelings
  • Grading of Emotions
  • Calming coping strategies
  • Contingency Maps (Mirenda, 2005)

85
Contingency Maps
  • Similar to visual schedules, only more detailed
    and with a different purpose
  • Goal to provide information about the current
    problem and desired behavioral pathways related
    to problem behavior
  • Will help the individual understand why he or she
    should engage in the behaviors associated with
    the desired pathway!

_at_ Pat Mirenda, PhD., 11/05
86
Contingency Map
  • A contingency map depicts
  • The antecedent that typically triggers a problem
    behavior
  • The problem behavior
  • The consequences that will follow if it occurs
  • Ideally, the natural consequences if not,
    artificial
  • A functionally-related (desired) alternative
    behavior
  • The consequences that will follow if it occurs
  • Again, ideally, the natural consequences

87
Antonia
  • Grade 2 student with autism, little speech
  • Included for half of the day remainder spent in
    resource room because of problem behavior
  • Problem behaviors head-butting, hitting, and
    pinching classmates and adults when she had to
    wait
  • For her turn during buddy reading
  • In line
  • For the computer to boot up, etc.
  • Waiting was also an enormous problem at home

_at_ Pat Mirenda, PhD., 11/05
88
Wait Signal
  • Antonias SLP taught her to wait, using a wait
    symbol (a red circle that symbolized wait)
  • SLP provided systematic instruction in a
    simulated buddy reading activity to teach A.
    the meaning of the red circle you will get what
    you want, but not quite yet
  • Wait symbol was then used in real buddy reading
    by both A. and her classmates, along with other
    visual supports

_at_ Pat Mirenda, PhD., 11/05
89
Contingency Map Waiting in Line
_at_ Pat Mirenda, PhD., 11/05
90
Generalization
  • Once A. learned what the wait signal meant in
    buddy reading, contingency maps were created to
    help her generalize this understanding to other
    situations at school and at home.

_at_ Pat Mirenda, PhD., 11/05
91
Del
  • 6-year-old boy with autism, good verbal skills,
    high need for predictability and order
  • Prob Behavs screaming, crying yelling,
    self-injurious behavior
  • Triggers paper-and-pencil tasks in grade 1 and
    PE class on Thursdays in the gym (unpredictable,
    chaotic)
  • Function escape from difficult activities
  • Impact Del was socially isolated from his
    classmates because they were afraid of him

_at_ Pat Mirenda, PhD., 11/05
92
Intervention
  • Paper-and-pencil task teach Del to ask for a
    short break, as needed
  • PE class teach Del to ask the teacher for
    permission to sit and watch the class instead of
    participating, as needed
  • Verbal explanations given regarding the new,
    desired behaviors before each relevant activity
  • No changes in Dels behavior

_at_ Pat Mirenda, PhD., 11/05
93
Contingency Map
_at_ Pat Mirenda, PhD., 11/05
94
Contingency Map PE
_at_ Pat Mirenda, PhD., 11/05
95
Result
  • Immediate and dramatic reduction in Dels problem
    behavior as he began to use the new, desired
    behaviors
  • Lasted throughout grade 1 and into grade 2
  • Del received the most votes when the class was
    asked to choose who they wanted to sit next to
    for a new seating plan

96
We have the tools to develop...A deep tool chest
of intervention strategies

For more information email vkalashian_at_slvusd.org
mwolsen_at_monterey.k12.ca.us
97
Resources to Get Started
  • Atwood, T. 2004. Exploring Feelings Cognitive
    Behavior Therapy to Manage ANXIETY. Arlington,
    TX Future Horizons.
  • Atwood, T. 2004. Exploring Feelings cognitive
    Behavior Therapy to Manage ANGER. Arlington, TX
    Future Horizons.
  • Baker, J.E. 2003. Social Skills Training for
    Children and Adolescents with Asperger Syndrome
    and Social-communication problems. Shawnee
    Mission, KS Autism-Asperger Publishing.
  • Baker, J.E., 2001. The Social Skills Picture
    Book Teaching play, emotions and communication
    to children with autism. Arlington, TX Future
    Horizons.
  • Boardmaker Plus Mayer-Johnson, Inc. Solana
    Beach, CA
  • www.mayer-johnson.com
  • Britton Reese, P., and Challenner, N., 2002.
    Autism PDD Social Skills Lessons.
    Primary.Intermediate and Adolescent. Moline, IL
    LinguiSystems, Inc.

98
More Resources...
  • Brown, K., Mirenda, P. (2006). Contingency
    mapping A novel visual support strategy as an
    adjunct to functional equivalence training.
    Journal of Positive Behavior Interventions.
  • Elder, P., Crain, S. Goossens, C. (1999).
    Engineering the preschool environment for
    interactive symbolic communication. Birmingham,
    AL Southeast Augmentative Communication
    Conference
  • Erickson, K. Casey, K. (1998). Literacy,
    Augmentative Communication Children with Autism
    and/or Pervasive Developmental Disorders. AAC in
    the Mountains Conference. Park City, UT.
  • Fullerton, A., Stratton, J., Coyne, P. and Gray,
    C. 1996. Higher Functioning Adolescents and Young
    Adults with Autism. Austin, TX Pro-Ed.
  • Gray, C. 2003. The New Social Story Book
    Illustrated. Arlington, TX Future Horizons, Inc.
  • Gray, C. White, L. 2002. My Social Stories
    Book. London Jessica Kingsley Publishers.

99
  • Gray, C. 1994. Comic Strip Conversations.
    Arlington, TX Future Horizons, Inc.
  • Gray, C. 1995. Teaching children with autism to
    read social situations. In K.A. Quill (Ed.).
    Teaching Children with Autism Strategies to
    Enhance Communication and Socialization. New
    York Delmar Publishers.
  • Hodgdon, L. Visual Strategies for Improving
    Communication. Solving Behavioral Problems in
    Autism. QuirkRoberts Publishing.
  • Ivey, M.L., Heflin, Juane, I., and Alberto P,
    2004. The use of social stories to promote
    independent behaviors in novel events for
    children with PDD-NOS. Focus On Autism and Other
    Developmental Disabilities, 19, 164-176.
  • Johnson, A.M. and Susnik, J.L., 1995. Social
    Skills Stories Functional Picture Stories for
    Readers and Nonreaders K-12. Solana Beach, CA
    Mayer-Johnson, Inc.
  • Johnston, S., Nelson, C., Evans, J., and
    Palasolo, K (2003). The use of visual supports in
    teaching young children with autism spectrum
    disorder to initiate interactions. Augmentative
    and Alternative Communication, 19, 86-103.

100
  • Light, J., Roberts, B., Dimarco, R., Greiner,
    N. (1998). Augmentative and alternative
    communication to support receptive and expressive
    communication for people with autism. Journal of
    Communication Disorders, 31, 153-80.
  • Light, J.C. and Bilger, C. 1998. Building
    Communicative Competence with Individuals Who Use
    Augmentative and Alternative Communication.
    Baltimore Paul Brookes.
  • McAfee, J. 2002. Navigating the Social World A
    Curriculum for Individuals with Aspergers
    Syndrome, High Functioning Autism and Related
    Disorders. Arlington, TX Future Horizons.
  • McClannahan, L. E., Krantz, P. J. (1999).
    Activity schedules for children with autism
    Teaching independent behavior. Bethesda, MD
    Woodbine House.

101
  • Mirenda, P. Schuler, A. (1998). Teaching
    individuals with autism and related disorders to
    use visual-spatial symbols to communicate. In S.
    Blackstone, E. Cassatt-James D. Bruskin (Eds.),
    Augmentative communication Intervention
    Strategies, (pp.5.1-17-5.1-25). Rockville, MD
    American Speech-Language-Hearing Association.
  • Moyes. R. A. 2003. Incorporating Social Goals in
    the Classroom A guide for Teachers and parents
    of Children with High-Functioning Autism and
    Asperger Syndrome. C. Thomas Publishing.
  • Rubin, E., Asperger Syndrome and High-Functioning
    Autism Addressing Social Communication and
    Emotional Regulation. 2004. Topics in Language
    Disorders, 24 (4).
  • Rubin, E. Laurent, A. 2002. Feelings Book.
    Communication Crossroads. www.commxroads.com
  • Smith Myles, B., Trautman, M., Schelvan, R. 2004.
    The Hidden curriculum Practical Solutions for
    Understanding Unstated Rules in Social
    Situations. Shawnee Mission, KS Autism-Asperger
    Publishing Co. www.asperger.net

102
  • Twachtman, D.,1995. Methods to enhance
    communication in verbal children. In K.A. Quill
    (Ed.). Teaching Children with Autism Strategies
    to Enhance Communication and Socialization. New
    York Delmar Publishers.
  • Prizant, B., Wetherby, A. Rubin, E., Rydell, A.
    and Rydell, P. 2006. The SCERTS Model Volume 1
    Assessment Vol.2-Program Planning and
    Intervention.Brookes Publishers.
  • Winner-Garcia, M. 2008. Thinking About YOU
    Thinking About ME. Volume 2. San Jose, CA Center
    for Social Thinking. www.socialthinking.com
  • Winner-Garcia, M. 200 _. Think Social! A Social
    Thinking Curriculum for School-Age Students. San
    Jose, CA Center for Social Thinking.
    www.socialthinking.com
  • Winner-Garcia, M. 200_ Think Social! Worksheets.
    San Jose, CA Center for Social Thinking.
    www.socialthinking.com
  • Winner-Garcia. 2008. Sticker Strategies to
    Encourage Social Thinking and Organization.
    www.socialthinking.com

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Web resources
  • www.portacom.bc.ca
  • www.disabilitysolution.org
  • www.news-2-you.com
  • www.sandbox-learning.com
  • www.socialthinking.com
  • www.thegraycenter.com
  • www.usevisualstrategies.com
  • www.adaptedlearning.com
  • www.aheadwithautism.com
  • www.asperger.net
  • www.aspergersyndrome.com
  • www.autism-society.org
  • www.CommXRoads.com
  • www.do2learn.com
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