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How Autism Spectrum Disorder Affects Learning in the Classroom

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How Autism Spectrum Disorder Affects Learning in the Classroom B.J. Freeman, PhD Professor Emerita, UCLA School of Medicine Alabama CASE Conference – PowerPoint PPT presentation

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Title: How Autism Spectrum Disorder Affects Learning in the Classroom


1
How Autism Spectrum Disorder Affects Learning in
the Classroom
  • B.J. Freeman, PhD
  • Professor Emerita, UCLA School of Medicine
  • Alabama CASE Conference
  • February 25, 2014

2
  • Autism Spectrum Disorders are best viewed as
    social-communication learning disabilities.
  • ASDs represent a wide spectrum of abilities and
    disabilities.

3
  • All children with ASDs require intense
    multi-disciplinary evaluations and intensive
    early intervention (as soon as diagnosed) that
    focuses on teaching social communication skills
    in the natural environment.

4
  • Research has shown that even very mild social
    communication issues in younger children can
    result in significant behavior issues as they
    age.
  • Current consensus is that the best approach to
    intervention for the core symptoms of ASDs
    includes a program of coordinated, intensive
    educational and behavioral intervention.

5
  • The most tested intervention is applied
    behavior analysis (ABA) which has been shown
    to significantly improve the core symptoms in
    almost all children.
  • Complete recovery is rare, but the number of
    children showing recovery has been increasing
    over the past few years.

6
  • Recent research has demonstrated that early
    intervention actually changes brain function.

7
Diagnostic Criteria For 299.0 ASD
  1. Persistent deficits in social communication and
    social interaction across multiple contexts, as
    manifested by the following, currently or by
    history

8
  • 1. Deficits in social-emotional reciprocity,
    ranging, for example, from abnormal social
    approach and failure of normal back-and-forth
    conversation to reduced sharing of interests,
    emotions or affect to failure to initiate or
    respond to social interactions.

9
  • 2. Deficits in nonverbal communicative behaviors
    used for social interaction ranging, for example,
    from poorly integrated verbal and nonverbal
    communication, to abnormalities in eye contact
    and body language or deficits in understanding
    and use of gestures, to a total lack of facial
    expressions and nonverbal communication.

10
  • 3. Deficits in developing, maintaining and
    understanding relationships ranging, for example,
    from difficulties adjusting behavior to suit
    different social contexts, to difficulties in
    sharing imaginative play and in making
    friends, to absence of interest in peers.

11
  • Severity Level is specified based on the persons
    specific communication impairments.

12
  • Severity Level 1 Requires support for deficits
    in social communication that cause noticeable
    impairments without supports in place difficulty
    initiating social interactions, and clear
    examples of atypical or unsuccessful response to
    social overtures of others.
  • (For example, a person who is able to speak in
    full sentences and engages in communication but
    whose to- and-fro conversation with others fails,
    and whose attempts to make friends are odd and
    typically unsuccessful.)

13
  • Severity Level 2 Requires substantial support
    for marked deficits in verbal and nonverbal
    social communication skills social impairments
    apparent even with supports in place limited
    initiation of social interactions and reduced or
    abnormal responses to social overtures from
    others.
  • (For example, a person who speaks simple
    sentences, whose interaction is limited to narrow
    special interests, and who has markedly odd
    nonverbal communication.)

14
  • Severity Level 3 Requires very substantial
    support for severe deficits in verbal and
    nonverbal social communication skills that cause
    severe impairments in functioning very limited
    initiation of social interactions and minimal
    response to social overtures from others.
  • (For example, a person with few words of
    intelligible speech who rarely initiates
    interaction and, when he or she does, makes
    unusual approaches to meet needs only and
    responds to only very direct social approaches.)

15
  • B. Restricted, repetitive patterns of behavior,
    interests or activities as manifested by at least
    two of the following, currently or by history

16
  • 1. Stereotyped or repetitive motor movements, use
    of objects, or speech, (e.g., simple motor
    stereotypies, lining up toys, or flipping
    objects, echolalia, idiosyncratic phrases). 

17
  • 2. Insistence on sameness, inflexible adherence
    to routines, or ritualized patterns of verbal or
    nonverbal behavior (e.g., extreme distress at
    small changes, difficulty with transitions, rigid
    thinking patterns, greeting rituals, need to take
    same route or eat same food every day).

18
  • 3. Highly restricted, fixated interests that are
    abnormal in intensity or focus (e.g., strong
    attachment to or preoccupation with unusual
    objects, excessively circumscribed or
    perseverative interests).

19
  • 4. Hyper- or hyporeactivity to sensory input or
    unusual interest in sensory aspects of the
    environment (e.g., apparent indifference to
    pain/temperature, adverse response to specific
    sounds or textures, excessive smelling or
    touching of objects, visual fascination with
    lights or movement).

20
  • Severity Level is specified based on the persons
    restricted, repetitive patterns of behavior.

21
  • Severity Level 1 Requires support for
    inflexibility of behavior that causes significant
    interference with functioning in one or more
    contexts difficulty switching between
    activities problems of organization and planning
    that hamper independence.

22
  • Severity Level 2 Requires substantial support
    for inflexibility of behavior, difficulty coping
    with change, or other restricted/repetitive
    behaviors that appear frequently enough to be
    obvious to the casual observer and interfere with
    functioning in a variety of contexts distress
    and/or difficulty changing focus or action.

23
  • Severity Level 3 Requires very substantial
    support for inflexibility of behavior, extreme
    difficulty coping with change, or other
    restricted/repetitive behaviors that markedly
    interfere with functioning in all spheres great
    distress/difficulty changing focus or action.

24
  • C. Symptoms must be present in the early
    developmental period (but may not become fully
    manifest until social demands exceed limited
    capacities, or may be masked by learned
    strategies in later life).

25
  • D. Symptoms cause clinically significant
    impairment in social, occupational of other
    important areas of current functioning.

26
  • E. These disturbances are not better explained by
    intellectual disability (intellectual
    developmental disorder) or global developmental
    delay. Intellectual disability and autism
    spectrum disorder frequently co-occur to make
    comorbid diagnoses of autism spectrum disorder
    and intellectual disability, social communication
    should be below that expected for general
    developmental level.

27
Characteristics of Curriculum
  • How to Select Skills/What to Teach
  • Skills should be meaningful to the student,
    functional, age appropriate and lead to
    independent functioning in the natural
    environment.

28
  • What Skills Should Be Selected?
  • Multiple environments Skill will enhance
    students functioning in increased number and
    range of environments.
  • Functionality If student does not perform the
    skill, someone else will have to do it for them.

29
  • Chronological Age Appropriateness Skill is
    culturally sanctioned within students age group.
  • Practice Student will have opportunities to
    perform skill under non-instructional conditions,
    once acquired.

30
  • Required in Adulthood Skill is required, needed,
    respected or allowed expression in post school
    years.
  • Student Preference Student will enjoy being able
    to perform the task.
  • Parent Preference Parent would like student to
    learn the skill.

31
  • Physical Enhancement Skill will enhance the
    students physical well being.
  • Social Contact Enhancement Skill will increase
    students chances for positive social
    interactions, particularly with non-disabled
    peers.

32
  • Acquisition Probability Student should be able
    to acquire skill in a reasonable period of time
    if adequate resources are devoted to its
    instruction.
  • Status Enhancement Skill will enhance students
    status in the eyes of many non-disabled people.

33
  • Six kinds of intervention should have priority
  • Functional, spontaneous communication should be
    the primary focus of early education.
  • Social instruction should be delivered throughout
    the day in various settings, using specific
    activities and interventions planned to meet age
    appropriate, individualized social goals.

34
  • 3. Teaching of leisure skills should focus on
    activities with peers, with additional
    instruction in appropriate use of toys, games and
    other materials.

35
  • 4. Other instruction aimed at goals for cognitive
    development should be carried out in the context
    in which skills are expected to be used, with
    generalization and maintenance in natural
    contexts as important as acquisition of new
    skills.

36
  • Because new skills have to be learned before they
    can be generalized, documentation of rates of
    acquisition is an important first step.
  • Methods of introduction on new skills may differ
    from teaching strategies to support
    generalization and maintenance.

37
  • 5. Intervention strategies that address problem
    behaviors should incorporate information about
    the contexts in which behaviors occur, positive
    proactive approaches, and a range of techniques
    that have empirical support (e.g., functional
    behavior assessment, functional communication
    training, reinforcement of alternative behaviors).

38
  • 6. Functional academic skills should be taught
    when appropriate to the child.

39
  • Taking into account the needs and strengths of an
    individual child and his/her family, the childs
    schedule and educational environment in and out
    of the classroom should be adapted as needed in
    order to implement the IEP.

40
  • Educational services should include a minimum of
    25 hours a week, with no more than a 2-week
    break, where the child is engaged in
    systematically planned, developmentally
    appropriate activities aimed toward identified
    objectives.

41
  • Where activities take place and content of
    activities should be determined on an individual
    basis, depending on characteristics of the
    activity, the child and family.

42
  • Individual Instruction
  • The child must receive sufficient individualized
    attention on a daily basis so that individual
    objectives can be effectively implemented.
  • Individualized attention should include
    individual therapies, developmentally appropriate
    small group instruction, and direct 11 contact
    with teaching staff.

43
  • Need to teach readiness skills for learning
    before curriculum.
  • Ongoing assessment of the childs progress in
    meeting objectives should be used to further
    refine the IEP.

44
  • Lack of objectively documentable progress over
    3-month period should be taken to indicate a need
    to increase intensity by lowering student/teacher
    ratios, increasing programming time,
    reformulating curricula, or providing additional
    training and consultation.

45
  • To the extent that it leads to specified
    educational goals (e.g., peer interaction skills,
    independent participation in regular education),
    children should receive specialized instruction
    in settings in which ongoing interactions occur
    with typically developing children.

46
  • Characteristics of Teacher
  • Interaction Strategies
  • working knowledge of ASD characteristics
  • develop sense of trust between teacher and
    student with ASD
  • accept students cognitive and social abilities,
    and learning potential
  • accept student for who he or she is
  • training in ABA

47
  • Characteristics of Learning Environment
  • Individualized Supports Services
  • Should be based on applied behavior analysis
    (ABA).

48
  • Incorporation of childs preferences special
    interests into instructional program.
  • Focus on childs strengths weaknesses to
    determine the most appropriate density and level
    of instruction to meet childs individual goals.

49
  • Systematic Instruction
  • Targeting meaningful skills to be taught.
  • Planning when how to provide instruction based
    on unique characteristics of student.
  • Determining data collection method to measure
    students progress instructional effectiveness.

50
  • Comprehensible, Structured Learning Environment
  • Organize instructional setting
  • Provide schedule of activities
  • Carefully plan provide choice-making
    opportunities
  • Provide behavioral support

51
  • Define specific areas of classroom, school
    settings
  • Provide temporal relations
  • Facilitate transitions, flexibility, change

52
  • Goals of the Classroom
  • Increase accessibility to learning by decreasing
    disruptive/aggressive behaviors.
  • Maximize learning (pre-academic, academic,
    self-care, motor skills, receptive/expressive
    learning, etc.)
  • Maximize communication
  • Readiness for learning

53
  • Signs of a Good Class
  • extensive reinforcement
  • systematic intervention plans
  • continuous teaching/no down time
  • comprehensive programming
  • natural teaching

54
  • Instructions designed for Educators
  • Communicating to the student
  • Encouraging communication with the student
  • Social supports includes specific teaching,
    rehearsal, practice modeling of social skills
    in natural settings.

55
  • Environment Routine
  • Presentation of material
  • Assessment assignments
  • Homework
  • Self-management of behavior

56
Functional Behavior Assessment
  • Dynamic process that addresses behavior on
    individual basis.
  • Is a work in progress should not be fixed.
  • Key to success

57
  • 10 steps toward supporting appropriate behavior
    in the classroom
  • Understand characteristics of ASDs that may
    influence students ability to learn and function
    in school environment.
  • Acknowledge that behavior serves a function, is
    related to a context, and is a form of
    communication.

58
  • Use FBA as first step in designing behavior
    support plan
  • identify, describe behavior
  • describe setting, demand, antecedent
  • collect baseline data, work samples

59
  • complete functional analysis, develop hypothesis
  • develop implement positive behavior support
    plan
  • collect data, monitor effectiveness
  • revise as needed

60
  1. Think PREVENTION.
  2. Use antecedent and setting event strategies.
  3. Make teaching alternative skills an integral part
    of program.
  4. Effective behavioral change may require everyone
    involved to change their behavior as well.

61
  1. Design long-term prevention plan.
  2. Discuss how student fits into school-wide
    discipline practices procedures.
  3. Collaborate, hold regular team meetings.

62
  • ABA Strategies
  • Should not focus on excessive behaviors, but lack
    of new skills
  • Most studied, most scientific support
  • Curriculum consisting of simple complex target
    behaviors involving hundreds of programs
    developed through years of research.

63
  • Child-specific curriculum adaptations
  • Task analysis
  • Repeated practice through discrete trials
  • Masses expanded, dispersed formats
  • Clear, discriminable instructions

64
  • Common Behavior Strategies
  • Proactive procedures
  • identify function of disruptive behavior
  • select replacement behavior
  • break skill into discrete parts
  • teach discrete skill until mastery
  • concentrated systematic teaching
  • provide assistance as necessary
  • make learning fun as natural as possible
  • provide reinforcer for appropriate behavior

65
  • Reactive procedures
  • create behavioral momentum
  • provide reinforcer for absence of disruptive
    behavior
  • disruptive behaviors result in least amount of
    attention necessary loss of opportunity for
    reinforcement
  • shape de-escalation
  • remain calm

66
  • Reinforcement guidelines
  • Cannot assume!
  • Reinforcers should be reinforcing.
  • Reinforcement should be contingent may have to
    be taught.
  • Use a variety of reinforcers.
  • Pair social with tangible reinforcers.
  • Continuously develop reinforcers.

67
  • Initially, reinforcement should occur
    immediately.
  • Thin reinforcement schedule as soon as possible.
  • Label behavior being reinforced.
  • Dont use bribery.
  • Utilize differential reinforcement.

68
  • Goal is for the natural environment to take over
    the reinforcement and the person learns to
    control his/her own behavior.

69
  • Common Misunderstood Behaviors
  • Compliance
  • Is the instruction necessary?
  • Does the child understand instruction?
  • Will you/Can you follow through?
  • Dont issue multiple instructions.
  • Provide choices when possible.
  • Phrase with expectation of compliance.

70
  • Create behavioral momentum.
  • Catch the child listening.
  • Give in early.
  • Provide meaningful consequences.
  • Utilize errorless compliance training program.
  • If non-compliance occurs, provide least amount of
    attention.

71
  • Stress management
  • Develop calming place
  • Create calming object
  • Teach concept of calm
  • Identify stressors
  • Arrange stressors into a hierarchy
  • Teach relaxation skills (holding object, guided
    imagery)

72
  • Expose to mild stressor
  • Cue relaxation
  • Reinforce calm
  • Fade cueing
  • Systematically expose to more natural environment
  • Expose systematically to higher stress levels

73
  • Teachers learn according to the same principles
    as their students. Multiple exposures,
    opportunities to practice, and active involvement
    in learning are all important aspects of learning
    for teachers as well as students.
  • Educating Children with Autism
    National Research Council, Lord et al, 2001
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