Advanced Hands-on Autism Training

Oregon Technical Assistance CorporationMarch 2013

• Sign-in• Bathroom• Breaks• Lunch• Review 3 day agenda• Move around if you need to• Ask questions and share your experience

Housekeeping

Autism is a developmental disability linked to genetic, dietary, and environmental risk factors that impact brain development

History of Autism• 1911 - “autism” used to describe symptoms of

schizophrenia• 1938-43 – Leo Kanner used the term “inborn autistic

disturbances” to describe children he saw at Johns Hopkins• 1944 – Hans Asperger described children he studied as

“little professors” and termed “autistic psychopathy”• 1940’s – 60’s Autism considered an emotional illness

• 1950 – The term “refrigerator mother” popularized by Bruno Bettelheim in his book, The Empty Fortress

• 1964 – Bernard Rimland provided evidence that autism has a biological basis

• 1966-2006 – Eric Schopler and Robert Reichler began a career that regarded autism as a perceptual difference. Their work with families strengthened the work of Division TEACCH the Autism program at UNC

• Present – ASD is better understood but lacks funding for research and support for adults on the spectrum

General Criteria for Diagnosis• Qualitative impairment in social interactions• Qualitative impairment in communication• Restrictive, repetitive, and stereotyped patterns

of behavior, interests, and activities• Onset prior to age 3 of delays in at least one of

the following:– Social interaction– Social communication– Symbolic and imaginative play

Pervasive Developmental Disorders (PDD)*

* In May 2013 the DSM5 will be released and the criteria for PDD’s will change

autismAsperger’s Syndrome

Rett Syndrome

Childhood disintegrative disorder

PDD-NOS

The autism diagnosis is an underlying condition

What sets up:

What sets off:

What I see: What does the person gain/ avoid by doing this:

Replacement Behavior

Underlying condition:

Autism

• Visual learners• Focus on details• Problems with multiple

perspectives• Difficulties with time and

organization• Sensory and perception

problems• Restricted repertoire of

behaviors

Characteristics of Autism

Differences in:• Thinking• Learning• Neurobehavioral

patterns

Characteristics of AutismCharacteristic of

AutismImpact on the person

Visual Learner Learns best when information is visual. Difficulties with communication and language, memory, processing speed, and development.

Focused on details Difficulties with generalization, relevant and irrelevant, concrete vs. abstract thinking, and problems integrating ideas.

Problems with multiple perspectives

Difficulty with joint attention, multi-tasking, eye contact, listening skills, choices, perspective taking, judgment, and responding to other’s emotions

Characteristics of AutismCharacteristic of

AutismImpact on the person

Time and organization

Difficulty with organization, sequencing, initiating, time management, understanding time, following routines, and transitions.

Sensory and perception problems

Inappropriate or inconsistent responses to sound, touch, smells, sights, pain, and textures. Can be easily distracted and have difficulties in open spaces.

Restricted repertoire of behaviors

Upset by changes and insisting on sameness. Learns repetitive routines easily. Unusual and elaborate rituals and routines. Compulsive and driven behaviors.

http://www.youtube.com/watch?v=xMBzJleeOno&feature=youtu.be

Autism: Above the surface

Underlying Characteristics

We look below the surface at what we can’t see to understand what we

do see

Chronic bowel issues SeizuresVomiting Won’t sit for longSmearing feces Poor sleep

• Gastrointestinal problems• Food allergies and intolerances• Difficulties with communication and

language• ADHD• Sensory and perception problems• Anxiety

Biological Challenges

• Distress when routine changes• Heightened anxiety• Restricted repertoire of behaviors• Problems understanding sequences• Sensory and communication differences• Environments are confusing• Sameness provides comfort• Visual learners

Attachment to Routines

Insists on specific routes CryingThrowing objects Refusing to transition Completes routines independently

http://www.youtube.com/watch?v=IcS2VUoe12M&feature=youtu.be

Hitting Pinching self/othersScreaming Throwing objectsSaying, “No” Banging head

• Limited ability to communicate• Difficulties with initiation• Disrupted routines/schedules• Not having enough information• Not understanding others feel

pain/sadness• Sensory and perception challenges

Aggression and Self-Injury

Laughing Sharing personal information Answering questions as a characterPreferring to work alone Demanding

• Feelings are abstract• Processing difficulties with eye contact• Problems with communication and

language• Difficulty with organization and

sequencing• Difficulty with joint attention and multi-

tasking• Problems with multiple perspectives

Social Judgment and Relating

Spinning Collecting unique items Scripting TV shows Watching scenes repeatedlyFlooding the sink Lining up objects

• Relaxation and creativity is difficult• Preference for structure and routine• Difficulties with social skills and relating

to others

Limited Play Skills

Scripted Responses Waiting for cuesRefusing hygiene Not following directionsChanging clothes repeatedly Hitting/Yelling

• Dependence on prompts• Difficulty with sequencing• Doesn’t know where to start or finish• Doesn’t understand expectations or

consequences• Different concept of what is rewarding• Difficulty with time and organization• Sensory differences

Difficulty with Initiation

Eating/Chewing non food items RunningStripping Asking repetitive questionsClimbing Leaving unsupervised

• Overstimulation/Sensory differences• Not understanding expectations• Communication differences• Driven by strong impulses• Rarely deliberate to “push buttons”• Misunderstanding social cues• Focus on details

Appearing Defiant

• Understanding the characteristics of autism

• Structuring the physical environment

• Using visual supports• Developing meaningful routines• Careful, Ongoing Assessment• Using Strengths, Interests, and

emerging skills• Family/Team Collaboration to

develop an individualized plan

TEACCH Educational Principles

References• Dawson, Geraldine .(2008). Early behavior intervention, brain

plasticity, and the prevention of autism spectrum disorder. Development and Psychopathology, 20 , 775-803. Retrieved March 24, 2012 from http://www.psy.miami.edu/faculty/dmessinger/c_c/rsrcs/rdgs/autism_clinical/dawson.devpsychopath.2008..pdf

• DiCiccio, E., Lord, C., Zwaigenbaum, L., Courchesne, E., Dager, S.R., & Schmitz, C., et al. (June 28, 2006). The Neurobiology of Autism Spectrum Disorder. The Journal of Neuroscience 26(26), 6897-6906. Retrieved March 24, 2012 from http://www.autismspeaks.org/docs/DiCicco-Bloom.pdf

• Mesibov, G.B., Shea, V., & Schopler, E. (2004). The TEACCH Approach to Autism Spectrum Disorders. New York, Springer Science+Business Media, Inc.