Kathy EckardAutism Specialist, HPS

828-324-8884

I can…describe at least 1 of the 5 deficit areas that effects those with ASD and a strategy with which it could be strengthened.

Definition

Autism spectrum disorder (ASD) is a range of complex

neurodevelopmental disorders, characterized by social

impairments, communication difficulties, and restricted,

repetitive, and stereotyped patterns of behavior. Although ASD varies

significantly in character and severity, it occurs in all ethnic and socioeconomic groups and affects

every age group.

Change in Definition-DSM V-2013• The separate diagnostic labels of Autistic

Disorder, Asperger’s Disorder, and PDD-NOS have been replaced by one umbrella term Autism Spectrum Disorder (ASD).

• More thorough and strict criteria for ASD diagnosis

• The revisions have been made with the hope that the diagnosis of autism spectrum disorders will be more specific, reliable, and valid.

Prevalance of ASDAutism Speaks, 2013

The Centers for Disease Control and Prevention estimates that 1 in 88 children in the United States has been identified as having an autism spectrum disorder (ASD), according to a new study released. Autism spectrum disorders are almost five times more common among boys than girls – with 1 in 54 boys identified.

Cause?

• Underlying biological/genetic cause that produces organic and/or physical changes during brain development, resulting in atypical cognitive and social development and behaviors

• Tends to occur more frequently than expected among individuals who have certain medical conditions, including Fragile X syndrome

• Research indicates other factors besides the genetic component are contributing to the rise in increasing occurrence of autism, such as environmental toxins (e.g. heavy metals such as mercury) and diet (gluten free).

• The vast majority of research indicates it is not caused by vaccinations

Deficits

The DSM-V provides five deficit areas to consider as diagnostic criteria for identifying individuals with ASD:

• Communication• Socialization/Social skills• Restricted interests• Sensory integration• Behavior

Early Signs

• Lack of eye contact

• Lack of joint attention (i.e., attention to the same item or topic as another person)

• Lack of reciprocal conversation (i.e., ability to engage in verbal turn taking)

• Atypical sensory/motor processing

Core Deficits• Difficulty identifying important global concepts and elements of tasks

• Difficulty processing auditory information—understanding, retaining, and retrieving;

• Difficulty generalizing skills—teach skills in context;

• Difficulty with sequencing information or steps in a task;

• Difficulty transitioning between different activities and places;

• Difficulty with time concepts and time management;

• Atypical and/or uneven academic, social, or emotional development (e.g., high functioning in some academic areas, low functioning in others).

Communication

• Deficits in speech development and production• Echolalia• Abstract and inferential thinking• Understanding figurative language—idioms, metaphors, similes, and irony—

multiple meanings and sarcasm• Organization and time management, completing multi-step tasks and procedures• Reciprocity and perspective-taking during conversations;• Initiating, terminating, and repairing a conversation;

Strategies- CommunicationComprehension• Pre-teach new concepts and vocabulary to students prior to group • Model procedures, expectations, thinking strategies, or directions• Post visual reminders of the lesson’s essential questions • Identify auditory signals that alert students to important information or indicate when and where students should focus their attention• Pair verbal instructions with visual cues• Provide visual supports for lectures• Identify verbally and visually when transitions will occur.

Strategies-CommunicationExpressive• Develop a functional communication system• Create assessments that do not rely heavily on essay or short answer

questions• Provide communication supports that facilitate student independence

Sensory Integration and Regulation

• Hypersensitivity/hyposensitivity• Attention and focus• Regulation of activity level• Transitions between activities and places• Control of impulses, behavior, and/or fear in dangerous situations• Fine or gross motor skills, motor planning, or coordination• Oral motor• Recognition of personal space- their own and that of others’

Strategies for Accommodating Difficulties with Sensory Integration and Regulation

Physical Layout of the Classroom

• Consider desk location

• Display visuals with instructions, routines, behavioral expectations, and schedules

• Delineate work areas, sensory areas, leisure/free time areas

• Provide a bumpy seat for the student’s chair during seat work

• Provide a quiet/respite area

Movement Activities that Promote Task Engagement and Focus

• Provide opportunities for rhythmic, sustained movement-trampoline, swinging, marching, or bouncing on a ball

• Provide a sensory task before seat work.

• Provide additional opportunities for movement • Brain Gym-crossing the mid-line • Use timers

Socialization/Social Skills

• Engaging in reciprocal social interactions• Maintaining eye contact during conversations• Attention to nonverbal aspects of communication- gestures and facial

expressions• Adapting and conforming to rules governing social behavior• Feeling empathy because they tend to intellectualize feelings or play behaviors• Demonstrating age appropriate social skills• Initiating or engaging others appropriately in social situations• Initiating, terminating, and holding conversations

video

Strategies for Improving Socialization Skills

• Provide explicit instruction of conversation etiquette

• Rehearse skills needed for appropriate social interactions

• Practice newly learned social skills with puppets, peers, or adults

•Teach to associate different facial features with emotions

• Introduce procedures for using a stress thermometer or tension gauge

• Schedule frequent daily review of social stories

•Have conversation about differences

• Video role play

Behavioral Issues• Ritualistic and compulsive • Impulsivity • Stereotypic behaviors • Aggression • Inappropriate social interactions

Strategies for Minimizing Behavior Difficulties

Ritualistic and Compulsive

• Intervene early before behavior becomes a habit

• Teach students when ritualized behaviors may appropriately occur during the day (e.g., structure when hand washing can occur)

Impulsivity

• Use social stories to teach social skills/minimize negative behaviors

• Rehearse appropriate behaviors the student should use

Stereotypic

• Develop a menu of appropriate sensory interventions to aid with sensory. regulation and heightened anxiety or stress

• Develop a daily sensory schedule

Aggression• Remove or minimize environmental stressors that trigger aggressive

behavior • Redirect with visual supports• Minimize the use of words• Restructure necessary stressors to ease transitions • Clearly identify all components of task• Provide clear directions

Inappropriate Social Interactions• Rehearse appropriate social interactions• Reward appropriate behaviors• Use social stories

Research Based Practices Effective w/ ASD ~The National Professional Development Center on Autism Spectrum Disorders

PromptingTime DelayReinforcementTask Analysis and ChainingShapingComputer-Assisted Instruction (CAI)Differential Reinforcement of Other/Alternative Behaviors (DRO, DRA, DRI)Discrete Trial Teaching (DTT)ExtinctionFunctional Behavioral Assessment (FBA)Functional Communication Training (FCT)

Research Based Practices continued

Peer-Mediated Instruction/InterventionPicture Exchange Communication SystemPivotal Response TrainingPositive Behavioral Intervention and SupportResponse Interruption & RedirectionSelf-ManagementSocial Skills GroupsSocial StoriesStimulus Control and/or Environmental ModificationVideo ModelingVisual SupportsVoice Output Communication Aids

Community Resources

• http://www.disabilityscoop.com/2014/02/06/feds-clarify-tracking-devices/19085/

• http://nationalautismassociation.org/big-red-safety-boxes-now-available/

Resources• http://www.autisminternetmodules.org/dash.php?cat=dash_tab_mn• http://www.myautism.org• http://nationalautismassociation.org• http://www.autism-society.org• http://www.autism.com• http://www.child-behavior-guide.com/• http://www.thegraycenter.org/social-stories• http://www.thewatsoninstitute.org/teacher-resources2.jsp?pageId=

2161392240601226415747290• http://www.disabilityscoop.com/autism/• http://www.do2learn.com/disabilities/Overview.html• http://www.positivelyautism.com/free/• http://www.filefolderheaven.com

Bibliography

• http://www.nea.org/assets/docs/HE/autismpuzzle.pdf

• http://ec.ncpublicschools.gov/disability-resources/autism-spectrum-disorders