Strategies to Support Students with Autism
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Transcript of Strategies to Support Students with Autism
Strategies to Support Students with Autism
Tracy Huckell & Tammy TaypotatGSSD Student Services
September 2013
Autism/Asperger Syndrome Definitions Characteristics of Autism or ASD (Autism
Spectrum Disorder) Proactive Strategies for the Classroom Rage Cycle and Strategies to Support
Students and Staff - video Understanding Students with ASD Questions
Overview
Autism Spectrum Disorder is a pervasive developmental disorder characterized by:◦ impairments in communication, social interaction,
and sensory processing◦ repetitive and stereotypical patterns of behavior,
interests and activities (American Psychiatric Association).
‘Spectrum’ indicates the symptoms can be present in a variety of combinations and can range from mild to severe
Autism (ASD)
According to DSM-IV (1994) criteria, an Asperger’s diagnosis must meet criteria for social impairment and repetitive actions, but have normal cognitive and language development.
Characterized by impairments in social language ◦ appear socially awkward, have difficulty with empathy, and
misinterpret social cues.◦ Often talk incessantly about a favorite topic and have difficulty
switching to another topic◦ Conversation can appear overly formal◦ Individuals with AS want to interact with others despite their
lack of skills May have difficulty with motor coordination, balance,
dexterity, and handwriting May be hypersensitive to some stimuli and engage in
unusual behavior to regulate
Asperger Syndrome (AS)
Average or above average intelligence and may appear quite capable, but have relative weaknesses in abstract thought, problem solving, and making inferences or judgements. This rigid thinking causes difficulty in adapting to change or failure, and difficulty learning from mistakes or errors.
Students with AS often give the impression they understand more than they do due to their advanced vocabulary, formal tone of voice, and rote-like responses
May be inattentive, easily distracted and be diagnosed with ADHD at some point
Severe social anxiety is also commonly associated with AS.
Appear overly controlling to those around them but that is their strategy for reducing anxiety and the unknown
Asperger Syndrome (AS)
Impairments in Communication◦ Range from being non-verbal to having extensive
vocabularies with deficits in the use of social language◦ Difficulty with facial expression, use of gestures, imitation,
eye contact, shared focus of attention◦ May have repetitive speech patterns and perseverate on a
favorite topic◦ Difficulty with pragmatics (social use of language) – problems
initiating conversation, maintaining a topic, interrupting, rigidity, multiple meanings of words, and understanding subtle social messages and rules
◦ May talk with exaggerated inflections or a monotone style, stand too close or too far away, stare intently for long periods of time or fail to make eye contact, or fail to use gestures or facial expressions that accompany verbal messages
◦ Difficulty explaining how they feel or why they did something◦ Interpret phrases very literally – ‘pull up your socks’
Characteristics of Autism
Impairments in Social Interaction◦ Difficulty reading and understanding social situations◦ Limited social interaction does not necessarily reflect a lack of
desire to interact with others, they just don’t have the skills◦ Difficulty attending to relevant social cues and shifting
attention when necessary◦ Difficulty with appropriate use of nonverbal behavior and
reading this behavior in others◦ Difficulty understanding their own feelings and sensing what
others are feeling◦ Difficulty understanding different points of view or the
perspective of others – struggle to understand others’ feelings, desires, and intentions (easy targets for teasing and bullying)
◦ May engage in excessive or inappropriate laughing or giggling◦ Difficulty connecting their actions to other’s reactions◦ Difficulty with turn taking and politeness
Characteristics of Autism
Unusual Behaviors and Interests◦ Restricted range of interests with preoccupations ◦ Repetitive motor mannerisms such as hand
flapping, rocking, spinning, walking on tiptoes, spinning objects – often due to hyper or hypo sensitivity
◦ Resistant to change◦ Excitement in a student with ASD often causes
the same reaction as stress. When overly excited the student cannot monitor his/her behavior and may lose control/escalate
Characteristics of Autism
Attention Difficulties◦ Difficulty disengaging and shifting attention from
one stimuli to the next◦ Impairment in ability to share attention – joint
attention◦ May have a short attention span and be
distracted by stimuli that doesn’t bother peers
Characteristics of Autism
Cognitive Deficits and Learning Styles◦ May have deficits in:
attending to relevant cues and information receptive and expressive language impairments especially in
abstract and social language concept formation and abstract reasoning ability to plan, organize and problem solve Often select one problem solving strategy and use it consistently
regardless of the situation or outcome – can trigger escalations when student becomes frustrated or confused as to why the strategy they chose is not working
◦ May have strengths regarding: Rote memory and ability to recall simple information but
difficulties applying more complex information Putting puzzles together and often perform well with spatial,
perceptual and matching tasks Remembering information presented visually – some ‘think in
pictures’
Characteristics of Autism
Unusual Responses to Sensory Stimuli ◦ Responses to sensory stimulation vary from
hyposensitive (high tolerance for pain) to hypersensitive (aggravated by tags in clothing, preference for sweat pants over jeans, seams in socks hurt their toes)
◦ May crave pressure which often has a calming effect◦ Some are hypersensitive to odors, bright lighting, and
noise (even the hum of florescent lights)◦ Individuals with severe sensory processing problems may
go into total shutdown or experience escalations when they become overstimulated. Self-stimulating behaviors are often used to help the individual calm down by generating a self-controlled, repetitive stimulus
Characteristics of Autism
Anxiety ◦ Many individuals with autism experience anxiety due to
their difficulties with: being able to express feelings, thoughts, emotions processing sensory information fear of some sources of sensory stimulation the need for predictability and having to cope with changes
they may not have been prepared for understanding social situations a sense of a loss of control misperception of social events rigidity in moral judgement that results from a very concrete
sense of right/wrongIn contrast to peers, students with AS often do not reveal their stress through voice tone and overt agitation which can result in escalation to the point of crisis because others are unaware of their discomfort or anxiety, and because of their inability to predict, cope, and manage uncomfortable situations
Characteristics of Autism
Use of visuals◦ Aids for organization such as daily schedules, activity
checklists, day to day class agenda, choice boards, first/then routines, steps to complete a task/problem, written instructions for learning new info, story maps etc.
◦ Strategies for organizing the environment such as labelling objects, containers for homework etc.
◦ Supports for social development such as posting rules and routines, and using social stories to teach social skills
◦ Allows decreased reliance on teacher or EA – gradual release model to teach use of visuals to complete tasks
Key is to consider when planning ‘how can this information be presented in a simple visual format?’
Strategies for the Classroom
Provide a structured and predictable classroom environment◦ Provides consistency and clarity◦ Reduces anxiety as students know what to expect
and can anticipate what comes next◦ Alternate familiar successful activities with less
preferred activities◦ Alternate large group activities with calming activities ◦ Implementation of a sensory diet that allows student
to decrease sensory overload and calm before becoming anxious or escalated – proactive vs. reactive
Strategies for the Classroom
Provide positive specific praise about what the student does right or well
Use concrete examples and hands-on activities when teaching abstract ideas
Avoid long strings of verbal information – break down instructions and use visual aids
Provide opportunities for choice - ways to show what they know, order of activities etc.
Use first/then Use meaningful reinforcers that student can
choose from
Strategies for the Classroom
Plan and present tasks at an appropriate level of difficulty – too difficult leads to anxiety and sometimes escalations due underdeveloped coping skills
Note tasks and activities that create frustration and examine environment for sounds and activities that result in sensory overload
Provide a calm, quiet designated area the student can go to relax when they are feeling anxious or beginning to escalate – set this up ahead of time, discuss expectations and practice using this space and be consistent from teacher to teacher/class to class with this
Strategies for the Classroom
Plan for transitions and prepare the student for change through use of visual schedules (that highlight changes and what comes next) and social stories (that teach the student about new situations)
Give ample time warnings (5 min left, 2 min left etc) and use visual timer
Ensure all teachers set and uphold similar expectations to provide structure and consistency
Expectations need to be translated into rules and routines students understand
Reduce the amount of visual stimuli in the classroom especially in direct line of view of student with Autism or AS
Strategies for the Classroom
Social Interaction◦ Provide opportunities for meaningful contact with
peers who have appropriate social behavior◦ Teach appropriate social behavior, problem
solving and coping skills explicitly like academic skills – step by step with gradual release and lots of opportunity for practice
Strategies for the Classroom
Managing Challenging Behavior◦ ABCs of Behavior – Antecedent (what happened
before the behavior), Behavior description/frequency/intensity, Consequence (what happened as a result of the behavior/reaction)
◦ Data collected should be analyzed to identify patterns, triggers, and possible reinforcers
◦ Consider the function of the behavior: Gain attention Tangible – get something Escape from an unpleasant situation or task Self-regulation or tension release
Strategies for the Classroom
Behavior Strategies◦ Provide clear expectations for behavior and use visual
aids to help student understand what is expected along with reinforcement
Teaching and Reinforcing Alternate Behaviors◦ Once the function of the behavior has been identified,
the team should identify an alternative/more appropriate behavior that serves the same function rather than escalating and storming out, the student
identifies he is escalating and uses a break card to request a break
Instead of yelling or whining when frustrated, the student learn to say, “I need help with this”.
Strategies for the Classroom
Observe the student for signs of increasing anxiety and environmental factors that could be contributing to the anxiety
Teach the student to say “I need a break” or use a break card.
Provide opportunities for relaxation in brief 5 – 10 min periods. Student can go to a break area in class or another room, listen to music that is calming, use of fidget. Discuss with student what is calming for them.
Anxiety
Students with AS sometimes exhibit a sudden onset of aggressive or oppositional behavior
Seem to escalate without being provoked and appears to come out of nowhere - students with ASD struggle to communicate verbally or nonverbally the early signs of stress
Meltdowns do not occur without warning – the pattern of behaviors are there but are often very subtle (what have you noticed?)
The rage cycle is not a time to teach new skills – only to support the student in utilizing skills he/she already knows and can use fluently
Escalations follow three-stage cycle:◦ Rumbling Stage◦ Rage Stage◦ Recovery Stage
Tantrums, Rage and Meltdowns
Initial stage May clear throat, grimace, lower voice, tense muscles, tap feet,
bite nails or lip, or erase paper until a hole appears – easy to ignore these seemingly minor behaviors
May emotionally or physically withdraw May challenge authority, swear, and attempt to engage in
power struggle Imperative that staff intervene at this stage without becoming
part of the struggle◦ Staff need to be flexible as the student cannot◦ Interventions at this time are band-aids to allow the student and staff to
survive the cycle – this is not a teachable moment ◦ It’s imperative that staff know which behaviors/reactions are likely to
escalate the child from the rumbling stage to the rage stage◦ Staff must remain calm, project calmness, minimalize verbalizations,
use a quiet voice and avoid power struggles◦ Primary focus is preventing occurrence of the rage stage and may mean
leaving an assignment unfinished
Rumbling Stage
Remove the student from the environment they are experiencing difficulty in – send them on an errand, use break card etc.
Move near the student in a non-confrontational supportive way
Using a prearranged signal to let the student know you are aware he/she is under stress (tapping desk) as a cue to employ a strategy (such as squeezing a stress ball, deep breathing, or taking a break)
Redirect student to their schedule to remind them of a preferred activity or reinforcement that is next on the schedule
Strategies to Use in Rumbling Stage
Redirect the student by discussing something that is of special interest to the student which can often be calming
Diffuse tension through humor or a joke the student would like and understand
Signal student to take a break or go to home base room – should be calming positive and neutral environment with a selection of items/activities that are calming to student
Students can also take class work to home base to complete after a brief respite to calm
Home base can also be used for check-in/check-out and to introduce changes to the typical routine
Strategies to Use in Rumbling Stage
Acknowledging student difficulty – staff briefly support the verbalizations of the student and help them complete the task they are struggling with to avoid an escalation eg. “Yes, this problem is tough. Let’s start with the first step” and provide the scaffolded support the student requires.
Just walk and don’t talk – silence is important as the student in a rumbling stage will likely react to any statement and may misinterpret it. The child can vent at this time without fear of discipline and the adult should remain calm, show as little reaction as possible and never be confrontational
Goal is to avoid rage stage and help them regain control of emotions while retaining respect and dignity
Strategies to Use in Rumbling Stage
Use of the Incredible 5 Point Scale to identify where they are at between 1 and 5 and prompt them to choose a prearranged strategy (this need to be taught and practiced prior to use in rumbling stage)
Self calming – when calm/stabilized, work with the student to develop a calming routine that works for them and have it available visually (pictures or words) to refer to. eg:◦ Take three long breaths◦ Stretch your arms over your head, down and up again◦ Rub your hands together and count to 3◦ Rub your thighs and count to 3◦ Take another long breath
Strategies to Use in Rumbling Stage
Raising voice or yelling Making assumptions Acting superior Preaching or nagging Backing the student into a corner Pleading or bribing Insisting on having the last word or that the adult is right Bringing up unrelated events Using sarcasm Using tense body language Holding a grudge Making unsubstantiated accusations Using unwarranted physical force Commanding, demanding, dominating Using degrading, insulting, or humiliating putdowns
Adult Behaviors that can Escalate a Crisis
Student acts impulsively, emotionally and sometimes explosively, and can include hitting, screaming, biting, kicking, self-injury or destroying property
Once it begins, this stage often must run its course Emphasis should be placed on student, peer and staff safety Get the child to home base before this occurs if possible. If not,
remove other students. Redirection at this stage often escalates behavior as the student
can’t process the demands placed on him/her Refer to previously developed behavior plans that outline NVCI
team and protocol regarding who to call, removal of other students, and providing restraint only if the child is hurting others or him/herself.
Staff should disengage emotionally so as not to escalate as well and should remain calm and quiet
Rage Stage
Protect the student, others and the environment Don’t discipline or be confrontational – be calm and
quiet Remove the audience Follow the plan and obtain assistance Use few words – remember less is more Prevent a power struggle Be flexible – the student cannot Don’t take things personally Disengage emotionally Be conscious of your verbal cues Take deep breaths
Rage Stage Interventions
Allow to sleep if necessary Support use of relaxation techniques Do not refer to rage behavior Support with structure Consider the student ‘fragile’ Determine appropriate option for student:
◦ Redirect to successful activity or special interest◦ Provide space and further rest time if needed
Monitor to see if student is ready to learn Do not make excessive demands
Recovery Stage Interventions
Students with AS/Autism often cannot fully remember what occurred during the rage stage and become apologetic
Some become sullen, withdraw or deny that inappropriate behavior occurred, while others are so physically exhausted they need to sleep
Students are not ready to learn at this stage – discussion of behavior at this time could lead to further escalations
Focus on helping them get back into the day’s routine beginning with a highly motivating task that can easily be completed (activity related to their special interest)
Some may require engagement in further relaxation techniques or sensory activities
Teacher needs to take time to regroup and discuss what occurred with a colleague (debrief)
Recovery Stage
It’s essential for school teams to recognize the fragile emotional state of students on the ASD spectrum and adapt the environment to meet their needs◦ Become skilled at recognizing the initial behavior signs
of stress and anxiety ◦ If the student is doing fine during the day but parents
report they fall apart at home frequently, stress may be building during the school day and when they get home they let go of the pressure that is bottled up
◦ When student is in a fragile emotional state (precipitating events), temporarily reduce expectations to help them through a difficult day without escalating
Understanding Student with ASD
Determine stressors in the school environment (substitute teacher, changes to regular schedule, unrealistic demands, long assignment with no idea how to begin, information presented to fast or not in visual format, difficulties working with peers etc.)
Increase supports and reduce stressors Identify specific situations that routinely lead to tantrums,
rage, or meltdowns and modify environment to reduce these situations
When in fragile emotional state, provide more opportunities to engage in high interest activities or those that emphasize strengths
Increase use of home base or break room if needed – proactive rather than reactive
Understanding Students with ASD
Balance stressors and learning – as student becomes more stable, gradually increase regular demands while consistently monitoring emotional state
Always consider whether the student has the skills to perform a task. If not, develop a plan to teach the prior skills required.
Understanding Students with ASD
Students with ASD do not want to engage in escalations, rage or meltdowns.
The rage cycle may be the only way they know how to cope with stress and other emotions
The best intervention is prevention – breaks, adequate support, clear and appropriate expectations, teaching the skills that are lacking, motivators/reinforcement for completion of tasks and learning new skills
Understanding Students with ASD
Ministry of Education (1999). Teaching Students with Autism: A Guide for Educators
Myles, B. S. & Southwick, J. (2005). Asperger Syndrome and Difficult Moments: Practical Solutions for Tantrums, Rage and Meltdowns
Myles, B.S. (2005). Children and Youth with Asperger Syndrome.
Key Resources
Questions