Good Practice Conference by Cs309NI4

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									   Good Practice Conference

“…collating, disseminating and encouraging
     the adoption of good practice…”
Understanding ASD: the Way
   to Effective Practice


Professor Rita Jordan OBE
 Autism Centre for Education & Research
        University of Birmingham


   Good Practice Conference, Stirling 2009
                Education & values
• 'Education' often taken as synonymous with forms of
  therapeutic input directed at identified 'deficits' or difficulties

• People with ASD challenge view that goal of education should
  be to make them ‘less autistic’ or to behave ‘normally’

• SEN not derived purely from a clinical condition
                                 SEN of ASD
Jordan (2005)
• children with ASDs have needs that are:
     – common (as children)
     – individual (as individuals - assessed needs)
     but also
     – group (related to ASD)

•   and it is only through awareness of group needs that individual needs can be
    recognised and met

•   all stakeholders (children, parents, teachers,aids, therapists, psychologists,
    headteachers, local authorities) saw lack of understanding as key barrier to
    inclusion (ACER, 2008)
         What’s Special about ASD?
• need to learn explicitly what others acquire intuitively or
  through social tutoring

   –   identity of self/ other
   –   saliency of social signals
   –   agency and intention
   –   relevance and priority
   –   social/cultural meaning
   –   nature of communication
   –   emotional consciousness
          Difficulties & Differences
• executive functions
   – ‘monotropic’ attention
   – impulse control
   – idiosyncratic perception
• imagination & reality testing
• empathy & emotional/ conscious understanding
• concept development
   – problems abstracting
   – rigidity of concept & schema boundaries
                          Strengths
•   sustained attention to interests
•   no social distractions
•   usually visual information
•   careful attention to detail
•   no social heirarchy - no deceit - get job done
•   accurate detailed memories
•   ‘fresh’ idiosyncratic art - visual/ poetry/ music
•   vulnerability brings out the best in others (often!)
                        Learning Style
• visual or procedural rather than verbal
• memory
    – cued
    – rote
• ‘social’ a dimension of difficulty
• emotions & cognition
    – use interests for engagement
• often at sensory stage of meaning
    – presentation --> reference
• repetition & consolidation
• explicit strategies for problem solving
• need to learn explicitly what others acquire intuitively
                   The ‘ASD’ lens
• individual needs determine learning and should
  determine teaching
• individuality is even more the case in ASD
• yet a lack of mutual empathy means
   – teachers have to use non-intuitive routes in teaching those
     with ASD
   – just as those with ASD have to use non intuitive routes in
     their learning
            Sensory challenges
• if assessed as challenge for child
   – environmental / proximal adaptation
   – inform Behaviour Support Plan
• if not assessed
  – be alert to sensory issues and develop
    understanding of environment to reduce
    sensitivity - likely to be either ‘over’ or ‘under’
    sensitive to different senses
         Perceptual Challenges
• staff need to be aware for all so that there is:
  – teaching for meaning (emphasise goals not parts
    of tasks, reward effort not success)
  – explicit rules & instructions (visual?)
  – time for processing
  – recognition of effect on learning & teaching
  – checks on child’s perspective
          Memory Challenges
• recognition that ‘savant’ skills may be
  weakness
• processes for teaching or generalisation of
  skills in functional environments
• methods to enable memory cues across
  home/ school environments e.g. in homework
• teaching a range of memorisation strategies
    Language & Communication
           Challenges

• augmentative systems for those without speech
   – at right ‘meaning’ level
• ’educational’ language
   – assumes communication
   – joint attention/ advance organisers/ gestures/ literality
• SALT support for communication programmes for all with
  ASD
• structured teaching to reduce reliance on social &
  linguistic mediation of learning
• programmes for expressive and receptive speech
   – include communication gestures
   Social & Emotional Challenges

• awareness of implications of lack of salience of social signals
    – teaching attention to social signals
    – use taught attentional signal as a signal
• teaching social meanings
    – explicit teaching
    – allowance in behaviour management
    – enabling positive social experiences for practice
• teaching emotional awareness & control
    – necessary understanding prior to ‘management’ or understanding of
      facial expressions
                Teaching for Purpose

• different approach needed to suit
   – individual characteristics
       •   sociability
       •   language
       •   cognitive level
       •   sensory issues
       •   age
   – goal
   – practitioner comfort/ ability/ knowledge
            Child factors: Sociability
• Wing’s classification
   – withdrawn/ solitary -> passive/ responds -> ‘active but odd’ ->
     eccentric & sensitive
• varies with conditions & with teaching
• level suggests optimum form of approach
   –   withdrawn - 1:1 directive & desensitisation
   –   passive - interest & structured play experience
   –   active but odd - social rules & experience (context)
   –   eccentric - social skills in context e.g. buddy
           Curriculum for ASD
• entitlement to culturally valued skills,
  knowledge & understanding
• therapeutic needs from ASD difficulties
• additional explicit content for otherwise
  ‘intuitive’ knowledge
• long-term need for a ‘curriculum for life’
      Later: Ecological Curriculum
• assess individual
• assess current and future environments &
  occupations
• gaps in skills, appreciation, knowledge and
  experience form curriculum goals
• teach in functional ways
• practise in functional contexts
                           Evidence
• no single approach
• evidence for:
   – structure
   – modern behavioural methods
   – training parents in social interaction & communication techniques
• in all studies some do well and some do not
• in all studies children tend to learn only what are explicitly
  taught
 Important Distinction (Mesibov
             2009)

• Evidence Supported           • Evidence Based
  Treatment (EST)                Practice (EBP)
  – most common use              – what we should do
  – starts with treatment        – starts with child and
    & asks if it works for a       asks how we can
    particular (narrow)            achieve best outcome
    group
         Importance of Process
• sensitivity & flexibility of implementation at
  least as important as particular programme
• rigid interpretation of manuals leads to poor
  outcomes
• lack of understanding of ASD de-skills staff and
  prevents effective individualisation
                 Definition of EBP
• the integration of the best available research and clinical
  expertise within the context of patient characteristics, culture,
  values and preferences.
 (APA, 2006)

• practitioner expertise involves interpersonal skills and not just
  single programme knowledge
       Single vs Eclectic Curricula
Single                      Eclectic
• enables staff expertise   • can match to goal
• better monitoring &
  easier evaluation         • all needs can be
• builds staff & parent       addressed
  confidence                • needs compatibility
                              checks & child
• enables positive views      perspective
                            • take strengths from
                              each
                        Conclusion
• normal intuitive learning requires cognitive effort
• normal levels of stimulation cause stress
• lack of control from
   – poor self understanding
   – poor social understanding
   – poor communication
• understanding & individualisation is key to effective support &
  education
• treating students equally does not mean treating them the
  same but differently, to ensure equal access

								
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