Understanding and Living with ASD - Parent Training

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					Understanding and
 Living with ASD
Prepared by the 2003-2004 Autism Team
Parenting children with autism
 spectrum disorders requires
  flexibility, creativity, and a
     willingness to change.
Autism is referred to as a spectrum disorder
  to signify similarities among a group of
individuals who share a common diagnosis,
 but who differ in how core characteristics
  are manifested, and in the number and
     severity of specific characteristics.
             Spectrum Disorder
• Because of broad variability in:
  –   Measured Cognitive Ability
  –   Social-Emotional Development
  –   Communication Ability
  –   Motor Skills: Both Fine and Gross
  –   Sensory Processing
        Causes of Autism Spectrum
•   No Specific Known Cause
•   Neurobiological Disorder
•   Genetic Component
•   Perhaps Multiple Causal Factors
•   Subtypes Based on Predicted Time of Onset
 Pervasive Developmental Disorders
• Autism
• Pervasive Developmental Disorder Not
  Otherwise Specified
• Asperger’s Syndrome
• Rett’s Syndrome
• Childhood Disintegrative Disorder
• Characterized by difficulties in communication,
  social interaction, and imaginative play, and the
  presence of restricted interests and activities
  prior to the age of 3.
                  PDD NOS
• Atypical autism presentations that do meet the
  criteria for Autistic Disorder because of late age
  at onset, atypical symptomatology or
  subthreshold symptomatology.
          Asperger’s Syndrome
• The disturbance causes clinically significant
  impairment in social, occupational, or other
  important areas of functioning.
• There is no clinically significant general delay in
  language (e.g., single words by age 2 years,
  communicative phrases used by 3 years).
              Rett’s Disorder
• A genetic disorder, that only occurs in girls.
• Normal development for the first 5 months.
  Head growth ceases between 5-48 months with
  loss of previously acquired skills.
• Results in difficulties in expressive and receptive
  communication, poorly coordinated gait and
  trunk movements, and cognitive disabilities.
 Childhood Disintegrative Disorder
• Extremely rare.
• Develop normally for at least the first 2 years
  and then display significant regression in
  communication, motor, and social interaction
   Characteristics of Children with
    Autism Spectrum Disorders
• Social Difficulties
• Expressive and Receptive Communication
• Restricted Repertoire
• Additional Considerations
• Sensory Processing Difficulties
• Theory of Mind
• Executive Functioning
         Areas of Difficulty
•   Social                 •   Attention
•   Pragmatics             •   Motivation
•   Obsessive Interests    •   Motor
•   Black/White Thinking   •   Executive Functioning
•   Rigidity               •   Emotional Regulation
•   Sensory                •   Hidden Social Rules
       Behavioral Characteristics
•   Obsessions/Rituals
•   Compulsive Mannerisms
•   Self-Stimulatory Behavior
•   Refusal
•   Withdrawal
•   Self-Injury/Abuse
•   Aggression
    Sensory Processing Difficulties
• Each of us have various sensory systems which
  process information and assist us in making
  sense of the world.
• People with autism spectrum disorders have
  difficulty processing and using sensory input in a
  meaningful and relevant way.
• Some individuals are over sensitive and others
  are under sensitive to sensory input.
    Sensory Processing Difficulties
•   Visual
•   Auditory
•   Tactile
•   Vestibular
•   Olfactory
•   Gustatory (taste)
•   Proprioceptive
 As a result of these sensory
 difficulties, individuals may
experience sensory overloads
      and or meltdowns.
Common Stressors at School
                             • Academic
• Unstructured times           – Understanding what to do
   –   Bus                       & how to do it
                               – Breaking down tasks
   –   Before/after school
                               – Writing
   –   Transitions
                               – Organization
   –   Lunch
                             • Social
   –   Physical education
                             • Novel Events
• Sensory
                             • Changes
   – Crowds
   – Space
   – Noise
       Common Stressors at Home
                   • Completing routines
• Sensory             – getting ready for
   – food               school
   – haircuts         – doing homework
   – dentists         – chores
                   • Family activities
   – medical
                      – Adjusting “their”
   – clothing           agenda/interests with
   – showers            family plans
        Lower Expectations

• Temporarily, be flexible

• This is not the time to teach new skills!

                    • Adreon & Gitlitz, 1998
Increase Environmental Supports
• Make the environment as predictable as

• Provide consistency
  – Prepare the individual for any unavoidable
  – If a change is unavoidable, further reduce
    expectations/demands following the change
                      • Adreon & Gitlitz, 1998
    Remove/Reduce Stressors

• Remove/decrease disliked activities

• Remove/decrease difficult activities
   – Simplify work
   – Reduce writing assignments
   – Simplify all tasks involving organizing, planning &
   – Eliminate discussions on feelings
                             • Adreon & Gitlitz, 1998
    1. Operate on “Their Time”
• Twice as Much Time,
  Half as Much Done = A
  Successful Day

• Avoid Rushing!
         2. Balance the Agenda
• Assess the demands for the student when planning the
• Incorporate a balance of LOW-STRESS, HIGH-
  PLEASURE activities for the individual.
• Include “stress-free” time in the schedule.
         Balance the Agenda (con’t)
• Conserve energy

• Assess the upcoming demands on the student for the day.
• Remove any stressful tasks/activities that are not essential.
• Do not remove tasks that the student enjoys.
Use this to assist student in
managing time and anxiety
    3. Manage the Environment
• Provide consistency in the

• Avoid sudden changes.

• Adapt the environment
  when there are changes.
               4. Set the Tone
• Speak in a calm, relaxed

• Give facts in an
  unemotional tone of

• Model positive
            5. Share the Agenda
• Live Out Loud

• Let the student know the
  sequence of upcoming

• Provide information
  about time periods.
Prepare a schedule for daily routines.
    A calendar may be helpful!
Arrange schedules from top to bottom or
 left to right - allow way to check off or
          remove task when done
         6. Simplify Language
• Keep your language concise and simple.

• Tell the student specifically what to do.

• Break down tasks into components.
 Giving the child checklists is particularly helpful when they
has to complete short series of related activities or when they
 need to organize a group of materials. For a chore at home
     they might need a checklist for completing the steps

                necessary to clean their room.

         make your bed _____
         put away your clean clothes _____
         put your books on the shelf _____
         put your school notebook in your backpack _____
         put your toys in the toy bin _____
         sweep the floor _____
    7. Manage Change of Plans

          Field Trip to Science Museum

• Handle changes PROACTIVELY!

• Incorporate “back-up” plans for which you can
  control the variables.
         8. Provide Reassurance
• The student with AS

• Reassure the child about the
  sequence of events.

• Utilize “check-ins”
     9. Be Generous with Praise
• Find opportunities to
  build-up/compliment the
10. Increase Opportunities to
Engage in Activities of High
 Interests and/or Strengths

                • Access to preferred
                • Allow individual work
                • Schedule for activities
                  individual enjoys
                   – computer
                   – reading
                   – drawing
                       • Adreon & Gitlitz, 1998
           11. Listen to the WORDS
•   Words convey the meaning for children with AS.
•   Listen to what the child is saying.
•   Interpret what the child is saying literally!
•   “Probe” for further information
•   Encourage clarification
          Students might also be able to
   communicate more effectively if given some

          structure to help talk about their day.

On the way to school today on the bus, I
One thing that happened in homeroom today was
In science and social studies today, I did two things,
They were__________________________________________ and
In math and English, I did two things
___________________________________________________ and
One more thing that I did today was
A difficult thing that I did today was
A really fun thing that happened today was
       12. Recognize “Teachable
• Orchestrate positive exchanges

• Provide direct feedback

• Capitalize on your child’s strengths/interests!
                 13. Be Realistic!
•   You’re only human!
•   Do the best you can!
•   Be patient with yourself!
•   Remember, the child is
    doing the best he/she
      14. Increase Social Supports
•   Utilize Your Community
•   Increase Reassurance
•   Increase Clarity of Feedback
•   Increase Access to People They Like
•   Protect from Teasing/Bullying
•   Schedule “Support Talk”
                          • D. Adreon, 1998
15. Set up System for Monitoring
 • Often difficult to recognize signs of stress &
 • Need to carefully monitor how the student is
   doing in various social situations (through
 • Carefully monitor whether schoolwork is
   being completed and turned it
      Stabilization Strategies
The goal is to help the individual survive
each day successfully
– Lower expectations
– Do not teach new tasks at this time
– Increase supports
– Reduce stressors
  Five Steps to Remember to
 Help Stabilize when Problems
1) Gather information from a number of
   sources to assess the student’s emotional
2) Determine the stressors that exist in the
3) Decrease the stressors by modifying the
   requirement for disliked and/or difficult
   tasks and temporarily eliminating any
   emphasis on teaching new skills (con’t)
            Stabilization (con’t)

4. Make the environment more predictable and
   increase the use of home base.
5. Balance stressors and learning.
Be Patient with Yourself!
    Thank you for coming !
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