INTRODUCTION TO AUTISM Rosemary E. Cullain Ph.D. Colorado Training Associates Inc.

Training Topics Characteristics and Implications of ASD Teaching Strategies Strategies to Improve Social Interaction Interventions Related to Sensory Differences

Characteristics of Autism Neurological in origin Brain Organized Differently Differences in social relationships Communication Repertoire of behaviors

Paradox of Autism ASD Learning Style 1. Predictable 2. Organized 3. Repetitive 4. One Modality 5. Visual 6. Concrete 7. Rote 8. Over Focus Attention Neuro Typical Style 1. Flexible 2. Dynamic 3. Random 4. Multi Modalities 5. Auditory 6. Social 7. Analytical 8. Shifts Attention

Differences in These Areas Thinking Learning Sensory

Thinking Details versus concepts Cause and effect Irrelevant versus relevant Concrete versus abstract Organization and sequencing

Sensory Easily over stimulated Difficult to modulate Problems with segmenting Prefer orderly, predictable, familiar

Learning Visual or Verbal Poor Imitators Prompt Dependent Need meaningful routines and strategies Need concept of finished

Helpful Teaching Interventions TEACCH Model (Mesibov & Schopler) Picture Exchange Communication (Bondy & Frost) Relationship Development Intervention (Gustein & Sheely) SCERTS (Prizant, Weatherby, Rydell) Social Communication (Quill)

Good Interventions Alter Environment to make world more meaningful Based on strengths Provide physical and visual structure Provide organization of the day Work has beginning and end

Schedules Individual to developmental level Independence is goal Student manipulates Resist over prompting Provides visual system to teach flexibility

Issues to Consider with Schedules Can student match objects, pictures of words – can he read Can student follow a sequence of activities using a visual cue Where is the best location What information is important Where does he mark off finished work Who sets up and makes changes

Work System Method for presenting work in an organized systematic way. System teaches independence Not just work baskets Has a definite beginning and end Can have many faces

Questions Work Systems Answer What do I have to do? How much do I have to do? When am I finished? What do I do next?

Sensory Implications School environments include sensory information that is unfamiliar and different in intensity and duration Elementary classrooms furniture visually distracting cafeteria smell noise Middle/High School multiple passing periods Numbers of teachers, styles, expectations Noise Myriad of hallways

Strategies Priming Preview activity Provides predictability Reduces anxiety and resulting behaviors Working Independently Initial instruction Provides practice Adjust if necessary Access to place apart from routine environment Positive atmosphere not punishment or escape from tasks Allows for regrouping, planning, recovery

Home Base Access apart from routine environment Positive not punitive Allows person to regroup, plan, recover Social Stories Stores from their perspective Describe social situations Relevant cues Visually descriptive less directive Addresses fears, anxiety obsessions

Strategies Visual Supports Concrete representation Reduces ambiguity Helps anticipate Organizes physical space Helps with transition Helps to understand expectations Can convey directions

Social Developmental Levels Level one: Tuning In (Birth) Emotional Attunement Social Referencing Excitement Sharing

Social Developmental Levels Learning To Dance (6 months) Learns rules, roles and structures of experience sharing Likes variety Synchronized actions Observing and regulating to coordinate.

Social Developmental Levels Level 3 Improving and Co –Creating (one year Constant co variation Fluid transitions Improvisation Co-Creation

Social Developmental Levels Level Four Sharing Outside Worlds (18 months) Perception Sharing Perspective Taking Unique Reactions Adding Imagination

Social Developmental Levels Level 5 Discovering Inside Worlds (30 mos) Sharing Ideas Enjoying Differences Inside and Outside Worlds Primacy of Minds

Social Developmental Levels Level 6 Binding Self to Others (48 mos) Unique Self Belong to Groups Pals and Playmates Enduring Friendships

Social Implications for ASD Most ASD are missing critical parts of the skills in Level 1 Need to teach those critical parts before kids are ready for groups Must recognize their social development is different Must remediate these needs Plan social demands around those needs Avoid friendship groups etc until at least level 5

Social Teaching Strategy L 1 Teach child to visually scan adult actions and reactions (use video) Teach child to reference adults when uncertain or anxious Teach visual cues that child can recognize as a sign to shift attention Teach simple games and model excitement for the child to imitate.

Social Teaching Strategy L 2 Teach child to carry out coordinated interactions Teach child to perform his role in a coordinated interaction Teach child to time himself to coordinate this interaction Teach regulation in a social interaction Teach methods to communicate to maintain coordination in a social interaction.

Social Teaching Strategy L 3 Multi step level Co-variation (novelty) Fluid transitions Improvising Co creation

Social Teaching Strategy L 4-6 Multi step involving Joint attention Perspective Taking Unique Reactions Imagination

Sample Activities Level One – Turn taking games Level Two – Mirror Games Level Three – Cooperative Games Level Four – “Sharing” Games Level Five and Six - Groups

This is What we do as Parents and Teachers The loving mother teaches her child to walk alone. She is far enough from him so that she cannot actually support him, but she holds her arms to him. She imitates his movements, and if he totters she swiftly bends as if to seize him, that the he might believe that he is not walking alone…her face beckons like a reward, an encouragement. Thus, the child walks alone with his eyes fixed on his mother’s face not on the difficulties in his way. He supports himself by the arms that do not hold him and constantly strives toward the refuge in his mother’s embrace, little suspecting that in the very same moment that he is emphasizing his need of her he is proving that he can do without her, because he is walking alone. (Kierkegaard)