A Unique Child Ann Yates Early Years Consultant March ‘10 Workshop looks at ASC in the EY – a huge area – with only 45 mins aim to focus the key issues around supporting childen on the spectrum Also wanted to raise awareness of IDP Introduce IDP materials – ask who is aware/used these For in house CPD can be used at own pace includes elearning materials IDP materials are intended for use at Universal Level some of the strategies out lined will be of use for many children not necc on the spectrum e.g. Downs Syndrome, language delay, children who find it hard to listen and attend etc Everyone is Unique / different Could say no such thing as typical We aim to adopt an individualised and holistic approach to supporting learning and development

The triad of impairments Communication Triad of impairments (Sensory processing) Better recognition of ASC – increasing number with diagnosis We need to understand autism and be able to identify ind. Needs as early as possible to help child reach their full potential Triad of impairments – need to unpick Communication Social understanding Flexibility of thought and behaviour In addition to this Sensory processing difficulties - over sensitive or under sensitive to noise, touch, smell, taste, sights Wide Spectrum - difficulties will manifest themselves very differently from one child to another Aspergers, high functioning, semantic pragmatic difficulties Social understanding Flexibility of thought and behaviour

Recognising Autism in the Early Years What sort of behaviours might you see that could indicate that a child is on the autism spectrum ? lack of eye contact, reluctant talkers, children who find it difficult to share, take turns, children that find it hard to listen, follow directions, children who are very driven by their own agenda, children who appear to lack sensitivity to how others feel, lack of awareness of personal space, obsessive or restricted interests, preference for sameness Children who show these types of behaviours May not necc reach criteria for diagnosis, could be indicative of other ‘hidden conditions’ such as dyslexia, dyspraxia, ‘adhd’ non verbal learning diffs, ‘unconventional or disorganised child’ may or may not receive diagnosis Whether child has the label or not is not the issue Unique child – focus on the child, knowing them, planning support

How do children with autism differ from their peers? They are much less likely to understand the needs, views and feelings of others. They are likely to find it more difficult to make friends, to form good relationships with adults and peers, and may need additional support to help them to learn to take turns and share. They will have greater difficulty in using language, particularly joining in with conversations, and understanding jokes and non-literal language. Some children with autism may not speak, instead communicating in other ways, including through their behaviour. As we all know children develop in individual ways and at varying rates. Already said every child is different, unique – but if diffs present a barrier to learning and development they would be identified as needing support that is different from or additional to support that may be needed for most children - SA, SAP as in the graduated response outlined in the SEN code of P Examples for each point Unaware of personal space, Barging through other children, one sided conversations, may dominate play, find it diff to listen to others ideas, difficulties with rules in games, waiting for a turn May show interest in others but observe from the outside, finding it hard to approach and join in with play Make use of learnt phrases ‘do you want the toilet Jo?’ when indicating a need to go to the toilet Literal interpretation – child with cut finger – put it under the tap. Also diffs with understanding the speakers intentions, e.g. when asked if they know what they had for b’fast? , to be told ‘Yes’ physical manipulation, inappropriate behaviour may be an attempt to communicate – e.g. screaming when wanting something out of reach

How do children with autism differ from their peers? They are less likely to explore new ideas and objects, and more likely to stick to what they know. They are much more likely to be upset or confused by changes to their routine or environment, or by new and unfamiliar experiences. They are less likely to play imaginatively, such as acting out characters in stories, and much more likely to play in quite a rigid way, in which actions are repeated over and over again with their favourite toys. Repetitive play, focus on special interests, games and puzzles that satisfy the need to have things in order, sensory issues.flicking, spinning –almost as if play gets stuck need for structure and predictability – child upset by minor detail – change of computer table, may find ending an activity difficult, transitions can be difficult Sometimes children will act out scenes from a fav TV prog, could appear to imaginative but actually just repeating, acting out with the same TV commentary PLAY - a very important part of children’s learning and development This is an area where children with ASC need a high level of support

Case Studies Ravi Kyle Handouts refer up to case study Case studies – selected two very different children Go through and highlight main points case studies (yellow)

Partnership working Working with parents Working with other services Understanding stress Good open relationships Listening to parents Working with other services This is a a very important area – needs to be a whole training course on it’s own, time now only to briefly look at this When developing relationships with parents, practitioners also need to be mindful of the fact that life will at times be difficult and stressful for them and they will often need time to come to terms with their child’s difficulties If needs identified at pre-school setting info should have been passed on through transition, Portage may have been involved Other services likely to be involved include SLT, EP

In this clip you will see 4 people talk about diff aspects of parents partner relationships Sheila – NN Alison – teacher Shirley – Mum Penny – head of centre

Supporting Learning Developing a profile of strengths and needs Involving parents and other agencies Monitoring progress As with all children Refer to case study profile sheet Discussion with each other, parents and others The development of an IEP to support next steps (SMART targets) - give an example of iep target for case study

How do we communicate? Use child’s name first, to get attention Give choices Break up instructions, reduce your language Use ‘then’ to help child understand a sequence of events Use ‘finished’ to help understand duration of an event Say things in order in which they will happen Tell the child what to do, rather than not what to do Use visual ways to help the child understand Give time for the child to process and respond to instructions Children with ASC tend to process visual information more easily than information presented verbally. We need to modify our own behaviour and adopt strategies to meet the needs of the child with autism Need to adapt speech and provide visual cues Eye contact – can be reluctant or inappropriate eye contact – can be uncomfortable, make the child anxious, may listen and attend better when looking at the floor Can do this by: Using speech consistently, always saying things using the same words, Singing instructions – can engage a child’s attention Visual support – include gesture, signing, photo’s, symbols,

Video – visual supports

Entering the child’s world Following the child’s lead, imitating sounds, movements. Playing alongside, modelling play Focussing on interactive play and early social interaction skills Providing short bursts of structured play Play is not a trivial persuit – an important part of learning Sometimes a child’s play can be limited, and repetitive, often a child will choose to play alone and avoid interaction with his peers, sometimes will show an interest in peers but will find it difficult to enter their play Mirroring – leads to the child making a connection with the adult – paying attention to what the adult is doing, can lead to insights of why the child is doing a particular thing e.g. crouching and rocking in a particular spot Once the practitioner has entered the child’s world can support communication and interaction – e.g. providing a running commentary To engage the child’s attention, develop shared attention – work on skill e.g. Turn taking ,imitation, anticipation, shared attention Adult led activities to address specific objectives - e.g. to support slt targets should be playful experiences PLAYING, LEARNING AND INTERACTING – leadership day

Working with the child’s interests Finding out – what? Using interests to extend child’s experiences Using interests as incentives/ rewards Interests as a starting point for developing learning Observation, communication with parents Common interests include trains, cars, small world animals, dinosaurs etc but also could include specific objects e.g. a particular pen, or box lid, could also include cause effect toy e.g. music box, pop up toy.something shiny or sparkley sensory stimulating Use child’s interests to extend their range of activities or try things they have been reluctant to engage in before. E.g. making dinosaur biscuits to encourage a child who is tactile defensive Collect a box of special toys that could be offered as a reward e.g. for completing a task Interests as starting point for developing their learning e.g. lining up cars, can sort into colours , make a garage for them out of wooden blocks.- meaningful contexts, racing cars down corresponding coloured tracks, child can be involved in making the coloured tracks

This clip shows staff and children in a nursery. Beverly and Michelle talk about the progress of Ty a young boy on the spectrum

Adapting the environment Providing visual structure Providing opportunities to make choices Importance of routines Opportunities for time out Good practice to ensure that all children know where activities happen and when they happen The environment should have clearly defined areas indicated by written signs, symbols or pictures, if boxes and equipment and labelled children will know where to find resources Children ASC particularly these need visual sign posts to make a setting less confusing and predictable –– avoid changing things round Identify opportunities through out the day where children can be encouraged to indicate their preferences, choices, e.g. snack time, choosing an activity Photo’s or symbols of everyday objects and activities can be used as visual prompts to support understanding - should use the right visual support material to suit child’s level of understanding - SLT advice Useful to develop a bank of symbols, displayed on the wall or in a book A visual time table can reinforces routines – helps children understand what happens next – so on a time line, wash hands , then lunch It is important to stick to routines, provide visual signals for the start and end of activities, introduce change gradually. Objects or symbols can be used to help a child understand what will happen next, e.g., fork before lunch, football for outside, objects of reference Symbols can be used as a prompt for a child who may find it hard to initiate an activity, or to help the child make choices, as well as for preparing for change Symbols that are presented as a time line can be removed one at a time to indicate that an activity has finished Sand timers – help children prepare for change, how much time is left before activity ends, or to indicate when it is her turn Identify a quiet area in the room, for the child is feeling stressed or over stimulated to calm down COOMUNICATION FRIENDLY SPACES

From IDP – good example of how useful SLT advice When developing individual visual support systems need to draw on advice of SLT

Golden Rules Understand the Autism Reduce your language Use structure Change the environment Reduce anxiety Be consistent Plan transitions Use rewards that motivate the child Understand the Autism Think about the triad of impairments and how children with ASD experience the world in particular sensory overload. Children aren’t being deliberately naughty, they’re usually trying to communicate something and make their world more orderly and predictable Reduce your language Don’t go into too much detail, use key words and say what you want the child to do in the order that they will happen e.g. ‘Coat then play’ is better than ‘ We’re going out to play in a minute so you need to put your coat on now, it’s on your peg’ Use Structure Use visual structure to help the child understand what will happen next and to prepare for change. Be organised and consistent about routines. Remember to use the concept of ‘finished’ Try changing the environment and what you do before changing the child Most problems can be prevented by modifying the environment, reducing language and planning ahead to warn children of changes in routine or of transitions from one activity to another Reduce anxiety Anxiety is likely to lead to an increase in repetitive or stereotyped behaviours or obsessive behaviour. Watch for signs of anxiety and be aware of triggers like sensory overload or a change in routine. Talk to parents and try and find activities that calm the child. Be consistent Children with ASD like predictability & routine. Try and use the same language, prompts & routines both at home and at school Plan transitions Try to plan for transition time e.g. home to school and for moving from one activity to another. Use warnings and visual cues. Use rewards that are motivating for the child These may be unusual and related to the child’s obsessions