Getting Educational Services Right for Children & Young People with ASD Prof Rita Jordan PhD Emeritus professor in Autism Studies University of Birmingham, UK NAS Surrey Conference: 01/10/2011

Diagnostic Changes AS (Asperger syndrome) currently part of ASD, which is part of PDDAS (Asperger syndrome) currently part of ASD, which is part of PDD in DSM-V (2012)in DSM-V (2012) –PDD = ASD –no subcategories (AS & PDD-NOS gone) –triad for a category replaced with 2 dimensions: social/communication; flexibility –sensory dimension recognised social/ service consequences for ASsocial/ service consequences for AS

What will diagnosis mean? broad category (ASD) then individual profilebroad category (ASD) then individual profile needs-led services?needs-led services? distinction between ASC & ASD?distinction between ASC & ASD? recognition of wide vulnerability (1/38?)recognition of wide vulnerability (1/38?) individualisation of education & servicesindividualisation of education & services ‘ASD of Asperger type?’‘ASD of Asperger type?’

SEN arise from: difficulties related to the condition,difficulties related to the condition, strengths and compensationsstrengths and compensations interests and motivationinterests and motivation characteristics of the situationcharacteristics of the situation issues of entitlement and access but also a therapeutic environment

Learning Style visual rather than verbalvisual rather than verbal memorymemory –cued –rote ‘social’ a dimension of difficulty‘social’ a dimension of difficulty emotions and cognitionemotions and cognition –use interests for engagement repetition & consolidationrepetition & consolidation explicit strategies for problem solvingexplicit strategies for problem solving

Individual factors: Sociability Wing’s classificationWing’s classification –withdrawn/ solitary -> passive/ responds -> ‘active but odd’ -> eccentric & sensitive varies with conditions & with teachingvaries with conditions & with teaching level suggests optimum form of approachlevel suggests optimum form of approach –withdrawn - 1:1 directive & desensitisation –passive - interest & structured play experience –active but odd - social rules & experience (context) –eccentric - social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

Teaching Play & Making Friends essence of play is:essence of play is: –spontaneity –emotional engagement need informed choice about ‘friends’need informed choice about ‘friends’ –fear of loss of control –no experience 2 strands to play teaching2 strands to play teaching –cognitive sensori-motor -> relational -> functional -> symbolicsensori-motor -> relational -> functional -> symbolic –social alongside -> imitative-> ‘join in’ -> co-operate - collaboratealongside -> imitative-> ‘join in’ -> co-operate - collaborate Legotherapy & SHEDSLegotherapy & SHEDS –structures interaction –enables social role learning & cooperation

Teaching Social Understanding cognitive aspects of early interactioncognitive aspects of early interaction Social StoriesSocial Stories Comic Book ConversationsComic Book Conversations SULPSULP LegotherapyLegotherapy SEAL?SEAL? PfCPfC explicit labels What did she say? What did she mean?explicit labels What did she say? What did she mean?

Strengths sustained attention to interestssustained attention to interests no social distractionsno social distractions usually visual informationusually visual information careful attention to detailcareful attention to detail no social heirarchy - no deceit - get job doneno social heirarchy - no deceit - get job done accurate detailed memoriesaccurate detailed memories ‘fresh’ idiosyncratic art - visual/ poetry/ music‘fresh’ idiosyncratic art - visual/ poetry/ music ICTICT vulnerability brings out the best in others (often!)vulnerability brings out the best in others (often!)

Reasons for challenging behaviour in ASD biologybiology –epilepsy –perception/ sensory disturbance –sensory ‘deprivation’ –reactions to pain lack of communication skillslack of communication skills lack of self-awarenesslack of self-awareness adaptation to the environmentadaptation to the environment

Background Factors DietDiet –peptide theory –effects of diets SleepSleep –chronic deprivation –melatonin ExerciseExercise –daily aerobic

Teaching to cope with stress teaching relaxation and ‘escape’teaching relaxation and ‘escape’ –careful not to reward –observation of ‘build up’ –teach alternative –general strategies - relaxation, aerobic exercise, cognitive behavioural therapy coping with paniccoping with panic –automatic response

Functional Analysis SettingsSettings –‘last straw’ not always ‘trigger’ –whole child (inc. skills) & whole school approach –parent collaboration BehaviourBehaviour –accurate –frequency –duration –intensity ResultsResults

Teaching Consequences less able - single trackless able - single track more able -more able - –railway - no turns –2 clear termini with no connections –choice point emphasised Moment of choice Problem Taught alternative

Basic Guide to Anxiety Reduction relaxationrelaxation –general - sensory/ meditation/ yoga/ deep pressure –specific - fold arms, close eyes, chant or hum exerciseexercise –aerobic/ contingent & non-contingent dietdiet –GI index low / low stimulants/ sugar & additives talking with otherstalking with others –drawing? music

Atypical Reactions in ASD misinterpret ‘bumps’ as intentionalmisinterpret ‘bumps’ as intentional may accept as inevitable (Gerland, 1997)may accept as inevitable (Gerland, 1997) may react inappropriately to pain/ insultsmay react inappropriately to pain/ insults may not be able to report or use inappropriate language or not give context or timemay not be able to report or use inappropriate language or not give context or time cannot think when anxious & react emotionally - forgetting trained responsecannot think when anxious & react emotionally - forgetting trained response

Teaching to Cope pre-empt:pre-empt: –stress - prosthetics & exercise –anger - alternative –frustration - communication –panic - posture / drill train for ‘escape’train for ‘escape’ teach relaxationteach relaxation teach social understandingteach social understanding –Social Stories/ video life/ soaps

Train for sensory ‘panic’ need for trained response for ‘panic’ situations &need for trained response for ‘panic’ situations & buddy or visual cue buddy or visual cue to remind. to remind. note use of prime numbers!note use of prime numbers!

Buddy schemes useful foruseful for transitions & as model

Use of LSA care from a distancecare from a distance checking not creating ‘learned helplessness’checking not creating ‘learned helplessness’ available to othersavailable to others

Teaching adaptations visual instructionsvisual instructions lists for meaninglists for meaning allow time for interestsallow time for interests work then playwork then play

Managing Democracy Managing Democracy no tact orno tact orsensitivity no intentional rudenessno intentional rudeness give alternativegive alternative mark for future teachingmark for future teaching

Curriculum Issues individual - no subject exclusionsindividual - no subject exclusions foreign language teaching a good model for social & linguistic understandingforeign language teaching a good model for social & linguistic understanding use interests where feasible or ‘work then play’use interests where feasible or ‘work then play’ aspects of some subjects a problem - teach specifically or by-passaspects of some subjects a problem - teach specifically or by-pass

Conclusion no ‘autism’ curriculum or single approachno ‘autism’ curriculum or single approach needs to fit:needs to fit: –individual –family –practitioner –context –current goals –prognosis