1. Autism and School-Based Therapies: Introduction Adapted PE Occupational Therapy Physical Therapy Speech/ Language Prepared By: Claire Greer, Consultant for Autism, Severe & Multiple Disabilities

2. 2 Autism Website http://www.ncpublicschools.org/ec/instructional/au tism/

3. 3 Objectives Name four barriers to instruction. Identify the elements that should be considered when planning visuals. Identify the four components of a good lesson

4. 4 Two Truths about Expressive Communication Behavior = Communication Communication = Effective and Efficient

5. 5 Barriers To Participation In Related Service Communication- –Behavioral regulation, expressive: to obtain or restrict a goal Requesting- “I want that ball.” “Can I get a drink?” Pointing, taking adult to object, etc. Protesting- “I don’t like this game.” “I don’t want to.” Throwing, hitting, sitting down, etc

6. 6 –Social Interaction, expressive  to attract attention to self Greeting- “Hi, how are you?” Waving. Answering- “I would rather play kick ball.” Running and getting a ball. –Joint Attention, expressive  to direct attention to an object or event Commenting- “Look, he’s on 3 rd base.” Showing another person an object. Asking questions- “Is he out?” Shrugging shoulders.

7. 7 Joint Attention Communication requires both a message & an ability to direct the attention of the other person Joint attention- share and direct attention

8. 8 Joint Attention Foundation of Communication Aware that Both are Focused on the Same Object or Event PICS – Delgado, Mundy, et. al.

9. 9 Joint Attention Examples Look, Reach, Give, Point, Show Comment Shrug

10. 10 Barriers Joint Attention –Orienting to social stimuli looking at and attending to –Coordinating eye gaze (attention) between objects and people –Displaying affect or emotion to a person sharing of affective state

11. 11 Joint Attention Con ’ t –Reading and interpreting the expressions of others –Drawing the attention of others to objects or events to share an experience

12. 12 Barriers Sensory Processing –Sensory processing ability to take in information through our senses organize and interpret that information make a meaningful response.

13. 13 1.Sensory Seeking- –Seeks deep touch –grab, pinch, bite, and hit –to obtain desired sensory input. 2.Over-responsive –overwhelmed with sensory input (noise, movement, touch, taste, smell) –fight or flight reaction.

14. 14 3.Under-responsive –lethargic –slump in their chair –may not feel pain appropriately –ignore a bleeding cut or a bump on the head.

15. 15 Barriers Motor Planning –The ability of the brain to conceive, organize, and carry out a sequence of unfamiliar actions. reduced ability to carry out novel movements reduced ability to motor plan when the student is under stress

16. Planning Activities The effects of these barriers can be reduced by: 1.using visuals, 2.simplifying/segmenting instruction, 3.reducing expectation for imitation.

17. 17 Create Predictability Set up a visual sequence that will be a consistent routine Assure high level of motivation Assure high level of success

18. 18 Why Do Visuals Work? Because the learner can continue to reference the visual to support memory, communication, behavioral expectations and organizational skills.

19. 19 Visuals Criteria: –Set up for success –Easily adaptable –Portable –Durable

20. 20 Three Areas to Ask Questions About Visuals Structure –What specific information does the student need to understand the task? Design –Which design feature will help the student cognitively process the information? Written, Photo, Picture Symbol, &&Object, Video

21. 21 Format –What format does the student need to access the support? Print, Interactive, Cue Card, Schedule

22. 22 Structure- What information does the student need? Rules Breakdown of task Cues Reinforcement Wants and Needs Demonstration of abstract to concrete

23. 23 Rules Designed for the teacher to communicate to the students The rules are there to help the students remember what needs to be remembered Make rules very clear and concise OR

24. 24 PE Process

25. 25 Task Organizers List all the materials needed List, in order, the steps needed to accomplish the task Select the essential steps Select design and format

26. 26 Teacher Direction Card The direction cards insure consistency of language used with the student Activity: Relax Arms Component: Muscular Strength How to do: 1. Sit in a chair, feet flat on the floor, hands in lap. (Relaxed position) 2. Use the verbal cue, “Tighten arm.” 3. Hold arm out straight (in front of body), make a fist and tighten whole arm. 4. Use verbal cue, “Relax.” 5.Slowly relax arm, bending at the elbow and slowly dropping arm back into relaxed position in lap. 6.Repeat using other arm.

27. 27 Student Card Sequence

28. 28 Activity: Breathing How to do: 1.Use verbal cue, “Take a deep breath.” 2.Take a deep breath, hold it for 2 seconds. 3.Say the word, “R-e-l-a- x” while letting air out. 4.Repeat 5 times.

29. 29 Cue Remind student of their choices. Broaden the range of possible choices Give the opportunity to request an acceptable behavior Reduce protesting behavior

30. 30 Social Stories

31. 31

32. 32 Motivator Natural reinforcer –Getting to do a desired activity or completing the activity is the reinforcer Secondary reinforcer –Praise, smiles, high fives (social) –Token

33. 33 Motivation Questions Is content of the activity being presented in inherently motivating ways for the student? –Example If content is not motivating, can I insert motivating elements into the content? –Example

34. 34 If not, can I add a motivator/reinforcer in activity to assure willingness? –How frequently do I present motivation – at end, periodically, throughout?

35. 35 Communication Using visuals to support verbal or non-verbal communication –Commenting –Questioning –Requesting –Greeting

36. 36

37. 37 Conversation Starters

38. 38 Demonstration of Abstract to Concrete Many school rules have variable meanings depending on teacher expectations Relationship words can often be difficult to understand (team work, decide as a group …, play nice, etc.) Understanding Personal Space

39. 39 Lesson Format Adapted from Foundations Introduction –Identify the specific skill to be taught –Identify why this skill is important –Assist in generalizing this skill to their life, make it relevant to their life

40. 40 Tell –Identify the essential behaviors needed to do the activity –Identify potential problems which may arise and how they should respond

41. 41 Show –Use visuals to demonstrate expectations, what does it look like and/or sound like –Model the essential behaviors needed to meet the expectations being taught –Model how to handle problems

42. 42 Do –Have the students practice the needed behaviors –Give students consistent and specific feedback regarding their performance

43. 43 Conclusion –Summarize the lesson –Have the student generate other settings in which this skill could be used

44. 44 Resources Foundations by Dr. Mickey Garrison and Dr. Randy Sprick, Educational Support Services, 1997 Boardmaker by Mayer Johnson, mayer-johnson.com

45. 45 Students with Autism: Strategies for Accessing the Curriculum Physical Education http://www.teachernet.gov.uk/_doc/6703/Physical%20E ducation.pdf http://www.teachernet.gov.uk/_doc/6703/Physical%20E ducation.pdf Wetherby, A. & Prizant, B. (1993). Profiling communication and symbolic abilities in young students. Journal of Childhood Communication Disorders, 15, 23-32. Wetherby, A. & Prizant, B. (2000). Autism spectrum disorders: A transactional developmental perspective. Baltimore, MD: Brookes Publishing. Quill, K.A. (2000). Do-Watch-Listen-Say. Baltimore, MD: Brookes Publishing.

46. 46 Sensory Processing Disorder and Autism by Lisa Jo Rudy http://autism.about.com/od/treat mentoptions/a/whatisspd.htm http://autism.about.com/od/treat mentoptions/a/whatisspd.htm Hodgdon, L.(1995). Visual strategies for improving communication: Practical supports for school and home. Troy, MI: QuirkRoberts Publishing