1. Understanding Autism: Below the Tip of the Iceberg
November 18, 2016
Pleasants County Aides In-service
Presented by: Kimberly D. Kehrer
Director of Special Programs

2. A Challenge For You
Line up by birthdate (consider month and day only--the year doesn’t matter)
You have 30 seconds to complete this task.
No questions!
No talking!!!

3. How Did You Do???

4. You have just experienced what it is like to have your communication impaired. How did it feel? Were you frustrated? Did you know what you meant? This is the life of many individuals with autism.

5. Neurological disorder that affects one’s communication and socialization ability.
Typically evident by age 3 (can now be diagnosed as early as 6 months old)
1 in 68 children per Autism Science Foundation (2016)
Almost 5 times more common among boys (1 in 42) than among girls (1 in 189)
Just over a decade ago, the prevalence rate was 1 in 10,000.

7. Iceberg Model Tip of the iceberg = observable behaviors Tantrum
Aggression
Self-Stimming
Screaming
Self-Injurious behavior
Isolating self
Refusal/non-compliance
Lack of understanding
(receptive communication)
Inability to express self
(expressive communication)
Social skill deficits
Difficulty with change
Sensory processing
problems
Below the tip = the underlying reasons for the observable behaviors
Adapted from Taylor, Utah State Office of Education

8. socialization. the sensory system.
BELOW THE TIP of the ICEBERG
Autism impairs one’s ability to communicate.
Autism affects
socialization.
the sensory system.
Autism can impact
cognitive skills.

9. SPECTRUM?
Mild
Moderate
Severe

10. Also known as High Functioning Autism
Children can move from one end of the spectrum to another with intensive Evidenced-Based intervention…
Mild
Moderate
Also known as High Functioning Autism or
Asperger’s Disorder
Severe
Autistic Disorder

11. The TIP OF THE ICEBERG and Social Interactions

12. Social Interaction As infants: As adolescents:
May be unresponsive to people
May focus on one item to the exclusion of others for long period of time
Fail to respond to their name
Avoid eye contact with other people
As adolescents:
Lack of peer relationships appropriate to age level
Less interest in other children
Not motivated by praise or physical affections
Difficulty interpreting what others are thinking or feeling
Don’t understand social cues (i.e. tone of voice, facial expressions)
Lack empathy
Prefer not to be held or cuddled or might cuddle only when they want to

13. The TIP OF THE ICEBERG and Communication

14. Verbal and Nonverbal Communication Issues
Delay in, or lack of spoken language
Difficulty Initiating conversations
Echolalia (repeating words or phrases said to them)
Doesn’t use or respond to gestures and other nonverbal cues
Have trouble expressing their needs using typical words or motions
Tend to be “narrowly-focused” in topics of conversation
Have difficulty expressing feelings in words or appropriate actions
May not point to objects to show interest

15. The TIP OF THE ICEBERG and Sensory and Behavioral Issues

16. Behavior/Sensory Issues
Engages in highly repetitive play
Preoccupied obsessively with specific interest or object
Lack of make-believe or imitative play
Dependent on routines, rituals and familiarity
Repetitive body movements
Easily overstimulated by noises, crowds, or lights
Extreme dislike of certain sounds, textures or situations
Doesn’t have strong response to pain
Have trouble adapting when a routine is changed
Have unusual reactions to the way things smell, taste, look, feel, or sound

17. If you’ve seen one child with autism,
But remember…
If you’ve seen one child with autism,
You’ve seen ONE child with autism.

18. Common TIP OF THE ICEBERG Signs
Insistence on Sameness
Difficulty in expressing needs; uses gestures instead of words
Repeating words or phrases in place of normal responsive language
Laughing, crying, showing distress for reasons not apparent to others
Preferring to be alone, aloof manner
Tantrums

19. Difficulty mixing with others
May not want to cuddle or be cuddled
Little or no eye contact
Unresponsive to normal teaching methods
Sustained odd play
Spins objects
In appropriate attachment to objects
Apparent over-sensitivity or unsenstivity to pain

20. No real fear of danger
Noticeable physical over-activity or extreme under-activity
Uneven gross/fine motor skills
Not responsive to verbal cues; acts as if deaf although hearing tests in normal range

21. MELTING THE ICEBERG
– 10 Tips for Educators

22. The Escalation Cycle
What the Student Does
What the Adult Does
Stage 1 beginning behaviors i.e. breathing deeply, self talking, isolation
Stage 2 moderately disruptive i.e. crying, talking loudly
Stage 3 disruptive i.e. screaming, aggression
Stage 4 danger to self and others
Stage 1 deescalation, calming techniques, frequent reinforcement for absence of stage 1 behaviors Stage 2 stimulus change and redirection Stage 3 firm and structured intervention Stage 4 hands on procedures may be required
Adapted from Taylor

23. Life Supports for DEEP Water
– Calming Strategies

24. Strategies for Calm Waters

25. 1. Visual Supports
Pictures of driver, aide, route (including anticipated changes)
Daily and weekly schedules including changes
Transition schedules including home/bus/school
Task completion skill cards – steps required to complete the task including how to know when the task is finished
Adapted from Taylor

26. 2. Social Stories
Stories written in the first person to increase students’ understanding of problematic situations. Begin with the child’s understanding, develop of the story by describing what is happening and why, how people feel and think. Scripts which suggest ways for both the student and the adult to respond. Structure increases understanding of situations and what behaviors are expected. i.e. loading procedures, emergency drills, etc.
Adapted from Taylor

27. Social Story – Field Trips
Sometimes my class goes on a field trip. We might go to the zoo or to a park. The bus driver will need to take a different route. This is okay. She will know how to drive the bus back to the school. Bus drivers know how to drive to many places. This is their job. Field Trips can be fun when I use my good bus behavior.
Adapted from Taylor

28. 3. Cognitive Picture Rehearsal
Cartoon drawings or pictures on cards combined with positive reinforcement principles. Always include the before, during, and after behavior (antecedent – target behavior – positive reinforcement)
Adapted from Taylor

29. Rules for the Bus – Visual Support
When you ride the bus
Keep your seat belt on
Until the bus stops at the school
Adapted from Taylor

30. Choice Board – depicts available choices of:
Behavior – I can keep my hands in my lap or by my side and say “that’s okay”
Reinforcement – I will earn a classroom buck or a tickle if I click my belt
Activity – I can play with the fiddle bag or listen to my headset
Adapted from Taylor

31. 5. Power Cards Connects desired responses with student’s interest.
The bus has rules just like basketball. The rules are:
Use the bathroom before riding the bus.
Click the seat belt until the bus stops.
Have a quiet mouth.
Keep my hands in my space.
Adapted from Taylor

32. They want you to know…