Handouts for Teacher Aides Workshop

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Handouts for Teacher Aides Workshop
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Workshop on Autism Spectrum Disorders Teacher
Aides

• Autism Behavioural Intervention

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The Early Signs of Autism
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Signs in Infancy

• Sleep disturbance.
• Lack of ability to be comforted.
• Feeding.
• Socialization.

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Socialization

• Eye contact (start, assistance, approval,
  reassurance).
• Reciprocal smile.
• Sharing the moment.
• Look at me !

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Socialization

• Interest in social activities.
• Mutual gaze.
• Reciprocity.
• Emotional variability and intensity.
• Treating people as objects.
• Solitude.

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Communication

• Suspected deafness.
• Lack of response when name called.
• Absence of proto-declarative gestures (look at
  that!).
• Lack of vocalisation.
• Echolalia and Borrowed phrases.
• Mannerisms to express emotions (excited).
• Self-injury when frustrated.

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Play

• Sensory experience. (spinning, tasting, tapping).
• Lack of symbolic/imaginative play.
• Prolonged attention to preferred activities.
• Attachment to objects.
• Fascination with order and symmetry.
• Special interest.
• Insistence on sameness.

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Sensory Perception.

• Hyperacusis. (Vacuum cleaner, sharpnoises).
• Tactile Defensiveness.
• Aroma and texture of food.
• Stoic in the perception of pain.

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Late Onset

• Around 18 months to 2 years.
• Lose speech, socialisation and constructive/imagin
  ative play.
• Indistinguishable from early onset by 3 years.

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Causes and How Common.

• Genetics. (Family history of Autism, Aspergers
  Syndrome, A.D.H.D.).
• Virus Infections in pregnancy and infancy,
  encephalitis.
• Inborn errors of metabolism.
• Prevalence, one in a thousand.
• MaleFemale ratio of 41.
• Neuro-developmental Disorder.

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Treatment

• Multi-disciplinary team.
• Programs for communication, behaviour, cognitive
  development, self care skills and motor skills.
• Quality and Quantity. (15-40 hours a week).

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The Continuum of Autism
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Aloof

• Avoid interactions.
• Mute.
• Behaviour the main means of communication.
• Fascination with sensory experience.

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Passive

• Approach adults for assistance with objects and
  for physical stimulation.
• Prolonged solitary play.
• Speech requires an external prompt, (echolalia,
  seeing an object/picture, dialogue borrowed
  from a favourite video).
• Fascination with symmetry and collecting specific
  objects.

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Active but Odd

• Often initiates interactions of short duration.
• Repetitive questions.(Social echolalia, script,
  alternative meaning, reassurance).

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Active but Odd

• Lack of social play with peers.
• Fascination with a specific topic or person.

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Aspergers Syndrome (Lorna Wing)

• Friendship skills.
• Codes of social conduct.
• Empathy.
• Emotion management.
• Language profile (pragmatics, pedantic, prosody).

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Aspergers Syndrome

• Special interests.
• Normal I.Q. but an unusual profile of cognitive
  skills.
• Impaired motor skills (upper and lower limb
  coordination, ball catching and hand writing).
• Sensory perception.

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Communication Skills
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Visual Communication Systems

• Photographs, pictures and words.
• Requests, choices and the sequence of activities.
• Basis of reading abilities.

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Speech and Language Characteristics.

• Pragmatics, Prosody and Pedantic.

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Pragmatic Aspects

• The art of conversation.
• Reciprocity.
• Repairing a conversation.
• Knowing when and how to interrupt.

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Pragmatic Aspects

• Inappropriate comments.
• Keeping on track.
• Primarily interested in an exchange of
  information.
• Appropriate topics.
• Monologues or scripts.
• Recognising and accepting different points of
  view.
• Literal interpretation.

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Literal Interpretation

• Hop on the scales.
• Toast the bride.
• Your voice is breaking.
• Draw your own conclusions.

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Prosody or the Melody of Speech.

• Lack of change of vocal tone and volume to
  indicate emotion and key words.
• Lack or variation in pitch, stress and rhythm.
• Accent not consistent with that of the local
  children.
• Difficulty understanding the relevance of the
  change in tone, inflection or emphasis on certain
  words when listening to the speech of others.

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I Didnt Say She Stole My Money

• I didnt say she stole my money ( but someone
  said it).
• I DIDNT say she stole my money ( I definitely
  did not).
• I didnt SAY she stole my money ( but I
  inferred it).
• I didnt say SHE stole my money ( but someone
  stole it).

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I Didnt Say She Stole My Money

• I didnt say she STOLE my money ( but she did
  something with it)
• I didnt say she stole MY money ( she stole
  someone elses)
• I didnt say she stole my MONEY ( she took
  something else)

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Pedantic Speech

• Overly formal.
• Excessive technical details.
• Adult quality, sophisticated grammar or
  phrases.
• Must correct errors.
• Precise intonation.

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Unusual Qualities of Speech.

• Idiosyncratic use of words. (Hoover).
• Neologisms.
• Volume.
• Vocalizing thoughts.
• Verbal fluency affected by anxiety.
• Late onset.

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Auditory Processing

• Auditory discrimination (two teachers).
• Auditory processing.
• Hyperacusis. Sudden/sharp noises, specific pitch,
  noise level.
• Explaining thoughts and reasoning using speech.

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Social Understanding
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• The nature of these children is revealed most
  clearly in their behaviour towards other people.
  Indeed, their behaviour in the social group is
  the clearest sign of their disorder and the
  source of conflicts from earliest childhood.

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Solitude

• The diagnostic criteria dissolve in solitude.
• Solitude is an effective emotional restorative.
• Preference for learning in solitude.

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Social Impairment

• Reciprocity (the balance between participants)
• Inclusion (My Way)
• End product.
• Spontaneity and humour.

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Social Impairment

• Maturity in friendship skills.
• Limited vocabulary for characterization.
• Limited response to peer pressure.
• Conspicuous preference for solitude.
• Unaware of the codes of social conduct.

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Social Impairment

• Level of maturity in deceit. (fantasies not lies
  or psychosis).
• Busy but not playing with anyone.
• See a room full of toys to play with not friends
  to play with.
• Limited ability with team skills.

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Ability to Attribute Social Meaning

• Noticing objects and facts rather than thoughts,
  feelings and intentions.

LDA Language Cards Emotions
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LDA Language Cards Emotions
Descriptions of pictures and events may not
include thoughts and feelings.
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Social Impairment

• Limited range of facial expression and body
  language.
• Difficulty reading the facial expressions and
  body language of others.(11, Corey).
• Limited ability to conceptualize the thoughts and
  feelings of others.
• Empathy. (mother characterization and being
  sad.).

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Eye Contact

• Social punctuation.
• Read a face.
• Construct a reply without interruption.
• Stimulus overload.

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Traffic Lights
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www.human-emotions.com
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Friendship Skills
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The Value of Friendship

• Learn alternative perspectives and solutions.
• Facilitates appropriate conflict resolution.

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Team Work Skills for Employment
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Basis of Adult Personal Relationships.
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The Value of Friendship

• Antidote to depression.
• Avoid bullying.

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Encourage Friendship Skills

• Behavioral strategies of observation and
  recording, task analysis, cues, prompting,
  shaping and rewards.
• Cognitive strategies to learn the theory and
  script using Social Stories.

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• Visitors guide to our social culture.
• Explain the secret code.
• Address both sides of the social equation.

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• A Social Story is written according to the
  Social Story Guidelines.
• These guidelines are based on the
  learning characteristics of
  children and adults with ASD.

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Six Stages.1. Determine the topic

• The first story recognizes social knowledge or
  success.
• Half of the Social Stories should record success.
• Known and future situations.
• Write a Social Story for a friend.

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2. Gather Information

• Observe and consider the perspectives and
  perception of all participants.
• Be careful not to make false assumptions.
• Prepare a rough draft that is shared with others.
• Determine the relevant cues and sequence of
  events.
• Acknowledge the childs developmental level,
  reading age and attention span.
• First person ( I ) present and future tense.

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Literal Accuracy

• We have art class on Tuesdays at 200.
• I ride the bus each day to school.
• Great! I have everyones eyes and ears!

• We usually have art class at about 200.
• I usually ride the bus on school days.
• Great! Everyone is looking at the story!

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3. Consider the Guidelines

• Descriptive Sentences. The where, when, who.
• Perspective Sentences. The thoughts, feelings and
  sensory perspective of each participant.
• Directive Sentences. Direct the childs
  behaviour. What to do or say.
• Control Sentences. Strategies to assist recall
  and provide motivation.

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• Sometimes a person says, I changed my mind
  (descriptive)
• This means they had one idea, but now they have a
  new idea. (perspective)
• I will try to stay calm when someone changes
  their mind. (directive)
• I can think of a caterpillar changing into a
  butterfly (control)

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My school has many rooms (descriptive). One
room is called the lunch room (descriptive).
Usually the children eat lunch in the lunch room
(descriptive). The children hear the lunch bell
(perspective). The children know the lunch bell
tells them to line up at the door (perspective).
We have a line to be fair to those who have
waited there longest (descriptive). As each
person arrives they join the end of the line
(directive). When I arrive I will try to join
the end of the line (directive). The children
are hungry. They want to eat (perspective). I
will try to stand quietly in the lunch line until
it is my turn to buy my lunch (directive). Lunch
lines and turtles are both very slow (control).
Sometimes they stop, sometimes they go (control).
My teacher will be pleased that I have waited
quietly (control).
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A Social Story on Assistance

• Sometimes children help me. They do this to be
  friendly. Yesterday, I missed three math
  problems. Amy put her arm around me and said,
  Its okay, Juanita. She was trying to help me
  feel better. On my first day at school, Billy
  showed me my desk. That was helpful. Children
  have helped me in other ways. Here is my list
• I will try to say thank you ! When children
  help me.

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4. Adherence to the Social Story Ratio

• Describe and explain more than direct.
• Ratio of more descriptive, perspective and
  control sentences than directive sentences.

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5. Incorporate the childs special interest in
the control sentences.

• Power Cards.

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6. Review and Monitor Progress

• Is the Social Story accurate?
• Can improvement be attributable to the Social
  Story?

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Philosophy and Attitude

• Discovery not correction. (advice perceived as
  criticism)
• Appeal to reason and intelligence.
• Teach understanding not compliance.
• Share information.

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Four Levels in the Development of Friendship
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0 - Toddlers

• Curiosity,parallel play and imitation.
• Hide their favorite toys from visitors.
• Conflict resolved with physical force.

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Level 1 3-6 Years
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Level 1 Approximately 3 to 6 Years

• Recognition of turn taking.
• Friend has toys the child wants to play with.
• One way assistance (he helps me).
• Proximity.

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Level 1 Approximately 3 to 6 Years

• Why is .. your friend?
• He sits next to me.
• Momentary friends.
• Conflict resolved by force and a referee.

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An Adult Acting As a Friend

• Observe the natural play of the childs peers,
  learn the games and rules.
• Learn child speak.
• Turn taking.
• Ask for help.

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An Adult Acting As a Friend

• Classmate catalogue.
• What else could it be?
• Video replay of social play scenes at school.
• Pause button.

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An Adult Acting As a Friend

• Follow my leader games.
• Hide and seek with objects and getting warmer.
• Chasing games.
• Share interesting moments and activities.

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An Adult Acting As a Friend

• Watch other children as a model of what to do.
• Rent a friend.
• Inclusion with neurotypical children as they can
  modify their social play to accommodate the
  child.
• Carol Grays Sixth Sense (the Social sense).

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Level 2 6-9 Years
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Level 2 Approximately 6 to 9 Years

• Reciprocity and being fair.
• Mutual assistance.
• Like the same activities.
• Knows the preferred activities of their friend.
• Chooses someone who is popular rather than
  mutually recognized. (Rent a friend).

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Level 2 Approximately 6 to 9 Years

• Why is . your friend?
• She comes to my party and I go to hers.
• Conflict Who started it not how it finished.
• Offender needs to retract the action (an eye for
  an eye).

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Level 2

• Two games. The actual game and the friendship
  game.
• Rehearsal, feedback and rewards.
• Social engineering (modelling and protection).
• Resources.

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Books on Friendship (www.tonyattwood.com.au)
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Programs on Pragmatics, Theory of Mind and Social
Skills.
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Theory Of Mind Skills
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• A very frightening experience when you discover
  for the first time you are in world full of
  people who have no reason to love or even like
  you and some even dislike you for reasons best
  known to themselves.

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Level 3 9-13 Years
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Level 3 Approximately 9 to 13 Years

• Aware of others opinion of them and how their
  words and actions affect the feelings of
  others.(white lie).
• Need for companionship rather than functional
  play.
• Cooperation more than competition.
• Share thoughts rather than toys.

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Level 3 Approximately 9 to 13 Years

• Personality characteristics, audacious, humor.
• Helps in times of emotional distress.
• Help the child feel good about themselves
  (compliments).
• Greater selectivity and durability.

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Level 3 Approximately 9 to 13 Years

• Gender split. (Boy and girl activities).
• Trust, loyalty and keeping promises.
• Why is .. your friend?
• I can trust her with my secrets.
• Conflict resolved by discussion that can
  strengthen the relationship.
• Conflicts forgiven.

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Teasing and Bullying

• Maternal or predatory instinct.
• Solitary, socially odd and vulnerable.
• Lack of intervention and justice.
• Imitation of TV heroes.

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Teasing and Bullying

• .
• Seek retribution.
• P.T.S.D.
• Special interest- military and weapons.
• Imitate bullies at home and in play.
• www.TheGrayCenter.org.

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• The fact is, at the end of the day, if your
  speech is odd and posture awkward and youre not
  even aware of that, only that you know you dont
  have the gift of the gab then the chances are
  your face is not going to fit. Its like the
  child with glasses or who is fat, but ten times
  worse.

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• Mom, I cant tell when people are teasing me or
  being nice, but someday someone will really want
  to be my friend and I want to be available.

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Friendship Characteristics Associated With
Aspergers Syndrome

• Intensity of the friendship.(Possessive).
• Not ageist, sexist or cultural bias.
• Exhaustion. It takes all my brain power to be a
  friend Steven.
• Girls. Imitation, doll play, reading fiction,
  imaginary friends, peer guidance and inclusion.

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• Science club.
• Buddy system.

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Affective Education
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Affective Education

• A project on a specific emotion.
• Start with happiness or pleasure.
• Create a scrap book that illustrates the emotion.
• Diary with new experiences.
• Compare and contrast other childrens scrap books.

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Affective Education

• A thermometer, volume control, ruler, gauge, rope
  on the floor or speedometer to measure the
  degree of intensity.
• Place photographs and words at the appropriate
  point on the thermometer.
• Increase precision and accuracy in verbal
  expression. Alexithymia.
• Semantic confusion.

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Thermometer
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The Understanding and Expression of Emotions

• Point to the degree of expression in a particular
  situation.
• How much other peoples words and actions affect
  their feelings.
• How much their words and actions affect the
  feelings of other people.

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The Understanding and Expression of Emotions

• Appropriate tone of voice. (counting, telephone
  directory).
• Different ways to say Yes or come here.
• Select a word or phrase and a mood and say the
  word according to the mood.
• Drama games for body language. (charades).

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Emotion Charades
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The Understanding and expression of emotions

• Emotion statues.
• Imitate the expression on computer screen, other
  person guesses the feeling.
• Non-verbal sounds. (cough, tut, mmm).
• Guess the message. (raised eyebrow, frown).
• Music.
• Colour to represent the emotion.

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Story books on emotionsBibliotherapy
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Examples of activities-Happiness

• My strengths and talents. (happiness from the
  special interest).
• How much do you like..?(1-10).
• What could your mother say to make you feel
  happy? ( Feeling rated from1-10).

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Examples of activities-Happiness

• What are the feelings and sensations when you are
  happy?
• Compliments can make someone feel happy.
  Choosing, giving and receiving compliments.
• Rope activity. Stand at the point that represents
  the level of feeling. Examples You find and can
  keep 20, Your mother says that she loves you.

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Mr. Men and Little Miss Books
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Examples of activities - Sadness

• How do you express feeling sad?
• Why do we cry?
• What to say or do if your friend is sad.
• Sadness diary, repairing their own feelings or
  another persons sadness.

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Sadness Expressed As Anger
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The Understanding and Expression of Emotions.

• Happy- Sad.
• Relaxed-Anxious.
• Affection-Anger.
• Problems with emotional arousal for both
  negative and positive emotions.
• Emotional cycles and rapid expression of extremes
  of emotion. (bipolar or manic/depressive?).

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Emotional Toolbox To Fix The Feeling

• First Aid Box.
• Sewing Kit..

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Physical Activity Tools. Increase Heart Rate

• Physical exercise, walk, run, trampoline.
• Wrestle with Dad.
• Sport. (Basket Ball, golf) or dancing.
• Creative destruction (recycling).

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Physical Activity Tools. Increase Heart Rate

• Drum Kit.
• Swing.
• Orange squeezing.
• Bite an apple.
• Break a pencil.

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Relaxation Tools. Decrease Heart Rate

• Music.
• Solitude.
• Massage.
• Reading.
• Repetitive action.

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Relaxation Tools. Decrease Heart Rate

• Sleep.
• Stress ball.
• Pleasures book.
• Deep pressure.
• Jigsaw
• Art

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Social Tools

• Talk to a family member or friend. (Mitchell).
• Talk to a pet.
• Share the problem.
• Seek a second opinion.
• Find someone to help change the mood.
• Lack of close friends to help the person calm
  down.

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Social Tools

• Helping someone.
• Being needed.
• Introduction to someone with similar issues.
• Counselor or mentor with Aspergers Syndrome.

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Thoughts and perspective

• Put the events in perspective.
• Reality check.
• Imagine what you would like to do or say.

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Thoughts and Perspective

• Comedy programs.
• Sense of humour.
• Compliments not criticism.
• Success at school work.
• Fear dissolved by knowledge (special project).

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Antidote to Poisonous Thoughts

• P (poisonous thought) or A (antidote). Evan
• Im a loser.( ).
• I can stay calm. ( ).
• Relaxing makes me think better. ( ).
• Everyone hates me. ( ).
• Create antidotes to the persons poisonous
  thoughts.

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Restoring the Emotional Equilibrium

• Pleasures Book.
• Numerical value for the emotional restorative or
  weight of each activity or memory.

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A Counter Balance

• Estimate the weight of the negative experience.
• Calculate how much weight of pleasurable
  thoughts are needed to restore the balance.

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Redress the balance with pleasure
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Special Interests

• An anxiolytic.
• Created by fear or pleasure.
• Collecting and cataloguing.(personal defrag).
• Distraction during a meltdown.
• Art, writing and music as a means of emotional
  expression.

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Medication As a Tool

• Treatment of clinical depression. (SSRI).
• Impulsive. (Stimulants).
• Mood changes. (anti-convulsants).
• Sedation. (anti-psychotics)

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Attitude Tools

• Knowledge.
• Respect.
• Humour.
• Patience.
• Discovery.
• Alternative culture and way of thinking.

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Sensory Tools

• Sounds. Ear plugs, headphones.
• Light. Irlen Lenses, hat, sun glasses.
• Aroma. deodorants, cleaning products.
• Tactile. Clothing.

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Other Strategies

• e-mail, poetry.
• Money.
• Acting.
• Repair the emotions of others.
• Borrow tools.

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Other Strategies

• Executive secretary to help with organizational
  problems.
• Environmental modification (sensory problems).
• Reduce the number of demands and choices.
• Homework and sport.

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Inappropriate Tools

• Fight.
• Being alone too long.
• Taking stress out on someone else.
• Hurt yourself.

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Inappropriate Tools

• Affection.
• Would a hug help?-no- I get madder.
• Punishment.
• Talking.
• Emotional.

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• Different tools at different points on the
  thermometer.
• Relaxation tools at low stress levels, physical
  tools at high stress levels.

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Motor Clumsiness

• Delayed attainment of motor skills.
• Described by parents and teachers as clumsy.
• Unusual locomotion (upper and lower limb
  coordination, wooden or puppet like).
• Unusual gait (bouncing or rolling) and stooped
  posture.

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Motor Clumsiness

• Immature ball catching skills.
• Poor coordination when using playground
  equipment.
• Poor manual dexterity.
• Untidy, large and slow handwriting (macrographia).

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Motor Clumsiness

• Avoidance of, and delay in completing, work that
  requires handwriting.
• Movement disorder (cerebral palsy).
• 17 of Hans Aspergers clients with A.S.had
  simple motor tics such as blinking and grimaces
  (Heppler and Klicpera 2003).
• Tics can occur in up to 50 of cases of A.S.

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Motor Clumsiness

• Can be delayed in gross motor abilities such as
  learning how to ride a bicycle.
• Can become agile and proficient through solitary
  practice in activities such as using the
  trampoline, golf or swimming, and stoic in
  endurance sports such as the marathon.

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Movement Abilities

• Typing rather than handwriting.
• Practice solitary sports.
• Coordination and agility activities.

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Cognitive Profile

• 48 of Hans Aspergers clinical cases had a
  Verbal I.Q. at least nine points higher than the
  Performance I.Q. (Hippler and Klicpera 2003).
• Lose marks on timed tests because of an inability
  to work fast due to being pedantic, distracted by
  details and handwriting problems.

133
Cognition

• Some academic skills are self-taught.
• Spikes of interest and troughs of lack of
  interest.
• Mathematics and reading ability or disability.
• Fear of failure.
• Refusal to do something unless it is perfect.

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Cognition

• Encyclopedic memory.
• Limited flexibility in thinking.
• Originality in problem solving.

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Cognition

• May not listen to or follow the instructions and
  advice of a parent, teacher or peer.
• Adherence to their own idiosyncratic ideas.

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Impaired Executive Function

• Impaired organizational and planning skills
  (getting started, being distracted,and timing).
• Impulsivity.
• Failure to recognize consequences.
• Problems with working memory.
• Need for an executive secretary and executive
  toys.

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Cognitive Abilities

• Fear of failure and mistakes.
• Preference for solitary learning.
• Using a computer and CD versions of the
  curriculum.

138
Sensory Sensitivity

• Sound sensitivity.
• Tactile sensitivity.
• Sensitivity to the taste or texture of food.
• Stoic in response to pain or temperature.

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Self-care Skills

• 26 of Hans Aspergers clinical sample were late
  in toilet training.
• Dexterity problems affecting activities such as
  tying shoe laces.
• Need for verbal reminders on aspects of personal
  hygiene.

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Managing Special Interests
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The Development of the Interests

• Stage 1. Parts of objects.
• Stage 2. Category of objects.(typical and
  eccentric). Pretending to be the object. Often
  transport, animals and electronics.
• Stage 3. Complex or abstract interests such as
  periods of history, geography.
• Stage 4. Interest in a person, fantasy literature
  and multiple interests.

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Nature of the Interests

• Typical and idiosyncratic.
• Self-directed and self-taught.
• Solitary and intuitive activity.
• Development of a cataloguing system.
• Creative arts, drawing, sculpture, music and
  poetry.
• Attention to detail and prodigious memory.

143
Teachers Perspectives

• Attention to other activities.
• Monologues make the child appear eccentric and
  ridiculed.
• A barrier to social inclusion.
• The nature of the interest (weapons).
• Benign eccentric or a pedantic bore.

144
Reducing or Utilizing the Interest1. Controlled
Access

• Time limit using a clock or timer.
• Scheduled times for access.
• Subsequent activity is enjoyable.
• Quality time to indulge in the interest with a
  parent.

145
2. Unacceptable Interests.

• Potentially dangerous, illegal or likely to be
  mis-interpreted.
• Modify the interest (poisons to the digestive
  system).
• Replacement interest.

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3 Constructive Application

• Employment.
• Private tuition.
• A means of making friends.
• Learning where, when, who with and for how long.

147
3. Constructive Application

• Motivation and learning. (reward, activity
  incorporates the interest).
• Prizes and certificates.
• Removal of access as a punishment.
• Power Cards.

148
Long Term Outcomes