Professor Rita Jordan OBE,

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Quality of life for adults with ASD
Professor Rita Jordan OBE, Autism Centre for
Education and Research, University of
Birmingham 4 December 2007
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Learning style

• Visual rather than verbal
• Memory
• cued
• rote
• Social, a dimension of difficulty
• Emotions and cognition
• use interests for engagement
• At sensory stage of meaning
• presentation reference
• Repetition and consolidation
• Explicit strategies for problem solving.

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Education and adults with ASD

• Continued entitlement to education for
• vocational skills
• leisure and occupation
• personal development
• Education as part of care and support
• facilitated and dignified
• Education as therapy
• social
• emotional
• communication
• flexibility training
• anxiety reduction.

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Ecological curriculum

• Assess individual
• Assess current and future environments and
  occupations
• Gap in
• skills
• appreciation
• knowledge
• experience forms curriculum goals
• Teach in functional ways
• Practise in functional contexts.

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Leisure support

• Need real-life experiences
• time to get used to it
• Extend obsessional interests
• Context for social skills
• Enriches life
• Informed choices
• Use of ICT.

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Living support

• Education needs to engage with support and
  self-advocate
• Separate communities is not favoured
• how to ensure necessary flexibility?
• Graded support within the community
• specialist segregated community
• learning disabled community
• group homes and satellites
• supported houses and flats
• community support workers
• personal support schemes
• voluntary schemes.

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Aesthetic and spiritual life

• Cultural participation
• Another dimension of experience
• Music and art may be a strength
• Nature and awe
• Need for physical exercise
• Schemes for appreciation
• activities in museums
• acting out pictures
• use of replication.

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ICT

• Internet monitoring service
• Mobile phones
• independence
• communication
• Virtual and augmented reality
• more able to manage social situations when in
  control
• Enables work and friendships
• Serves interests.

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Issues of personal involvement

• Reflection
• allow time
• include emotional context
• make pragmatically relevant
• Real and informed choices
• menus
• flow charts for challenging behaviour
• positive experience of alternatives.

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Practical issues

• Opportunities for control of others/events
• with feedback
• External cueing of emotional states
• notice signs
• teach to person with ASD
• make relevant, i.e. lead to action
• Have fun.

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Self-appraisal

• Build self comparisons
• chart progress on realistic goals
• Teach awareness of general problems for all, e.g.
  agony aunt to assess understanding
• Plan for failure as step in solution
• Draw attention to success
• Make mistakes explicit and reflect.

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Process

• No fixed assumptions
• Enabling structures for participation (including
  repetition)
• Supporting the supporters paired schemes
• Allowing risk excitement
• Peers better than training.

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Basic guide to anxiety reduction

• Awareness of initial build-up of anxiety
• as with emotional awareness outside in
• Positive attitude to coping (teach coping skills
  and awareness)
• drill for panic
• positive solution-focused problem solving
• Structure, e.g. lists
• preventative allows priorities and sense of
  accomplishment
• helps focus on positive actions.

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Basic guide to anxiety reduction (continued)

• Relaxation
• general sensory/meditation/yoga/deep pressure
• specific fold arms, close eyes, chant or hum
• Exercise
• aerobic contingent and non-contingent
• Diets
• GI index low
• low stimulants
• sugar and additives
• Talking with others
• drawing
• music.

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Cognitive behaviour therapy and ASD

• Growing use with ASD
• Hare
• Attwood
• Adapted materials for children with ASD
• Wood and Drahota, 2005 UCLA
• Traditional CBT relates well to traditional ASD
  techniques.

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Skills training

• Relaxation
• appropriate to situation
• general and specific
• Positive self-talk
• coach self through responses
• Self-reward
• supply or help identify positive consequences.

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Teaching consequences

• Less able single track
• More able
• railway no turns
• two clear termini with no connections
• choice point emphasised.

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Steven Degrieck purpose of a schedule

• To increase
• predictability
• independence
• flexibility
• quality of life.

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Quality of life

• Depends on
• communicating at the right level of understanding
• introducing variety
• enabling toleration of changes
• introducing choices.

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Poor quality of life

• Characterised by
• no influence on decisions affecting your life
• no changes. Rigidity, so no development over time
• no opportunity to increase skills and
  understanding
• no adaptation to you as an individual, including
• social
• cognitive
• sensory
• linguistic.

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Choosing without understanding
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Factors affecting choice in day-schedule

• Schedule is at wrong semantic level
• sensory presentation
  representation symbolic
• No experience of choice at mental level
• Teach semantics and choice
• Meanwhile, choose for them (enlightened
  dictatorship).

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Factors affecting choice in day-schedule
(continued)
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Including choice

• Directly in the day schedule
• advantage options are immediately visible
• disadvantage options are limited
• With a reference system
• advantage options are not limited
• disadvantage options are not immediately
  visible.

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Including choice (continued)
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Learning to choose

• Choosing is easier when options
• are communicated in a visual way
• are limited
• are known
• have different values (positive v negative)
• Remember, new always negative first.

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Conclusion

• Final goal is always quality of life
• satisfying occupation
• self-esteem
• understanding
• informed choices
• positive experiences
• education
• All must be individualised quality of life is
  often different for those with ASD.