CREATE A PSYCHOLOGICALLY SAFE ENVIRONMENT FITS WITHIN THESE EBP: - - PDF document

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CREATING A PSYCHOLOGICALLY SAFE ENVIRONMENT FOR STUDENTS WITH HF-ASD

Brenda Smith Myles, Ph.D. www.ocali.org www.texasautism.org

CREATE A PSYCHOLOGICALLY SAFE ENVIRONMENT

FITS WITHIN THESE EBP: Behavioral package, Modeling, Multi-component package, Naturalistic Interventions, Social interventions, Social narratives, Task analysis, Schedules

Learning: What to Teach

• Research shows that …
• Individuals with “soft skills”, including good social skills,

sociability, good work habits, punctuality, conscientiousness and those who participated in extra curricular activities are more likely to make more money, be employed, and attain high levels of education than those with good grades and high standardized test scores.

University of Illinois at Urbana-Champaign (2009, March 26). Social Skills, Extracurricular Activities In High School Pay Off Later In Life.

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Create a Psychologically Safe Environment

Predictability Predictability Communication demands Communication demands Sensory factors Sensory factors Physiological factors Physiological factors

Adapted from Loomis

PREDICTABILITY

Predictability

• The more predictable, the easier the interaction
• Routines and regularly occurring events
• Circle time
• Martial arts lesson
• Math cooperative group

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Predictability

• The learner with ASD must know answers to questions,

such as:

• What is the schedule?
• What am I expected to do?
• How much am I expected to do?
• What will other people be doing?
• How will I know when I am finished?
• What will I do next?
• What should I do if I don’t know what to do?
• Can I tell when I become overwhelmed, anxious, or upset?
• What should I do if I become overwhelmed, anxious, or upset?

Bolded items from Project TEACCH

Predictability

• One of the best ways to provide clear explanations is to

make:

• The unfamiliar

Familiar

• The unpredictable

Predictable

• Unclear expectations

Clear

Predictability: Tools

• Priming
• Video modeling
• Social narratives

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PREDICTABILITY: PRIMING

Priming

• Preparing the student for daily activities
• Can occur
• At home for the next day
• The morning of in school
• At the end of the school day for the next day
• Overview of schedule changes, assignments and

activities

Sample Priming Activities

• Look at a grocery list
• Look at a to-do list
• Look at a worksheet
• Look through a book
• Overview a test
• Show the visual schedule
• Practice with art supplies
• Talk about and show a finished project
• Show a work sample

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PRIME FOR TESTS!!!!!!

You can call them study guides, if it makes you more comfortable.

Priming Considerations: Explanation

• Get the child’s attention
• Tell the child what is going to happen
• Be brief yet thorough
• Show no panic or fear!

Sakai, 2005

Priming Considerations: Schedule

• Use a timeline
• Stick to it
• No last minute changes
• Consider this step as a trust-builder

Sakai, 2005

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Priming Considerations: Reward

• Tell or negotiate
• Expect and communicate reasonable compliance
• “Going with the program”

Sakai, 2005

Priming Considerations: Predicting

• Make the schedule clear
• What might happen?
• Examine all variables
• What has happened in the past
• Ask the child questions to check for comprehension
• With the child, think of possible alternatives … just

in case

Sakai, 2005

Priming Considerations: Predicting

• Brainstorm and include the child in the process
• Ask “What if”?
• Write it down
• Paper
• Post-It

Sakai, 2005

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Priming Considerations: Countdown

• Time needed varies

by activity and location

• Be prepared
• Do not use seconds
• Don’t say “just a

minute” unless you mean 60 seconds

Sakai, 2005

Priming Considerations: Wrap-Up

• Present the facts
• Not a time for scolding or making judgments
• A play-by-play listing of what occurred
• Make sure the child is calm before you wrap-up

Sakai, 2005

PREDICTABILITY: VIDEO MODELING

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PREDICTABILITY: SOCIAL NARRATIVES

Rule Cards

Proper Greeting Behaviors for an Adolescent in a New Situation With Peers

• 1. Make eye contact.
• 2. Say, “Hey, great to meet.”
• 3. Say, “What are we supposed to be doing?

Loomis, 2012

Conversation Starter Cards

Things to Talk About

• 1. Yesterday’s snowstorm.
• 2. The joke about the horse that dad told.

Remember each person should only hear the joke one time

• 3. The baseball game on television tonight.

Loomis, 2012

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Scripts

Marty’s Script

• Hi (peer’s name). How are you?
• Did you see (television show) last night?
• What did you think was funny.
• I liked it when everybody fell into the

swimming pool.

Loomis, 2012

Situational Fact Cards

Dinner at Restaurant

• Who will be there: Aunt Donna, Uncle John, Mark, Missy,

dad, mom, you

• What will you have to do beyond general ordering and

eating: (a) hug aunt and uncle hello and goodbye; (b) talk with Mark and Missy about their interests: hockey and American Idol; (c) it is appropriate for you to talk with Mark and Missy while the adults are talking with each

• ther
• After we leave the restaurant, you can de-stress with a

favorite video game

Loomis, 2012

Descriptive Stories

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Descriptive Stories

COMMUNICATION DEMANDS

Communication Demands

• Verbal communication
• Nonverbal communication
• Problem solving
• Hidden curriculum

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SIMPLIFY THE LANGUAGE EXPRESSIVE LANGUAGE DOES NOT EQUAL COMPREHENSION

Simplify the Language

• Students with ASD often appear to understand than they

actually do

• Many students can repeat back what they hear without

understanding

• Verbalization does not equal comprehension
• The answer to “Do you understand what you are

supposed to do?” is almost always, “Yes”. The meaning may be “No”.

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Communication

• Use student’s name to obtain attention
• Ask questions in different ways
• Have student paraphrase
• Tape gently on the desk prior to asking a question
• Have student demonstrate understanding
• Teach new vocabulary
• Explain that words have more than one meaning

COMMUNICATE VISUALLY

Cartooning

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Graphic Organizer

The human body

Respiratory system Skeleton Circulatory system Digestive system Reproductive system

The human body

Nervous system Respiratory system

The human body

Nervous system Skeleton Circulatory system Respiratory system

The human body

Nervous system

Insect Report Due Next Friday

Timeline Task Details Monday Read at least 2 sources to learn more about insects Can be on internet or information from books Tuesday Create outline 5-10 facts people should know about insects Wednesday Write 1st draft. Use information from research to add details to outline Introduction Body Conclusion Thursday Edit report (Ask your teacher to read it and make suggestions) Read and look for errors Correct errors Make changes based on suggestions Friday Read paper again. Check for spelling errors. TURN IN PAPER Look for spelling errors Correct spelling errors

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Lofland, 2010

USE SOCIAL AUTOPSIES

Bieber, 1994

PROMPTING, SET-UP, NARRATION

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Prompting

• Providing the subtle “nudge” to help the learner get

started or to provide direction

• Verbal
• Nonverbal

The Set-up

• Providing a brief introduction to help the learner get

started

• “John has something to say.”
• “We are going to the store and there is something that John would

like to ask you before we go.”

Narration

Her mouth is turned down and her arms are crossed. I think she is mad and is waiting for the students to stop talking.

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CREATE PRACTICE OPPORTUNITIES

HELP STUDENTS CREATE A COMMUNICATION PLAN

Before approaching a social situation

Gardella, A. (2015, April). How to network as an introvert. Real Simple. Retrieved from http://realsimple.com/work- life.

Make a To-Do List

• Jot down what you want to accomplish prior to attending a

social situation

• Make one or two goals
• Learn about a specific topic
• Listen to a speaker
• Meet an individual

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Stay Only a Short While (20 Min)

• It is usually acceptable to leave after your goals are

accomplished

• Check with a mentor to see how long it is necessary to

stay

• If you are having a good time, stay longer

Think Quality, Quantity

• Try to make one or two meaningful connections with

people you might enjoy

• In a group setting, strive NOT to be the person who talks

the most

Script Your Introduction

• Develop a three-to-five second ‘elevator pitch”
• Unique talents
• Professional background
• What you enjoy (in a sentence)
• Write them out so that the words sound natural, not forced
• Practice in front of a mirror and trusted people

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Learn to Ask Meaningful Questions

• If you ask questions, other people do the talking
• Don’t interrupt
• Come armed with questions
• People
• News
• Locale

Answering Questions

• Respond to “What do you do” with something you actually

did

• Previously identified and practiced
• Answer the question; ask a question

Duck Out Now and Then

• Take brief breaks to recharge
• Walk
• Go to hotel room
• Duck into the restroom
• Find a quiet spot

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NONVERBAL COMMUNICATION

Teach Nonverbal Language

TEACH NONVERBAL COMMUNICATION BODY LANGUAGE

Body Language Cheat Sheet for Writers

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ANGER

Anger

• Balling the fists
• Crossing the arms tightly
• Clenching the fists once arms are crossed
• Tight-lipped smile
• Clenched teeth
• Shaking a finger like a club
• Firmly pointing a finger at someone

Body Language: Cheat Sheet for Writers

CLOSED TO CONVERSATION

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Closed to Conversation

• Keeping hands in the pockets
• Especially men
• Arms crossed
• Sitting back
• Folding hands together on a table to create a barrier
• “Figure-four” leg cross

Body Language: Cheat Sheet for Writers cont

Closed to Conversation: Figure Four Leg Cross

DISTRESS

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Distress

• Stroking or rubbing neck (especially men)
• Think “pain in the neck”
• Crossed arms
• Self-hugging
• One-arm cross
• Clutching a purse, briefcase, or bag with both arms

Body Language: Cheat Sheet for Writers cont

Distress

• Adjusting cuffs or cuff-links
• Folding the hands together in front of the crotch (men)

Body Language: Cheat Sheet for Writers

LYING

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Lying

• Covering the mouth
• Shhh gesture
• Covering mouth similar to coughing
• Touching or rubbing the noise or just below the nose
• Quick, small gesture; not a scratch
• Rubbing the eyes (especially men)
• Scratching the neck with the index finger
• Averting gaze

Body Language: Cheat Sheet for Writers

OPENNESS AND HONEST

Openness and Honesty

• Exposure of the palms
• Arms and legs unfolded
• Leaning forward

Body Language: Cheat Sheet for Writers

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SUBMISSIVE

Submissive

• Smiling
• Some people smile when they are upset or afraid
• Slumping the shoulders
• Doing anything to appear smaller

Body Language: Cheat Sheet for Writers

SUPERIORITY , CONFIDENCE, POWER AND DOMINANCE

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Superiority, Confidence, Power and Dominance

• Steepling the fingers (setting the tips of fingers together)
• Folding hands behind the back
• Thumbs sticking out of pockets (front OR back pockets)
• Hands on hips
• Straddling a chair
• Hands folded behind head while sitting up (in men)
• Rolling eyes

Body Language: Cheat Sheet for Writers

THE INCREDIBLE 5- POINT SCALE

Matching emotions to actions and identifying interventions Buron & Curtis, 2013

Rating Feeling What It Looks Like What I Should Do

I have to leave; it is time to be alone Fast rocking; loud voice Use the secret signal with the adult you trust and leave the room when the adult acknowledges you. I need to move to a different place in the room Rocking back and forth; picking on my fingernails Say, “Excuse me”, if you can. If you can’t, just walk to a quiet part of the room and put on your headphones. Think about using your secret signal with an adult. I need to stop talking with this person or I might need help telling someone to be quiet Feeling like I want to flap my hands and cover my ears Think about saying one of these things, “I’ll talk with you later”, “I’m going to get a drink”, “I need to get some work done”. If that is not going to work, say “Gotta go!” And go stand by an adult you like and

• know. Ask the adult for help.

I can do this by myself Starting to tap my foot Taking a deep breath and count to 10 Think about saying one of these things, “I’ll talk with you later”, “I’m going to get a drink”, “I need to get some work done”. I am good. Nothing is really bothering me. Smiling, talking Keep doing what I am doing.

• 1. Make a

table

• 2. Label the

top columns

• 3. Write

numbers down the side

• 4. Write in

your feelings for each number.

• 5. Write

down what each feeling looks like for you.

• 6. Write what

you should do for each number.

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Buron & Curtis, 2012 Buron & Curtis, 2012 Buron, 2011

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Buron & Curtis, 2012 Buron & Curtis, 2012

LEARN TO SOLVE PROBLEMS

Efficiently and Calmly

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Problem Solving

Channon, 2004

ALL PROBLEMS HAVE A SOLUTION --

But you might not always get the solution you want. This is called life!

• 1. Figure out

what the problem is.

• 2. Look at the four choices.
• 3. For each choice

ask, “What would happen if I did that?” It is best to do this with an adult you trust.

• 4. Choose the best
• ne; practice how to

do it with an adult. Then do it!

Mataya & Owen, 2012

Talk it out and compromise Seek help from an adult Ignore and move on Let it bother you

Problem ________

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Mataya & Owens, 2013 Looks Like Feels Like What to Do Screaming Stomping feet Very embarrassed Very frustrated Go to home base Getting quiet Saying “bad words” A bit frustrated A bit embarrassed Folding arms Refusing to work Confused Making excuses “I don’t want to …” Uncomfortable Trying things Good attitude Happy Content Be proud of myself Buron & Curtis, 2014 Mataya & Owens, 2013

Hidden Curriculum

• The set of unwritten rules that no one has been directly

taught, but everyone knows. Violations of these rules can make an individual a social outcast.

• Phrase associated with hidden curriculum:
• “I shouldn’t have to tell you but … “
• “Everyone knows that … “
• “It’s obvious … “

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Hidden Curriculum Includes Hidden Curriculum Includes Hidden Curriculum Includes

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Hidden Curriculum Includes Hidden Curriculum

Differs Across

• Age
• Who you are with
• Culture
• Gender

Impacts

• Home
• Community
• School
• Workplace
• Legal system

EVERYWHERE!!!

THE HIDDEN CURRICULUM AND CULTURE

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British and American English

What the British Say What the British Mean What Americans Understand I hear what you say I disagree and do not want to discuss it further He accepts my point of view With the greatest respect You are an idiot He is listening to me I’m sure it’s my fault It’s your fault Why do their think it is their fault? You must come to dinner It’s not an invitation, I’m just being polite I will get an invitation soon

Hidden Curriculum

Differs Across

• Age
• Who you are with
• Culture
• Gender

Impacts

• Home
• Community
• School
• Workplace
• Legal system

EVERYWHERE!!!

One-a-Day Method

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Resources to Teach the Hidden Curriculum Resources to Teach the Hidden Curriculum

SENSORY DEMANDS

ANTECEDENT-BASED INTERVENTIONS

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Sensory Demands

• Some

experiences are experienced too intensely and

• thers are not

intense enough

Coulter Video

Sensory Demands

Relaxers/Fidgets

PHYSIOLOGICAL FACTORS

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Physiological Factors …

That Impede Interactions

• Fatigue
• Hunger
• Thirst
• Illness

Pain

Are Important

• Individuals with ASD often

have to use energy to “block out” extraneous stimuli

• Social processing

requires concentration, focus, balanced energy level Be interoception aware!!

PAIN SENSITIVITY IS HIGHER THAN AVERAGE

Or lower than average

Chen, Hung, Fan, Tan Hong, Chang, 2016

CONSIDER STRUCTURAL FACTORS

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Structural Factors

Number of people Number of people Types of people Types of people Relationships: Peers and adults Relationships: Peers and adults Time Time Physical space Physical space

Adapted from Loomis

NUMBER OF PEOPLE

Number of People

• The fewer people involved,

the lower the social challenge

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TYPES OF PEOPLE

Types of People

People Who Are Easy to Socialize With

• Speak slowly
• Listen carefully
• Articulate well
• Express themselves

directly

• Communicate feelings
• Are entertaining and fun
• Are reinforcing
• Who genuinely like the

child

• Who send clear

messages of support

• Who minimize figurative

language or explain it

PEERS

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Peer Buddies

• Can be coached to provide clear, straight forward

communication

• Can act as translators
• Can support the use of cartooning, social narratives

Teach Peer Buddies

• To initiate interactions
• To understand “unusual” behavior
• To interpret the intentions of the person on the spectrum
• To accept different preferences for levels of engagement

Peer Buddies

• Find common interests
• Find something you appreciate about

the individual

• Like the individual
• Enjoy each other’s company
• Let the individual know that
• You are happy to be with them
• You value them
• You know that they have something to

contribute

We should do this also!

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ADULTS

STUDIES OF TEACHER- STUDENT RELATIONSHIPS

Over 350,000 students Over 12,000 teachers

Behaviors of Teachers in Positive Relationships

• Engages in little

conflict

• Is supportive of

student needs

• Is empathetic
• Supports

independence

• Is trustworthy
• Feels close to students
• Accepts student ides
• Praises/reinforces
• Accepts student

feelings

• Is sensitive to

individual differences

• Involves students in

decision making

• Is warm

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Behaviors of Teachers in Positive Relationships

• Is respectful
• Encourages higher-

level thinking

• Is responsive to

learner developmental, social and personal needs

• Promotes student

success

• Is genuine

Student Outcomes

• Has better social skills
• Accepts peers
• Develops social

connections

• Follows rules
• Has higher academic

performance

• Attends school

regularly

• Is self-directed
• Participates in class
• Has better mental

health

• Explores higher

education

• Exhibits less defiant

behavior

LENGTH OF TIME

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Length of Times

• The longer it lasts, the

more tired the learner becomes, and the more taxing it becomes

• Social processing is

exhausting!

PHYSICAL SPACE

Physical Space

Less Exhausting

• Well organized
• Clearly defined

boundaries

• Enough space for the

activity

• Reasonable sound

level

More Exhausting

• Crowed spaces
• Large, open areas
• Noisy environments
• Echoing environments

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BE KIND

An evidence-based practice, according to me!

Kindness

• Use the golden rule +
• Do unto others what they need
• Assume that the individual is doing her best
• Assume that the behavior makes sense even if you don’t

understand it

• Understand the “refusal” is probably “can’t in the moment”

Aspy & Myles, 2016; Endow, 2016

THE POTENTIAL OF INDIVIDUALS WITH AUTISM IS LIMITLESS!