Introduction to Autism Spectrum Disorder (ASD) for Educators JUNE - PDF document

6/5/2018 SYLVIA J. ACOSTA, PHD ASSOCIATE PROFESSOR SUMMER INSTITUTE JUNE Introduction to Autism Spectrum Disorder (ASD) for Educators JUNE 15, 2018 Objectives Participants will:  Identify the 2 diagnostic categories for Autism Spectrum Disorder (ASD)  Understand the impact of ASD symptoms for students  Make considerations for their own educational environments for students with ASD 1

6/5/2018 What is Autism Spectrum Disorder (ASD)? A complex neurodevelopmental condition 1. Impairments in social communication 2. Presence of restricted behavior interests and activities ASD is a spectrum condition The skills and challenges among individuals with ASD can vary widely. The level of impact of ASD can also depend on other developmental and behavioral health factors. The prevalence of ASD has increased Centers for Disease Control Autism and Developmental Disabilities Monitoring Network (ADDM) 2018 Or 1.7% 2

6/5/2018 ASD eligibilities rising in schools Autism accounts for about 5-6% of all disabilities served as part of IDEA and many Children with ASD in schools participate in regular education for at least part of the day. 600 500 400 300 200 100 U.S. Department of Education, National Center for Education Statistics. (2016). Digest of Education Statistics, 2015 (NCES 2016-014), Chapter 2. 0 2000 2004 2008 2012 Educational eligibility of ASD focuses on the learning impact Educational need Educational eligibility can only be determined when all aspects of the evaluation, as defined by the Public Education Department, are completed Educational eligibility does not require a medical diagnosis 8 Medical diagnosis of ASD focuses on the impact of functioning Medical professional (pediatrician, neurologist, psychiatrist) provides, or participates on a multi-disciplinary team that provides, a diagnosis (criteria is based on DSM-5) May include some medical tests to explore other possible diagnoses, symptoms and related issues 9 3

6/5/2018 ASD consists of 2 core deficit areas: Deficits in social communication Presence of restricted, repetitive patterns of behavior, interests and activities Levels of support vary for each core deficit area Symptom severity is variable. How much support does an individual need at this point in time? How might this translate to their presentation in the school setting? Social communication differences can impact learning 4

6/5/2018 Social-emotional reciprocity May prefer to play alone Identify ways to integrate into activities May struggle to respond Be sure to give plenty of time to process May struggle with back and forth conversation Provide appropriate coaching Difficulty understanding idioms Use plain language Nonverbal social communicative behaviors Limited facial expressions Gain attention Limited gestures Check for understanding Difficulty integrating nonverbal Visual supports behaviors Imitation is limited Imitate and expand on their behaviors Relationships/play Limited interest in relationships Link favorite activities with people Sharing space challenges Structure activities for give and take Pretend play Model 5

6/5/2018 Repetitive behaviors and special interests can impact behavior Repetitive behaviors Unusual or intense movements Evaluate the form and intensity of repetitive movements and noises  Do they interfere with other activities (i.e. – will the child stop when asked or when there Repetitive noises is something else to do)?  Do they interfere with learning?  Do they interfere with social relationships? Echolalia  Evaluate whether stopping/changing them is a priority Routines/rituals Insistence on sameness Schedules Visual aids Difficulties with transitions Structure and routine 6

6/5/2018 Special interests Integrate! Incorporate strengths Sensory differences Strong reactions to sensory input Quiet environments (visual, auditory) are usually best (e.g., noise, lights, sounds, smells) May seem over or under reactive to sensory experiences ASD has a high number of comorbidities that can influence learning Fragile X Tuberous Intellectual Genetic sclerosis Disability conditions Tourette syndrome Mood ASD Anxiety Disorder Seizure disorders Language ADHD Medical Gastrointestinal Disorder Conditions disorders Feeding and eating problems Sleep disorders 7

6/5/2018 Individuals with ASD have a range of intellectual capacities Approximately 30% of those diagnosed with ASD have an intellectual disability and 24% have borderline intellectual functioning. Deficits in adaptive functioning can occur with individuals with ASD regardless of cognitive abilities. Individuals with ASD have a range of language capacities Difficulties in the acquisition and use of language Language abilities substantially below age expectations, impacting functioning Reduced vocabulary, limited sentence structure, impairments in discourse Medical problems can be common in ASD Sleep Gastrointestinal problems Seizures Feeding 8

6/5/2018 Comorbid behavioral health diagnoses can impact a student with ASD Anxiety ADHD Depression Other Disorders Inevitably, behavior problems can occur Problem behaviors begin because they allow the child to get needs met  Get something  Escape from people, places or activities  Get attention  Allow the child to get, or get away from, sensory input National Standards Project Phase 2 (NSP2) ESTABLISHED TREATMENTS (14) Behavioral Interventions Cognitive Behavioral Intervention Package https://www.youtube.com/watch?v=GxAh8pLYF5I Comprehensive Behavioral Treatment for Young Children Schedules Language Training (Production) Scripting Modeling Self-Management Naturalistic Teaching Strategies Social Skills Package Parent Training Peer Training Package Story-based Intervention Pivotal Response Training 9

6/5/2018 National Standards Project 2 FOR CHILDREN TO YOUNG ADULTS UNDER 22 YEARS Emerging (18) Unestablished (13) ◦ Augmentative and Alternative Communication Devices ◦ Animal-assisted Therapy ◦ Developmental Relationship-based Treatment ◦ Auditory Integration Training ◦ Exercise ◦ Exposure Package ◦ Concept Mapping ◦ Functional Communication Training ◦ DIR/Floor Time ◦ Imitation-based Intervention ◦ Facilitation Communication ◦ Initiation Training ◦ Language Training (Production & Understanding) ◦ Gluten-free/Casein-free diet ◦ Massage Therapy ◦ Movement-based Intervention ◦ Multi-component Package ◦ Music Therapy ◦ SENSE Theatre Intervention ◦ Picture Exchange Communication System ◦ Sensory Intervention Package ◦ Reductive Package ◦ Shock Therapy ◦ Sign Instruction ◦ Social Communication Intervention ◦ Social Behavioral Learning Strategy ◦ Structured Teaching ◦ Social Cognition Intervention ◦ Technology-based Intervention ◦ Social Thinking Intervention ◦ Theory of Mind Training National Standards Project 2 For adults 22 years and older ◦ Established (1) ◦ Behavioral Interventions ◦ Emerging (1) ◦ Vocational Training Package ◦ Unestablished (4) ◦ Cognitive Behavioral Intervention Package ◦ Modeling ◦ Music Therapy ◦ Sensory Integration Package A multi-university center to promote the use of evidence based practice for children and adolescents with autism spectrum disorders. (2008) 10

6/5/2018 National Professional Development Center on ASD (2014) Antecedent-Based Interventions Functional Communication Training Cognitive Behavioral Intervention Modeling Differential Reinforcement Naturalistic Intervention Discrete Trial Training Parent-Implemented Intervention Exercise Peer-Mediated Instruction and Intervention Extinction Picture Exchange Communication Functional Behavior Assessment System (PECS) Pivotal Response Training National Professional Development Center on ASD (2014) cont. Prompting Social Skills Training Reinforcement Structured Play Group Response Interruption/Redirection Task Analysis Scripting Technology-aided Instruction and Intervention Self-Management Time Delay Social Narratives Video Modeling Visual Support Resources available for educators Implementation Briefs http://autismpdc.fpg.unc.edu/content/briefs ◦ Definition ◦ Step by step guidelines ◦ Information regarding evidence base ◦ Data collection ◦ On-line Modules http://www.autisminternetmodules.org/ 11

6/5/2018 Neurodiversity in ASD Neurological conditions such as ASD are normal variations in the human genome Self-advocacy Identity-first language ◦ http://autisticadvocacy.org/home/about-asan/identity-first-language/ Cure vs. Treatment References American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. Baio J, Wiggins L, Christensen DL, et al. Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014. MMWR Surveill Summ 2018;67(No. SS-6):1 – 23. DOI: http://dx.doi.org/10.15585/mmwr.ss6706a1. National Autism Center. (2015). Findings and conclusions: National standards project, phase 2 . Randolph, MA: Author. National Research Council (2001) Educating Children with Autism . Washington, DC: National Academy Press. Wilkinson, L.A. (Ed.). (2014). Autism Spectrum Disorder in children and adolescents: Evidence-based assessment and intervention in Schools. Washington, DC: American Psychological Association. 12