Orientation & Foundations in Autism Spectrum Disorders (ASD) & Effective Practices

Orientation & Foundations in Autism Spectrum Disorders (ASD) & Effective Practices

Building Your Future Intensive Training

Today’s Itinerary• Morning:

– Orientation to the START Project and BYF Intensive Training

– Foundations in ASD

• Afternoon:– Meeting Mechanics

1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 20120

2000

4000

6000

8000

10000

12000

14000

16000

Michigan Students with an ASD Eligibility Label

Num

ber o

f stu

dent

s

1,208

15,976

Purpose of STARTSTART serves as a

coordinating and supporting entity for

regional sites across the state of Michigan to

increase access to local resources, training and

support for students with autism spectrum

disorder.

START Primary Components

Team-based Intensive Training

START Early Childhood Intensive Training

START K-12 Intensive Training

START Building Your Future Training

Making Professional Development EffectiveLang & Fox (2003)

0%10%20%30%40%50%60%70%80%90%

100%

w/out follow-up w/follow-up

• Traditional professional development (training without follow up to support implementation) yields a 5-10% implementation of strategies success rate.

• With follow up, that number can rise to 75-90%

START Intensive Training Goals

• Acquire content knowledge

• Apply content knowledge

• Develop teaming and collaborating skills

• Develop systems to assure implementation

Systems Change

• Big change only happens when we change whole systems

Systems ChangeCommon principles/practices for supporting students with ASD

• Positive behavioral interventions & supports• Integration of students and peer supports• Team approach for planning, development, and

implementation • Training and coaching to support implementation• Assessment and planning for program improvement• Networking and sharing across districts and counties

Big Ideas

LRE/Natural Environments

Independence & Socialization

Data-Based Decision-Making

Evidence-Based PracticesUse the ASD to the

Student’s Advantage

Families as Active

Team Members

Peers as Critical

Natural Supports

Universal Supports

Team Process and Problem Solving

Proactive / FrontloadAccountability

Goals for Individuals with ASD

Socialization Skills

Independent Skills

Employment

START Primary Components

Regional Collaborative Networks (RCNs)

START/ Autism Education Center at GVSU

SMART Lake side OCAN SMACWest

MAC LEAN MAC Wayne WIN4Autism

CAN4GCA CMACUPAN Thumb Kent

CANCRANNAN

Great Lakes

Intermediate & Local School District Trainer/Coaches

Student and Family

School Building Coaches & Teams

START Primary Components

• Annual START Conference, Leadership Meetings, Summer Institute

• START Website http://www.gvsu.edu/autismcenter/transition-312.htm

• Products and Materials developed by START partners (i.e. RCN)

START Conference 2014April 29, 2014 @ Lansing Lexington

KEYNOTE:Evidence-based intervention in transition and

adulthood

Peter Gerhardt, Ph.D.

START Primary Components

Resources for Evidence-Based Practices for Students with ASD

• NPDC: (http://autismpdc.fpg.unc.edu/)

• OCALI: AIM (Autism Internet Modules) (http://www.autisminternetmodules.org)

• National Autism Center: National Standards Project (http://www.nationalautismcenter.org)

Evidence-Based

Why Demand Use of Effective Practices

• Improved Student Outcome

• Legally Defensible

• Efficient use of Time and Money

The FutureA START Partner for Life!?

We are committed to supporting our training sites for the duration of our

grant funding through Regional Collaborative Networks and Coaches with a goal of improving outcomes for

all students with ASD.

START Building Your Future:

Secondary Transition Intensive Training

1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 20120

2000

4000

6000

8000

10000

12000

14000

16000

Michigan Students with an ASD Eligibility Label

Num

ber o

f stu

dent

s

1,208

15,976

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 260

200

400

600

800

1000

1200

1400

1

65

210

409

616

803

983

11431187

13071270

11581124

1059 1036

942

872

552

294

208 197162

129 136104

9

Number of Michigan Students with ASD by Age* Based on 2011 MDE, OSE Eligibility Count

Post-Secondary Outcomes

• Access to Higher Education

• Employment

• Independent Living

• Social Opportunities

National Data: Housing• 2008 Easter Seals study showed more than 80% of adults with ASD

ages 19-30 live at home with their parents

• Majority of adult children with ASD are living with aging parents Adults 19-30 with Autism

• With parents or guardian 81%• Independently, with spouse or partner 3%• With other family member/spouse/partner 0%• Supported residence for individuals with special needs 14%• Other 2%

Adults 19-30 with Asperger• With parents or guardian 71%• Independently, with spouse or partner 9%• With other family member/spouse/partner 5%• Supported residence for individuals with special needs 7%• Other 7%

Easter Seals, 2008

Autism

Multiple disabilities

Mental impairment

Orthopedic impairment

Visual impairment

Traumatic brain injury

Emotional disturbance

Hearing impairment

Speech / language impairment

Learning disability

Other health impairment

0 20 40 60 80 100 120

Engagement in education, employment, or training after leaving school

PercentageNLTS2, 2009

Employment OutcomesDespite the passage of the Americans with Disabilities Act, the Supreme Court decision in the Olmstead v. L. C. (1999) case with its emphasis on full community integration for individuals with significant disabilities, the majority of individuals with significant disabilities currently are not working in competitive employment.

Paul Wehman, W. Grant Revell, and Valerie Brooke (2003). Has It Become the "First Choice" Yet? Journal of Disability Policy Studies, 14(3), 163-173.

Michigan Response• Michigan ASD State Plan

– http://www.asdplan.cenmi.org/

• Autism Insurance in Michigan– http://www.michigan.gov/autism – http://autismallianceofmichigan.org/news-info/autis

m-legislation/ (Autism Alliance of Michigan)

START’s Response

START Building Your Future (BYF)

Projects

Regional Collaborative

Networks: PST Goal

Intensive Training

(IT)

Technical Assistance

(TA)

Purpose of the BYF IT• Increase Knowledge of ASD & Implementation of

Effective Transition Practices

• Increase Collaborative Teaming Practices

• Improve Transition Outcomes for Individuals with ASD:– Access to Higher Education– Employment– Independent Living– Community Involvement

Training Curriculum• Orientation and Foundations• Meeting Mechanics and Guiding Principles• Looking at ASD Differently / Adults• “Stop It” and Other Behavioral Strategies• Asperger• Natural Supports• Discovery & IEP• Systems Change

Getting STARTed: Today’s Trip

• Daily Schedule:– 8:30am - 3:30pm– Lunch provided– AM & PM Breaks

• Materials:– Module Materials– Tool Kit (Review)

• Activities:– Content & Discovery Process activities with each module– Action plan development– One meeting per team outside of START training

Snow DaysSTART Training is canceled if… “insert decision here”

• Phone Tree Plan:“insert decision here”

• Make sure to get home / cell #s

Getting STARTed• Table Folders

– Important Information– Save the Dates– Sub team lists / email addresses

• Sub-Team Email List Update– Sign in each session– Notify START continuity staff with changes

• CEUs

Improving the JourneyTraining Expectations Activity

• Wait for Team Time to Talk– Write notes if needed

• Cell Phones on Silent

• CONTRIBUTE– Everyone has a contribution to make

• OTHERS:– Sub-Team Expectations– Large Group Expectations

Foundations in Autism Spectrum Disorders

ASD 101 / FoundationsWhat do you know coming in?

• Novice

• Intermediate

• Advanced

Changing Rate of ASD

1994 2012

DSM IV CDC

4-5 in 10,000(1 in 2,000)

1 in 88

Foundations of ASDAutism identified in

1943 by Leo KannerAsperger Syndrome identifed in 1944 by

Hans Asperger

Autism’s First Child

The Atlantic Monthly

In 1943, Donald Triplett of Forest, Mississippi became the first person to be diagnosed with ASD. His parents chose not only to accept him as he was, but created a hometown environment of love and friendship that refused to allow others to misinterpret or misrepresent him or his “oddity.” 

DSM-IV Definition of Autism(MI definition)

Restricted & Repetitive Behavior

Impairment in Socialization

Impairment in Communication

Triad of ASD

DSM-V Proposed Change

Impairment in Social-

Communication

Restricted & Repetitive Behavior

Continuum of Skills for Individuals with Autism

Severe MR Gifted Aloof Passive Active/Odd Non-verbal Verbal Awkward Agile Hyposensitive Hypersensitive

The Advocate (2003)

Measured IQ

Social Interaction

Communication

Motor Skills Fine & Gross

Sensory

ASD is a neurbiological disorder that impacts:

• Processing

• Attention and shifting

• Basic social behaviors

• Interaction with the environment

• Learning

Lord, 2010

Socialization Skills and Development

Social Characteristics Limited appropriate use of nonverbal behaviors

in social situations (e.g., eye gaze, gestures, body language)

Difficulties recognizing and responding to subtle social nuances, cues, and unspoken messages Identifying and responding to people’s tone of

voice, facial expressions, posture, etc.

Social Challenges

• Social attempts may look like problem behaviors

• Developing relationships often challenging

Social Deficits and Difficulties• Social reciprocity and perspective taking

• Responding to social bids

• Social initiation

• Social repair

• Social isolation

Social Characteristics

Theory of mind deficits – difficulty with understanding and appreciating the thoughts and feelings of others

Theory of mind is the ability to attribute mental states—beliefs, intents, desires, pretending, knowledge, etc.—to oneself and others and to understand that others have beliefs, desires and intentions that are different from one's own

Theory of Mind

What I see is what others see. What I know is what others know.

What I feel is what others feel. What I believe is what others believe.

Autism is a Social Learning Disability

• We are wired to read social information into everything

• We are experts on faces and emotions most of the time

• Yawning (Senju et al., 2007)

• Social information is protective since it enables us to read situations

Communication Skills and Development

Communication• Facial expression doesn’t augment communicative

intent

• Prosody tends to be flat or exaggerated and voice can be too loud or soft with rate of speech being too slow or too fast

• Language can be repetitive, overly formal, idiosyncratic

• Echolalia (processing the utterance as a whole “chunk”, not as individual words)

• Difficulty with conversations

Three ASD Communication “Facts”

1. In ASD expressive language and receptive language are not equal

Understanding Meaning• I didn’t say she stole my money (but someone said it).• I didn’t say she stole my money (I definitely didn’t say it).• I didn’t say she stole my money (but I implied it). • I didn’t say she stole my money (but someone stole it). • I didn’t say she stole my money (but she did something with

it).• I didn’t say she stole my money (she stole someone else’s).• I didn’t say she stole my money (she took something else).

Three ASD Communication Facts

2. If you didn’t write it down you didn’t say it.

Communication-Stress & Anxiety

3. Understanding and communicative expression breaks down under stress-

– Even if a student has verbal language, it may be difficult for him to communicate when upset

– A student under stress needs more visual and less verbal input

Individuals with delays in language development are at risk for using challenging behaviors as a way to

communicate their needs and wants.

Florida State University , 2005

Restricted and Repetitive Patterns of Behavior

Restricted and Repetitive Patterns of Behavior

• Narrow interest of abnormal intensity or focus

• Fascinations: numbers, sports facts, computers

• Inflexible adherence to specific nonfunctional routines or rituals

• Distress at unexpected changes

Restricted and Repetitive Patterns of Behavior

• Stereotyped, repetitive motor mannerisms Hand or finger flapping Complex whole body movements

• Persistent preoccupation with parts of objects, such as spinning the wheels on a toy car

Sensory Differences Associated with ASD

• Not necessary in the diagnosis of ASD but virtually all individuals demonstrate sensory processing issues

• Strong reactions to everyday sensations

Hypersensitivity(too sensitive)

• Sensitivity to bright light or the  flicker of fluorescent lights

• Being fascinated with light and reflection

• Intense perception of colors     • The smell or taste of any food

is too strong • Intolerance of the texture of

certain foods • Painful reaction to loud and /

or high noises • Overreaction to hot/cold • Intolerance of the feel of

clothes or shoes • Extreme touch sensitivity

Hyposensitivity(minimally responsive)

• Seems not to feel pain or temperature.

• Prone to inadvertent self-injury

• Seeks deep pressure (e.g. crawls under heavy carpets) and tight clothes

• Appears not to hear certain sounds

• The person might wave his/her hands around or rock back and forth or make strange noises in order to stimulate the senses

Signs of Sensory Difficulties• Putting hands over ears (sensitivity to noise),

vocalizing to override the sound• Flicking fingers in front of eyes (visual sensitivity) • Having meltdowns (sensory overload) • Not appearing to hear certain sounds or showing

panic reactions to certain unexpected sounds (noise)

• Rocking, pacing, fleeing

Autism Spectrum Disorders Sensory Characteristics

When I was a child, large noisy gatherings of relatives were overwhelming, and I would just lose control and throw temper tantrums.

» Temple Grandin

Autism Spectrum Disorders Symptoms of Anxiety

• Pacing, motor over-activity• Perseveration –preferred topics or activities,

questions asking• Increased self-talk• Social withdrawal/avoidance• Poor decision making• Decreased attention span• Outbursts

Autism Spectrum Disorders Sources of Anxiety

• Sensory under- or over-stimulation• Changes in schedule, routine• New people, events, environments• Unfamiliar task demands• Immersion in social settings• Teasing

“People expect cognition and social functioning to be equally developed. When kids with Asperger’s Syndrome experience difficulty they wrongly assume it is deliberate misconduct.”(A. Klin and F. Volkmar, 1997)

IDEA ‘04“Almost 30 years of research and experience had demonstrated that the education of students with disabilities can be made more effective by having high expectations…”

The Universally Designed Classroom(2005)