In Service For Nurses

AUTISM OVERVIEW

• Autism is a neurological disorder. There are various theories regarding the cause of autism:-genetics-abnormal brain development-vaccines-environmental “triggers”

- None have been scientifically proven.

Students range in their abilities and skills within the spectrum.

• Autism Affects the following three areas:

1. Communication:

Non-verbal, minimal speechRepetitive speechDifficulties with comprehensionLiteral interpretation of languageMay use words without attachment of meaning.

2. Social Interaction: Poor eye contactLimited facial expressionsLimited or inappropriate interactions with peers Limited understanding of social rules or cuesUnusual reactions to social situationsMinimal cooperation with peers

3. Behavior Patterns: Repetitive movements, self-stimulationRestricted interestsInflexible routines/ritualsResistance to change/transitionsBehavior episodes (meltdowns/tantrums)Possible aggressive behaviorPossible Self-injurious behaviorsSensory issues

• Approximately 1 in 150 children have the diagnosis of autism. It is the fastest growing developmental disability.

• Ratio of 4 boys to 1 girl• Approximately 560,000 individuals in the

United States between the ages of 0 and 21 have autism.

• Autism is increasing at a rate of 10-17% per year. At this rate there could be 4 million individuals with Autism in the U.S. in the next decade.

• (Dr. Jennifer Sellers, Auburn University)

• Mental Retardation—75%• Seizure Disorder– 25%• Chronic constipation/diarrhea—50-60%• Sleep Problems—50-60%• Low muscle tone—30%• Sensory sensitivities• Ear infections( Dr. Jennifer Sellers, Auburn University)

• Weak Processing Speed• Verbalize more than they understand• Slow work speed• Poor writing skills• Poor organizational skills• Difficult to see the big picture• Immature and inappropriate social skills• Behavior/motivational issues• Perception and theory of mind issues• Sensory Integration issues

Challenge for students with autism Difficulty seeing the perspective of others Isolation from peers Difficulty managing day-to-day

interactions Struggle with communication skills Poor problem solving skills Confusion with “hidden curriculum”

The ability to pick up and act on social assumptions

The ability to think about other people’s thinking (Are they interested in what I’m saying ?) Generally have “wrong” perceptions of what others are thinking

Mind reading (facial expressions, body stance, voice tones)

They may not realize their comments can offend or embarrass others

Problems with planning, organizing, shifting attention and multitasking

Difficulties approaching complex tasks, breaking them down into parts and budgeting time

Waste time talking and worrying about a project rather than planning and working on it

May lead to losing supplies, forgetting assignments

Cannot take notes and listen to the teacher Need to finish one task before beginning a

second Unable to leave a task if it is not finished

The ability to draw diverse information together to construct higher level meaning in context

Understanding the “gist” of a story Grasping an underlying theme within

a message Seeing parts over wholes Represents both strengths and

weaknesses and should be thought of as a cognitive style

What is it?It is the ability to take in sensory

information, process the information and then respond to the information.

What are the sensory systems?Tactile-touch Olfactory-smellAuditory-hearing Proprioception-knowing Visual-seeing where your body is in spaceGustatory-taste Vestibular-movement

Oversensitivity Noises Visuals Fixations Excessive Verbalizations/talking ObsessionsSensory processing can be affected by

medication, lack of sleep, nutrition, holidays, etc. Be aware of what is going on in a child’s life.

May experience sensitivities to textures as in soaps or other “messy things”

Bothered by certain fabric or tags in shirts, waistbands

May like to be touched or to feel deep pressure or may want to avoid it

Experience high or low pain tolerance

May bite which may or may not be caused by sensory issues

Squint, blink, or rub eyes Avoid certain foods or crave others

(limited assortment) Some require a gluten free dietBe aware of sensory needs because over-

stimulation and not getting sensory needs met may lead to a behavior “melt-down”.

“Sensory Diet”: Breaks given for sensory activities, jumping, deep pressure, swinging, music, walking

Personal space: Be aware of proximity of others, line up first or last

Bathroom Accommodations: Difficulty with toilet training, (noise issues with flushing, routine in going)

Provision of fidgets: Helps with over stimulation, May use koosh balls, hand exercisers (some available in health room)

Social Stories to help with changes and to teach compensatory strategies for deal with sensory issues

Be generous with praise Be specific about what the student is

doing “right”. Use token cards/visual systems to manage

behaviors Establish reinforcements/incentives for the

students to complete work and to maintain positive behavior. These may change throughout the year.

Consult with Behavior Specialist (Functional Behavior Analysis )

Remember comprehension is not guaranteed Clearly define your expectations, tell the student

specifically what you want them to do Combine verbal instruction with pictures and/or

gestures Be specific with directions (call the student’s

name, have the student paraphrase directions) Encourage the student to clarify any direction he

does not understand Use simple verbal language

• Have “rules” specific for the student and teach him those rules.

• Use “gestures” to help in understanding

his needs• Teach him strategies to relax and to

use those when he requires them.• Use social stories to help in

understanding situations• Always prepare student for changes

Class Schedule____DOL____Reading____Snack/Break____Math____Lunch____Recess____Science____Social Studies

Rules for Seeing the Nurse

Come into her room with my teacher

Sit quietly and wait my turn

Listen to the nurse and follow her directions

____Close my eyes____Take 2 deep

breaths____Count to 10____Squeeze my arms____Take 2 deep

breaths

Ask: ___A. Am I relaxed?

YES. Then go back to class/work

___B. Am I relaxed: NO___Then start over

again

“When you have met one child with Asperger Syndrome, you have met one child with Asperger Syndrome.”

Stephen Shore

“They live in OUR world, but in THEIR OWN WAY rather than “in their own world.”

“When I was younger, I didn’t realize that I thought differently; therefore, It didn’t occur to me to ask for help or clarification.”

Dena Gitlitz

“If they can’t learn the way we teach them, let’s teach them the way they learn”. Paula Kluth

• “Students with AS/HFA live in a world that is often puzzling and unpredictable to them and therefore, stressful. In order to help them meet their potential, educators must help these students understand the world around them with strategies and supports that will foster success and independence.”

Simple Strategies that Work by Brenda Myles

Autism Society of America: www.autism-society.org Autism Research Institute: www.autismresearchinstitute.com Autism Society of Alabama: http://www.autism-alabama.org (Lending library available) Center for the Study of Autism: http://www.autism.org Division TEACCH: http://www.unc.edu/depts/teacch Educational for parents: www.firstsigns.org  Asperger Syndrome: http://www.asperger.org Tony Atwood: www.tonyattwood.com.au/ Asperger Information: http://www.udel.edu/bkirby/asperger/ Autism-PDD Resource: http://www.autism-pdd.net Autism: www.autismspeaks.org Sensory: www.sensorysmarts.com