Understanding and Working with College Students with Autism Spectrum Disorder Enjie Hall, MRC, PC, NCC Ohio State University.

Understanding and Working with College Students with Autism Spectrum Disorder

Enjie Hall, MRC, PC, NCC

Ohio State University

What is autism?

• A spectrum of behaviors

• Two adults, both with the same diagnosis, can act completely different from one another and have varying capabilities

• If you’ve seen one person with Autism...

well you’ve seen one person with Autism

Core Features

Impairments in:

Social interaction – Communication– Restricted, repetitive and stereotyped patterns

of behavior, interests– Onset before 3 years of age

Prevalence • Autism is the most common of the Pervasive

Developmental Disorders, affecting an estimated 1 in 68 births (Centers for Disease Control Prevention, 2012). – 2 million Americans today are believed to have some

form of autism• Based on statistics from the DOE and other

governmental agencies, autism is growing at the rate of 10-17 percent per year.

• The prevalence of autism could reach 4 million Americans in the next decade

• No racial, ethnic, social boundaries, family income, lifestyle, or educational levels

• It is five times more prevalent in boys than girls

Why are the numbers so high?

• Better diagnostic procedures

• Expanded professional awareness

• Increased prevalence

• Lends itself to expanded funding opportunities and more services

• Less pejorative connotation than other disability types leading to more hope for families

Diagnosis

• Look at person’s behavior and development

• Routine screening for symptoms

• Comprehensive diagnostic evaluation

• Can be diagnosed by:• Developmental Pediatricians• Child Neurologists• Child Psychologists or Psychiatrists• Adult Neuropsychologist

Common Traits

• Insistence on sameness; resistance to change • Difficulty in expressing needs, using gestures or pointing

instead of words • Repeating words or phrases in place of spontaneous or

generative language • Laughing (and/or crying) for no apparent reason or

showing distress for reasons not apparent to others • Preference for being alone; aloof manner • Tantrums • Not wanting to cuddle or be cuddled

Common Traits

• Highly restricted, fixated interests that are abnormal in intensity or focus

• Difficulty in mixing with others • Difficulty reading facial expressions and body language• Difficulty understanding the rules of conversation• Makes honest, but inappropriate observations• Short attention span for most lessons• Overly trusting or unable to read the motives behind

people’s actions

Traits (cont)• Little or no eye contact • Unresponsive to typical teaching methods • Obsessive attachment to objects • Apparent over-sensitivity or under-sensitivity to pain • No real fears of danger • Noticeable physical over-activity or extreme under-

activity • Uneven gross/fine motor skills • Stereotyped or repetitive motor movements• Difficulty understanding jokes, figures of speech or

sarcasm

http://www.calgaryautism.com/characteristics.htm

Differences in Males v. Females ASD

- 5:1 males to females with ASD

- Women with ASD are under-diagnosed, often leading to a diagnosis later in life

- Women are instructed from a young age to be quiet and reserved. If they do not act 'lady-like' they are told to change their tone or conversation skills.

- Boys are socially expected to be more boisterous.

- Girls who realize they are not socially accepted in situations, simply refrain from speaking so that they are not scolded. This can create even more social issues that will go undetected. Attwood, Grandin 2007

What happened to Asperger’s?

• Included in Autism Spectrum Disorder in DSM-5

• Social Communication Disorder

Challenges of Autism

• May appear self-centered• Immature• Poor adaptive behavior • Sleep problems• Gastrointestinal problems• Attention issues• Poor executive function

What helps?

• Medication for symptoms

• Identify a “safe” place for coping

• Use concrete examples and literal explanations

• Extra preparation for transitions

• Therapies

Preparing for daily activities• Write out rules making it clear who decides when someone

has broken the rule

• Visual supports

• Schedule special interest time at natural break

• Use hand signal cues

• Students with ASD often like maps. Print out a map suggesting the driver may use that route

• Have a written schedule for the day

• Try not to be offended by rude behavior as the underlying reason may not be related to the target.

Bloomfield, 2002

Moving into adulthood

• Judgment is a key deficit

• Social timing is poor

• Executive function is impaired– Difficulty starting and prioritizing– “Can’t see the forest for the trees”

• Impulsivity is problematic

• Need for control to lessen anxiety

• Tend to be punctual

Suggestions for University Staff

• Try to make your verbal interactions as concrete as possible

• Make sure you use repetition • Take your time because auditory processing for

these individuals may be a challenge• Realize that they may come to sessions feeling

incredibly anxious so do everything you can to make them feel comfortable

• Emphasize the importance of checking emails and phone messages/missed calls

• Provide guidance in writing

Disability Services Assistance• Meetings on a regular basis

• Release to speak with faculty/staff in order to help facilitate communication

• Release for parents in order for them to be a partner in the process

• Note-taking assistance

• Appropriate housing arrangements

• Advocacy with student conduct and academic misconduct instances

Vocational aspects

• Tend to be punctual• Like routines• May attend to details TOO well • Problems with teamwork• Problems with authority figures

– Taking constructive criticism– Giving correction

• Reluctance to ask for help or support• Perfectionism in some

Resources• Ohio Center for Autism and Low Incidence www.ocali.org• Autism Society of America www.autism-society.org • Autism Speaks www.autismspeaks.org • Organization for Autism Research www.researchautism.org • Wrightslaw www.wrightslaw.com • Hawkins Gail (2003) How to Find Work What Works for

People with Asperger Syndrome Philadelphia, Pa. Jessica Kingsley Publishers

• Autism Self Advocacy Network (ASAN) http://autisticadvocacy.org

• Wrong Planet www.wrongplanet.net• Rocky Point Academy http://

www.calgaryautism.com/characteristics.htm• CDC http://www.cdc.gov/ncbddd/autism/data.html• The Ohio State University Nisonger Center

http://aspirationsohio.org/

Questions