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CADS – Module du Trouble du Spectre de l’Autisme CADS - Autism Spectrum Disorder Module
By: CADS Technical Committee2015-2016
Training plan
1) Definition2) Category3) Strength4) Weaknesses5) Interventions
1) Communication2) Security
Aim of the Training Plan
Be able to assess communication and intervention strategies,
Be able to prepare for a ski lesson using multiple strategy and plans,
Be able to organize multiple choices within each ski lesson.
…. with and without the uses of pictograms.
1- ASD: definition
Autism Spectrum Disorder (ASD), also referred as autism, is:
A Neurological Disorder that causes developmental disability...and
affects the way brain functions resulting in:
◦Communication difficulties◦Social interaction difficulties◦May also include unusual behaviour patterns,
activities and interests.
1. ASD : Definition
The term “spectrum” refers to a continuum of severity or developmental impairment.
1. ASD : Definition
The conditions cover a wide range in:
Number and kinds of symptoms,Severity: mild (1) to severe (3),Age of onset,Levels of functioning,Challenges with social interactions,
1. ASD : Dx
Includes:
A. Persistent deficits in social communication and social interaction across contexts;
B. Restricted, repetitive patterns of behaviour, interests, or activities;
C. Symptoms must be present in early childhood;
D. Symptoms together limit and impair everyday functioning;
2- Severity Code
The severity code is in line with amount of support needed:
1. Need for support;
2. Important need for support;
3. Very important need for support;
DSM-V
Causes / origins…
Amygdala Emotion Aggressive
behaviours
Temporal Lobe Language Social
perception
Prefrontal cortex Attention Planning Abstract
thinking Social
behaviour
Cerebellum Attention Motor:
Coordination Balance Speaking
Parts of the brain affected by ASD
Strengths exhibited 1/2
Non verbal reasoning skills,◦Chess.
Reading Skills,
Perceptual Motor skills,◦Baseball.
Computer interest and skills with computers,
Strengths exhibited 2/2
Exceptional memory,
Visual and Spatial abilities,
Music Skill,
Drawing skills,
Exceptional memory & Drawing skills
Stephen Wiltshire, incredibly drawing the entire London skyline from memory
Weaknesses Exhibited
Impaired Communication:
◦Idiosyncratic words or phrases, (“Yes Sir” )◦Choppy language,◦Repetitive language,◦Difficulty staying on-topic,◦Poor conversation skills,◦Abnormalities in pitch, stress, rate, rhythm and
intonation of speech.
Weaknesses Exhibited
Impaired Social Skills:
◦Lack of Awareness: Awkward social initiation, Little to no social initiation, One sided conversation, Struggling with perspective taking, Takes you literally, Little to no eye contact,
◦Abnormal Seeking of Comfort when Stressed,◦Impaired Imitation Skills,◦Abnormal Toy Play,◦Difficulties forming relationships,◦Perseveration.
Weaknesses Exhibited
Dependence on routine,◦But not all individual.
Abnormal responses to Sensory Stimulation,◦Hyper-hyporeactivity.◦Hyper-hyposensitivity.
Behaviour problems◦Tantrum◦Self injuries◦Property destruction, etc.
Weaknesses Exhibited
Difficulties in Sleeping,
Eating challenges / diet,
Gastrointestinal problems,
Motor skills problems,◦Balance, ◦Agility, ◦Limb speed, ◦Coordination (Eye-Foot).
Interacting with an individual with ASD
Talk less – listen & observe,
Use show and tell strategy,
Avoid the Yes/No question type,
Brake the task into achievable pieces,
Interacting with an individual with ASD
Give time to process,
Utilise repetition:◦Re-teach, repeat and practice.
Ensure your communication style matches your student’s ability.
Interacting with an individual with ASD
Support Strategies (AOT)
Like / dislike?
Anything I should avoid?
Is there one strategy I should be using?
Checklist?
Interacting with an individual with ASD
Communication & behaviour tips:
First – then;◦Motivation
Countdown Strips;◦Shows how many more are needed◦Help stretch the First-then
Interacting with an individual with ASD
Communication & behaviour tips:
Token Boards;◦Motivation◦Positive feedback
Interacting with an individual with ASD
Communication & behaviour tips:
Timers;Good in transition between activities
Interacting with an individual with ASD
Communication & behaviour tips:
CHOICE
Play with snow ball
Built a Snowman
Go Snowboarding
Choice can be : verbal, written or pictures in a choice board
Interacting with an individual with ASD
Communication & behaviour tips:
Visual Scheduler…
◦Decrease anticipation -stress -anxiety
◦Help the individualunderstand what is going to happen today.
Interacting with an individual with ASD
Behaviour Support Tools:
Wait Cards;◦Make waiting more concrete◦Hold the card
Interacting with an individual with ASD
Behaviour Support Tools:
Visual support for teaching safety;◦How to wear equipment safely… example
Cognitive and Intellectual Disability
By: CADS Technical Committee2015-2016
Presentation for CI
DefinitionDown SyndromeFragile X SyndromeASDSeverity CodesBrain InjuryCommon difficulties
Definition
Defining cognitive disability/impairment (CI) is not easy, and definitions of cognitive disability are usually very broad.
Individuals with CI also present:◦difficulties in various types of mental tasks. ◦diminished cognitive and adaptive
development. ◦may require assistance in daily activities.
Down Syndrome
Known and called Trisomy 21 ◦Extra chromosome on the 21st pair (t21)
Refers to a type of cognitive delay in general intellectual functioning that may include deficits in :
◦adaptive behaviour, ◦motor coordination, ◦muscle tone,◦cardiac, digestive, vision and hearing
impairments.
Down Syndrome
Individual with Down Syndrome shows:
Loose joints ◦Hyperlaxia
Low muscle tone◦Muscular hypotonic
Atlanto-axial/occipital instability◦Two first cervical bone
Effect on learning style
Fragile X Syndrome
Fragile X is the second leading genetic cause of intellectual disabilities:
◦Most common cause in men,
◦Generally large in stature but with poor muscle tone,
Fragile X Syndrome
Behaviour features:
◦Reluctance to make eye contact,
◦Engage in odd stereotyped movements,
◦Hyperactivities,
◦Tremors,
◦Poor motor coordination,
◦Social and communication skills are not well developed.
Fragile X Syndrome
Similar behavioural symptoms are characteristic of ASD.
Three Subtypes of Fragile X (only two will be presented here)
◦1- Cognitive deficits more severe and share with ASD. Social avoidance Repetitive movement Severe delays in developing speech and language
◦2- affect motor skills (balance), present tremor and memory deficits.
Severity Code
Category Efficacy in 3 domain* Description
Mild 85
Can achieve academic success Mostly self-sufficient Need assistance with life decisions, finances,
nutrition, shopping and transportation
Moderate 10
Adequate communication but complexity is limited
Social cues and social judgment regularly need support.
Self care can be achieve (support may be required)
Can be employed with some support.
Severe 3-4 Communication skills are basics Self-care require daily assistance
Profound 1-2 Usually 24-h care and support is needed Presence of co-occuring limitations (sensory or
physical
*1-Conceptual, 2-Social, 3-Daily activities
Learning Disabilities
Genetic/neurobiological factors/injury that alters the brain functioning process relate to learning.
Its refer to a number of disorder that may affect:
◦Acquisition,◦Organisation,◦Retention,◦Understanding or use of verbal or nonverbal
information.
Brain Injury
Damage to the brain, which occurs after birth and is not related to a congenital or a degenerative disease.
Could be from but not restricted to:
◦Stroke, ◦Illness, ◦Traumatic Brain Injury (TBI), ◦Brain tumors, and ◦Meningitis.
Brain Injury
Impacts of Brain Injury could be observed in:◦Motor capacity (66%)
Agility, coordination, limp speed, reaction time Focal paralysis of on or few muscles
◦Sensory capacity (28%) Balance, and vision (61%)
◦Cognitive (93%) Learning, memory(79%)
◦Psychological (79%) Anxiety (61%), frustration-control of (68%)
Brain Injury
Lesions to the main line of the motor system may result in an enhancement of some features (positive features or exaggerated response) or a reduction (negative features). Positive features or exaggerated
response can include:◦Hyperreflexia and hyper-tonus (abnormal resistance
to passive movement).
Negative features can include: ◦Loss of strength, Loss of dexterity, Fatigability.
Brain Injury
Brain Stem System may lead to: ◦Dyscontrol of automatic behaviours, such as posture,
balance, locomotion and breathing.
Motor Areas of the Cerebral Cortex may
cause: ◦Weakness - hyperreflexia - spasticity. ◦Organising, shaping and refining movement
difficulties.
Cerebellum lesions may lead to:
◦Poor planning of movement,◦Poor regulation and timing of movement,◦Reduced smoothness and co-ordination of movement.
Brain Injury
Common difficulties:
Reduce Frustration tolerance,Self-Esteem,Social Skills,Hyperactive ,
◦Difficulties blocking out signals◦Prone to motor sickness
Hypoactive,◦Difficulties attending to signals
Tips to create a successful learning environment
Create positive relationship
Clear, simple and concise instructions
Give student time to process
Use the «Doer & Feeler» approach
Tips to create a successful learning environment
Maintain a positive attitude,
Give positive feedback,
Look for achievements, and be able to highlight it,
Exercises
For exercise #1a, #1b, #2a and #2b:
Use participant characteristic #1 for ASD
Use participant characteristic #2 and #3 for CI
ASD/CI Exercice #1a
Create an activity using Pictograms to perform any of the steps 1 to 4 (CADS Level 1) or steps 1 to 6 (CADS Level 2).
Be creative, Use suggested pictogram or Create your own, Time 15 min, AOT must include Checklist, Must include safety, Team up to 4.
Use the Marking grid to help candidate instructor building a successful ski lesson
ASD/CI Exercice #1b
Create an activity without Pictograms to perform any of the steps 1 to 4 (CADS Level 1) or steps 1 to 6 (CADS Level 2).
Be creative, Use other communication tools, Time 15 min, AOT must include Checklist, Must include safety, Team up to 4.
Use the Marking grid to help candidate instructor building a successful ski lesson
ASD/CI Exercice -2a
Create an activity using Pictograms to perform lift procedure
Be creative, Use suggested pictogram or Create your own, Time 15 min, AOT must include Checklist, Must include safety, Team up to 4.
Use the Marking grid to help candidate instructor building a successful ski lesson
ASD/CI Exercice #2b
Create an activity without Pictograms to perform lift procedure
Be creative, Use other communication tools, Time 15 min, AOT must include Checklist, Must include safety, Team up to 4.
Use the Marking grid to help candidate instructor building a successful ski lesson
ASD/CI Exercise - participant #1
13, Fille, 37kg Dx= Trouble du spectre de l’autisme (TSA) / TDAH, ScolioseRx= DexedrineSx= difficulté motrice et faible résistance/endurance (fatigue), Problème de posture, intolérance face à certaines textures d’aliment, mutisme sélectif (mais parle aux personnes connues)
___________________
13, Girl, 37kg Dx= Autism Spectrum Disorder (ASD) / ADHD, ScoliosisRx = DexedrineSx= Motor difficulties et little resistance/endurance (fatigue), Stance problem, dislike some food texture, do not speak to stranger (but do with known individual)
ASD/CI Exercise - participant #2
46, Femme, 85Kg,Dx= T21, glande tyroïdeRx= Syntroïde, (hypo)Sx= Sous-réactive (hyporéactive), difficultés motrices,
problème de prononciation (dysarthrie), anxiété sociale.__________________
46, woman, 85Kg, Dx= T21,down syndrome, Thyroid Rx= Syntroid (hypo)Sx= hyporeactive, motor difficulties, language difficulties (dysarthria), social anxiety.
ASD/CI Exercise - participant #3
18, homme, déficience intellectuelle léger, 65KgDx= Déficit d’attention, TDAH; déficit d’apprentissageRx= Pms methylphenidate, (4 fois par jour)Sx= Basse vision, dyspraxie, opération scoliose en mars 2008… mise en place d’une tige de métal. Problème de positionnement des pieds (ouverts) lors des déplacements
_______________________18, men, CI mild, 65KgDx= ADHD; learning disabilityRx= Pms methylphenidate, (4 times a day)Sx= low vision, dyspraxia, scoliosis surgery in march 2008… rods and screws. Foot (open) position when walking