Making sure that we are on the same Making sure that we are on the same page!!page!!

Making sure that we are on the same Making sure that we are on the same page!!page!!

Totally Social ASDTotally Social ASDChris Rans, Ed. S., Autism SpecialistChris Rans, Ed. S., Autism Specialist

Rans Consulting and Advocacy LLCRans Consulting and Advocacy LLCransconsulting@comcast.net

810 923-5620810 923-5620

How Do Persons with How Do Persons with Autism Spectrum Disorder (ASD) Autism Spectrum Disorder (ASD)

““See and InterpretSee and Interpret”” the World Around Them! the World Around Them!

How Do Persons with How Do Persons with Autism Spectrum Disorder (ASD) Autism Spectrum Disorder (ASD)

““See and InterpretSee and Interpret”” the World Around Them! the World Around Them!

ASD Strategies and Tools for Everyone!ASD Strategies and Tools for Everyone!

Increase of ASD to Increase of ASD to date!date!

Increase of ASD to Increase of ASD to date!date!

• 1 in 551 in 55– 1 in ????? (Boy born w/ HFA)

Intelligencevs.

Social Cognition “Oddities”!

New DSM VAutism Spectrum Disorders

ASDw/ Restricted and

Repetitive Interests!

So……….You, Me and So……….You, Me and Communication!Communication!

So……….You, Me and So……….You, Me and Communication!Communication!

What is expressive communication?What is expressive communication?

Learning to observe and recognize social Learning to observe and recognize social communication skills in the NTD person!communication skills in the NTD person!

What is Communication?

• A range of purposeful, intentional behavior, either verbal or non-verbal, evidenced by anticipation of an outcome, which is used to exchange information w/in a social context.

• ASD: A wide range of communication behaviors, from non-verbal to extremely verbal w/ varying degrees of communication intent.

• 3 Stages of Communication Intentionality– Prelocutionary (birth to 8 mon.)– Illocutionary Stage (8 to 12mon.)– Locutionary Stage (12 mon. +)

NTD Speech and Language Develop:

• Intentional Communication– Realizes that their acts have an affect on others– Attempts to control/interact thru non-symbolic

means i.e. gestures or vocalizations– Begins to use gestures/vocalizations to

communicate– Gestures used for a goal;

• Used to equate cognitive ability to dev. a plan to achieve a goal

– Social skills• Enjoys simple social games i.e. peek a boo or

patty cake– Reciprocity/turn taking

Illocutionary Stage…..8-12 mon.

• Coordinates non-verbal behavior by using their eyes, face, body and hands together to interact and regulate social interactions and read/understand the non-verbal behavior of others– Ex. Follow eye gaze and point reference to

look where someone else is looking. Understanding facial and vocal tones to denote happy, sad or angry. (JA)

• Again: prior to talking, baby can participate in reciprocal interactions using non-verbal social communication

Non-Verbal Social Communication by 12 mon.

• Coordinating attention to an event or object w/ another individual, sharing interest and social engagement, and showing an understanding that the partner is sharing the same focus– Note: mastery of JA is a reliable

predictor of language development

What is Joint Attention (JA)( Schertz & Odom 2004)

• The use of early gestures to coordinate attention between objects/events of another person

• Sharing experiences w/ others by drawing their attention to objects or events

• Following another person’s gaze or point of reference

• The use of a gaze to shift another person’s attention

More JA………..

• 2-3 mon.:– Infant smiles in response to a parent smile

or voice• 8 mon.:

– Baby is able to follow parents’ eye gaze (e.g. look at dog)

• 10-12 mon.:– Baby is able to follow a point reference and

then look back at the parent• “Checking back” = critical component

• 12-16 mon.: -Toddler initiates and draw’s parents’

attention to object of interest using sounds, pointing, and looking back and forth

JA’s Review:

• Talks about past and future ideas• Relates experiences so that they can be

followed w/ reason• Able to reason out questions such as “what

must you do when sleepy, hungry or thirsty”.

• Uses pronouns I, you, me correctly• Uses plurals and past tense• 3-4 word utterances/sentences• Plays make-believe

Review: NTD Language Developmentby 3 yrs.

Current Theories & Research

• Genetic predisposition with environmental triggers

So……what are these?• Playful• Comforting• Irritated• Bored• Ashamed• Nervous• Indecisive• Suspicious

• Joking• Desire• Flustered• Convinced• Impatient• Irritated• Aghast• Reflective

Eye Movements!Remember:

Studies and Research!Bits and Pieces of Info.

• Margaret Bauman• SC vs. Object• Who’s Afraid of ……• Box and Sticks (animation)• Monotone crying• Yawning! (Amygdala)• Dr. Simon baron-Cohen

– Research of the NTD “male” brain– Systematic vs. Empathetic Thinkers

The DSM-V Definition of Autism

(MI definition)

Differences in Behavior

Differences in Socialization

Differences in Communication

“The low functioning child with autism lives in a

world of his own, whereas the higher functioning child with autism lives in our world but in his own way.” Van Krevelen

Social Cognitive Challenges!

• Mild CI to Superior Intelligence– Difficulties may include:

• Difficulty shifting attention• Difficulty shifting two cognitive tasks

simultaneously• Generalizing information• Retrieving information on demand• Developing problem-specific solutions• Difficulty w/sense of time

More…Differences in Socialization

• Marked impairment in the use of nonverbal social communication to regulate social interaction– eye to eye gaze (more HFA)– facial expression– body posture– gestures

• Failure to achieve developmentally appropriate peer relationships

•Again, what is reciprocity?– What is talking “at” vs. “with” ?

Yet….More Differences in Socialization..

• Lack of spontaneous seeking to share enjoyment, interest, or achievements with other people Does not show, bring, or point to items

of interest (more HFA) What is talking “at” vs. with?

• Lack of social or emotional reciprocity Identifying and responding appropriately to

emotional states of other people (e.g., comfort a crying person)

• Impaired perspective taking Viewing situations from another

person’s point of view and predicting other’s behavior

The last for now! Difficulties recognizing and

responding to subtle social nuances, cues, and unspoken messages Responding to a person losing interest Identifying and responding to people’s

tone of voice, facial expressions, posture

May seem egocentric and may not show empathy in typical ways

Often aware of their differences (especially adolescents and young adults) which can lead to low self-esteem

Restricted and Repetitive Patterns of Behavior

• Encompassing preoccupation with one or more stereotyped and restricted patterns of interest, abnormal in intensity or focus; for example: History, Computer Games,

Gozilla Weather Systems, Animals Others

• Apparently inflexible adherence to specific nonfunctional routines or rituals Dressing rituals Distress at unexpected changes

Review: Overall Basic Components to Social

Communication!

Theory of MindCentral CoherenceExecutive Functioning

For YOU and ME!•Autism could feel like being

forced to move and live in Russia for the rest of your life and never being “taught” the Russian language, social rules/hidden curriculum and laws! You just learn to survive!

Theory of Mind“Mind Reading”• Knowing that you have a different

perspective than I do• Predicting others’ behavior• Inferring /referencing what is

going on around me• “Reading” the intentions of others• Understanding the motives of

others

Note:……Females on the Spectrum• Females below grade level tend to be

more severe than males• Females at or above grade level

– More Theory of Mind• More into fantasy: unicorns, wolves, cats

– Reads about fantasy, Ex. medieval

– Usually love animals to include stuffed• Thrive on details of certain animal information

Central Coherence• Not knowing what is important and what is

not important• Not seeing the big picture, but fixating on

details• Not maintaining a full range of interests• Not “connecting” things around me• Imposing one’s own perspective (their way or the high way)• Difficulty with new tasks• Apparent lack of compliance or NOT

Executive Functioning• Overall Planning and organization

• Inability to generalize skills from previous experiences or settings

• Behavior often appears rigid and/or

repetitive • Often narrowly focused on details of

items or topics of special interest

The “Real” Definition of Autism:

Autism means that someone is really smart in some things but needs a lot of help in other things.

Mrs. Fizell’s 2nd Grade class (1999) from Barry Prizant

Soooooo………Anxiety blossoms from:

• Too many words from adults• Changes in schedules, routines• New people, events, environments• Unfamiliar task demands• Immersion in social settings• Separation from “safe”

people/place• Teasing and bullying• Then comes sensory overload!

In trying to relate:• Autism could feel like being forced

to move and live in Russia for the rest of your life and never being “taught” the Russian language, social rules/hidden curriculum and laws! You just learn to survive!

Sooooooooo again……Behavior is Communication!Behavior is a Function!• Persons w/ ASD:

• Do not have the emotional resources to cope with the demands of things going on around them•Too many words!

• Can have reactions/temper outbursts in response to stress/frustration/anxiety.

• Can become confused, disoriented or scared

Strategies that work!Strategies that work!Who is Temple Grandin?Who is Temple Grandin?

Strategies that work!Strategies that work!Who is Temple Grandin?Who is Temple Grandin?

Gooooooooo Visual!Gooooooooo Visual!

Looking to Develop the ……Ultimate Goals for Persons w/ASD

• Functional independence– What social communication skills do I need

to acquire and hold a job?• Socially appropriate

– What social communication skills do I need in order to acquire and maintain a job/relationship?

• Academics/ and or Job Skills– What social communication skills do I need

to acquire and/or keep a job?.

Remember, persons w/ “social thinking” challenges” ……

•Are “visual learners” due to the language and communication processing challenges•So…what and how do we teach………?

What we take for granted!

First Learn to Recognize the……………….Hidden Curriculum!

What is the “Hidden Curriculum”?

•Most students are taught the academics– Say……………………. how to divide

•However, persons w/ASD need to be taught rules and/or guidelines that are “assumed” by most people

– Men’s bathroom– Nose Picking– David /Kmart– Shut-up– Who to talk to on the internet

• Not recognizing when someone is being bullied!

•Reading body language, gestures, facial expressions

HC in the…….Workplace for You and Me!

• Can present major obstacles for a person on the spectrum• Adults are assumed to know certain things• Adults are assumed to learn the rules in a short period of

time• Two organizational charts in every business

– The company manual/written document– HC/The other is the “hidden chain of command” not

written in any book• Other HC:

– Business email for personal stuff– Casual business dress– When to introduce a new idea– Who to avoid– Customer is always right– Disagreeing with your boss– Asking for a raise– Lunch– Break– Expressing anger

HC….in the Legal HC….in the Legal SystemSystemHC….in the Legal HC….in the Legal SystemSystem

Wow! What I did not know!Wow! What I did not know!

Helping people on the Helping people on the spectrum……..spectrum……..””conneconne

ctct””

Helping people on the Helping people on the spectrum……..spectrum……..””conneconne

ctct””LetLet’’s Go VISUAL Tos Go VISUAL To

Become Functionally Independent!Become Functionally Independent!

Manage, Establish and Learn Routines!

• Routines need to be taught

• Duck Tape City!!!!!!!! For US!

• Never assume that a person w/ ASD understand things that the neuro-typical adult “gets” naturally

• What is knowing things vs. what is knowing how to “connect” those things

Start w/:“Social Communication” Time!• For the person on the spectrum:

– What is recognizing and accepting their ASD?– What is recognizing “what and who” are

helpers/social coaches?– What is finding time to work on social

communication skills using visual strategies?• Most of the lessons can be on the

“go” around the school, home and in the community after the system has been established

4W’s Plus How(The only verbal visual!)

What is referencing, self, others and situations around by using the 4 W’s Plus How?

• Who• What• Where• When• How• NEVER------------------ WHY!

Priming w/ the 4 W’s and Visuals

• When planning “anything” staff need to prime a person ahead of time– Show them that activities can be changed,

cancelled or rescheduled– Use the 4 W’s and or other visual strategies– When unavoidable situations occur.

• Be flexible• Recognize that change is stressful• Adapt expectations• Adapt language

Listen To Their Words

• Listen and probe• Seek and offer clarification

– 4 W’s plus How• Continue to break down the words to

help clarify more and more information on what appears to be a challenge

Use Visual Strategies:

• SC Tool/Binders or an Ipad can house:– Visual tools:

• 4 W’s plus How– Sometimes use the computer to communicate

• Schedules– Mini-schedules

• Social Stories• Power Cards• 5 Point Scale• Comic Strips• Social Rules• Sensory Diet

Try and…..Draw and/or write as you talk!

• Materials/being prepared– Laminate marker board (big or

small)•Provide flexibility•Easy to erase•Use of different colored markers representing different feelings

Schedules and Mini-schedules!

• Helps to predict what is next in the details of a day

• Left to right• Vertical• How have you used schedules?

– Talk Time

Build in Sensory/Relaxation Time throughout the day!

• Build into the daily schedule as a positive tool!– Safe Place

• Quiet• Sensory• Relaxation Techniques• Reteach Time• Social Skill Development

– Time Away (Not Time Out!)• 5 Point Scale• Directed by a staff/parent

– Time with safe person

More ……..Visuals• Video Modeling• Role Play• Scripting• Movie Time

Remember….Set a Calm, Positive Tone

• If a person can not see out of their world then comes-------------Anxiety!

• Persons w/ASD can detect high emotional content– When a parent becomes agitated about

constant interruptions– Tend to take on the emotional tone of the

person that is upset – Can go into a full blown meltdown– Soooooooooooooooooooooooooo

Be Generous With Praise• Low self-esteem and limited self

confidence• Afraid to take risks

– Soooooooooooooooooooooo find time to praise throughout the day with very clear and specific comments

• Ex. “ Good morning, Danny. I hope that you slept well.”

• “I noticed you held the door open for Mr. Hake when he had his hands full, Joey. That was so thoughtful.”

• “You did well on your history test. Your studying really helped you do well.”

THEN……..Developing Social Communication Skills in the Home and Jobsite!

– Establish a social communication plan for home and on the job as a team• Create a PBIS Plan as a team to

establish objectives• Decide on a SC Curriculum to follow• Involve peer support when possible• Create a time for SC work time

When a behavior occurs…..

• We need to:– Recognize their lack of “disconnect”

• Play detective and “think how they think”!

• Provide a “teachable moment”– When, Where and who– Or communicate to appropriate staff/parents

Social Job Coaching is #1………. even on the job

site!• Who• How • When• Where• NEVER WHY!!!!!!!!!!!!!!!!

– For a life time!

Review-Basic Needs for Enhancing SC Skills!

• Structure and organization for learning SC skills

• Develop trust in who is teaching the skills• Life to be logical and predictable• Information to be more visual than auditory• An awareness of sensory needs when

anxiety is high and on overload