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Autism Spectrum Disorder Archive 2009

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Ann England, M.A. CCC-SLP-L
Speech-Language Pathologist
Assistant Director Diagnostic Center, Northern California

Ann has 27 years of special education experience and has extensive training and certification in the assessment and teaching of students with an Autism Spectrum Disorder (e.g., TEACCH, PECS, ADOS, etc.) She participates on a multidisciplinary assessment team at the Diagnostic Center to determine if students have an Autism Spectrum Disorder. She also provides the all day training “Teaching Students with an Autism Spectrum Disorder” to school staff throughout northern California. Additionally, she provides onsite consultation and mentoring to school district administrators and teaching teams to assist in the development and implementation of evidence-based public school programs for students with an Autism Spectrum Disorder. Ann has served on several California Department of Education committees related to Autism Spectrum Disorders and most recently was invited to participate on the Task Force on Education and Professional Development of The Legislative Blue Ribbon Commission on Autism.

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  • Do you have any “helpful hints” to make the holiday season any easier?

Question:

Dear Ann,

Although the rest of my family loves the holiday season it’s really challenging for my child with Autism. Do you have any “helpful hints” to make this time of the year any easier?

Thanks,

Irene


Answer:

Dear Irene,

Yes, December is certainly a month replete with special events and holidays. Consequently, families of and individuals with an Autism Spectrum Disorder often find this a challenging time of year because schedules and routines are disrupted. The following are a few strategies that may help to make it a more enjoyable time for everyone.

CALENDAR/SCHEDULE:

Include your events on the monthly calendar and individual schedule. If the event results in a change in the usual schedule and/or routine, use whatever symbol you have previously selected to designate this change (e.g., highlighter, change tab, etc.) Use your judgment as to how much in advance you want to alert the individual about the change. Some individuals require and do well with a lot of advanced notice while others may become too anxious with too much lead time. And, it’s probably best to maintain schedules and routines as much as possible.

SOCIAL STORY:

Create a social story about the new events, rituals and/or ceremonies. Make sure to personalize the story about your specific activity and read the social story to him/her regularly in preparation and especially right before the event. To learn more about Social Stories visit The Gray Center at: www.thegraycenter.org

PACING:

If the individual has difficulty with change, try pacing your activities. For example, if your holiday incorporates decorations, perhaps you might try decorating a little at a time and schedule these times on the calendar/schedule. Consider writing a social story about decorating. You can also develop a photo album or video that shows the home or community before and after the holiday season.

SELF REGULATION STRATEGY:

Even with all of your preparation efforts, the individual with an ASD may become overwhelmed. These are times when you will remind him/her to use those self-regulation strategies. If the individual isn’t at the level at which they are able to self-regulate, provide the support they need to recognize their emotional state and what they can do. For younger individuals, you can use a photo self-regulation card that shows several emotional states (frustrated, angry) and the corresponding activities they can do to self-soothe (e.g., listen to music, read a book, play on the computer, go to their room or a quieter area, etc.) Older individuals can have a written list of emotional states with the corresponding activities; they may need a reminder to use this if they are upset. If you are visiting friends or family, make sure you have brought along these activities and reviewed these self-regulation strategies before you arrive. Ask your host if there’s a quiet place available just in case.

PREPARATION:

If your activity involves a ritual or ceremony practice this ahead of time. You can support role playing with the development of social stories, photographs, video modeling, reading a book, etc. The important thing is to reduce the novelty so your child knows what to expect.

MAKE OTHERS AWARE:

When possible, communicate with family and friends. Maybe just a quick phone call before you arrive to explain that although you have prepared your child for the visit you may be bringing some special food, need to have a quiet space available to which to retreat if things become overwhelming, you may need to leave a bit earlier, or that your child prefers not to be hugged, etc. Having discussed all of this ahead of time will allow you the time you need to be attentive to your child at the event and not have to also explain your actions in the midst of things.

AIRLINE TRAVEL FACT SHEET:

The Center for Autism & Related Disabilities (CARD) has produced a great fact sheet entitled: “Airports, Airplanes and Autism: A Guide for Parents and Airline Personnel to Meet the Needs of Individuals with an Autism Spectrum Disorder.” It has a lot of great ideas for how to be prepared and proactive for travel for both the family and airline personnel. It’s available to download for free at:

http://ucf-card.org/uploads/factsheets/1241536463_eng.pdf

Remember that the most important thing is to enjoy your family and friends and the meaning of your activities. Preparation is the key as is remembering to keep it simple!

Have a wonderful holiday season!

Ann


  • Strong interests and difficulty with transitions are characteristic of individuals with an ASD.

Question:

Dear Ann,

I have a 12 year old boy with Autism in my Special Day Class who has mild to moderate cognitive impairment and behavior problems (i.e., he doesn’t follow directions). We are having a really hard time getting him off the portable DVD player. This is a problem because he works really well to earn time to watch parts of his favorite DVD movie but then we can’t get him off without a lot of resistance. When we insist it’s time to get off he won’t budge and sometimes he’ll kind of push us away. I’ve actually tried to stop allowing him to watch the DVD because it was becoming such a problem but that was really upsetting to him when he came to school and found that it wasn’t around anywhere. He looked all over the room until he found where I’d hidden it in a cabinet! He is able to read and understands the words and sentences on his schedule and the directions on worksheets. He can talk but sometimes he is hard to understand and mostly only talks when he is asked a question.

Any help you can give me would be great.

Susan


Answer:

Susan,

Thank you for your great question. I’m asked this question a lot in one form or another because strong interests and difficulty with transitions are a characteristic of individuals with an ASD.

First, let me commend you for incorporating your student’s strong interest (i.e., watching parts of his favorite movie on DVD) as a reward (reinforcer) for work completion in your classroom even though you’re probably wishing you hadn’t! I’m sure you know that using special interests to motivate students with an ASD is actually a best practice. And, you have definitely discovered the hard way that when you try to withhold an extremely strong interest you can actually increase the intensity of the interest. That’s why your student engaged in a relentless search of your classroom to try and find the DVD player. So let me give you some ideas about how to incorporate your student’s highly preferred interest and how to help your student make transitions more easily.

In your situation, you’ve been using your student’s special interest as a reward for “enduring’ a non-preferred activity (i.e., school work) and you’re having difficulty helping him transition from this highly preferred activity to a less preferred activity (i.e., anything else!) So based on the information you provided me here are some strategies that I suggest you try: 

INDIVIDUAL SCHEDULE:

You mentioned that your student has an individual schedule and that’s great. Make sure that your student’s individual schedule is portable and goes with him. Why? Because the Individual Schedule serves as a visual reminder of the activities of his day and he will see that he will have other opportunities to do his very favorite activity; this will hopefully help him transition to the next activity more easily.

8:15-8:35

Reading

8:35-8:40

Choice (DVD or Listen to Music)

8:40-9:00

Math worksheet

9:00-9:05

Choice (DVD or Listen to Music)

etc.

 

Note: Be sure to include the beginning and end time 
on the schedule as well as when he will use the DVD

Do remember to design his schedule in such a way that you aren’t requiring him to transition from his highly preferred activity of the DVD to an activity that he really really doesn’t like! Make efforts to transition from the DVD to an activity that is something in which he is interested and finds motivating. For example, if he consistently watches a favorite movie on the DVD perhaps the next activity would be a reading activity about the subject of that movie. 

ACTIVITY SCHEDULE:

You didn’t mention that you were using an Activity Schedule and it’s really important that you do in this case. Also referred to as mini-task schedule, embedded schedule or within-task schedule, this type of schedule outlines the specific steps your student needs to complete for the tasks or activities listed on his Individual Schedule. You wrote that your student can read so you can develop a written Activity Schedule to help your student follow the steps involved in watching his DVD.

Using an Activity Schedule will help your student become independent and decrease the need for the adults in the classroom (i.e., teacher, instructional aides, etc.) to give him verbal directives to stop a preferred activity which will (usually) escalate his resistance to stop (you mentioned in your question that telling him to stop watching the DVD doesn’t work and sometimes results in his pushing you away.) Remember, too, that verbal prompts are very difficult to fade and I know you don’t want your student to become dependent on others to tell him what to do, right? Here’s an example of an Activity Schedule that might work for your student:

Watching DVD
Turn on DVD player

 

Watch movie for 5 minutes
 
Turn off Time Timer  
Turn off DVD player  
Check schedule  
Note: Have student check off each step when completed

When your student transitions to the DVD player location in your classroom make sure the Activity Schedule is right there where he can see it. Review the Activity Schedule with him before he begins. I would consider having him read the Activity Schedule as it is a perfect opportunity to work on his reading skills (word recognition and reading comprehension) in a functional and meaningful context!

TIMERS:

Use a clock, watch or timer to help your student understand time periods and when changes will occur. Time is invisible so I like to use a TimeTimer (see Resources) because it is a visual display of time passing. It also takes away the need for the adult to inform him when the time is up thus reducing another opportunity for a power struggle. The TimeTimer that lets him know time is up!

CHOICES:

Provide choice-making opportunities whenever possible. Being involved in decision-making can help ease transitions for some students. Sometimes I allow the student to set and turn off the timer to offer a sense of control.

POSITIVE PRAISE:

Always remember to praise your student when he makes a transition appropriately and independently!

SOCIAL STORY:

Write a Social Story about using the DVD player to help him cope with change/transitions. Social stories are a great way to teach social and life skills to students with an ASD (see Resources).

Let me know how things go, okay?

Ann

RESOURCES:

Social Stories:www.thegraycenter.org

TimeTimer:www.timetimer.com

Autism Internet Modules: Free online training about autism. Once you register for this free site, you can access various video training modules that depict interventions in the areas of communication, social skills, structured teaching, job skills, etc. www.autisminternetmodules.org

Visual Supports: 
www.usevisualstrategies.com
www.dotolearn.com


  • How to communicate “No” and live to tell about it!

Question:

I have a student with Autism who has a tantrum when I have to tell him “No.” I don’t like to tell him he can’t have something but sometimes it just can’t be avoided. The other day during snack we ran out of goldfish crackers and no matter what I said or did he stayed very upset. Then another time he kept asking to ride the tricycle but it was a rainy day and we weren’t going outside so I had to tell him, “No.” I won’t even begin to describe what happened when our computer wasn’t working and he wanted to play on it! Please let me know what I can do.

Mary


Answer:

Dear Mary,

Yep, there are those rainy days when going outside to ride the tricycle isn’t an option and no matter what you do, you can’t stop the rain! So the challenge is how to communicate “No” and live to tell about it!

I know this may sound too good to be true but I have found that using the Universal No Symbol is a powerful and effective visual strategy. You can purchase clear plastic symbols (see Resources) and stick them to your laminated symbols to signal that the item or activity is not available. The student can see the original icon (picture symbol) through this clear plastic symbol. They can be easily removed once the item is available and then re-used over and over. If you’re on a budget you can use a red dry erase marker and draw the Universal No Symbol over a laminated picture symbol and then use a tissue to erase it. Here are some examples:

universal no sign

So, next time you’re out of goldfish crackers at snack, go ahead and place the picture symbol of goldfish crackers on the choice board for snack or in the student’s communication book but this time place the Universal No Symbol over it. Trust me, if you try to hide the picture symbol when it isn’t available the student will go searching throughout the classroom and in everyone’s binders to find the goldfish cracker symbol! I know you know what I’m talking about! Anyway, the visual strategy is what will communicate that something isn’t available and you won’t even have to say, “No.” Using this strategy to communicate “No” is very different than if you actually say, “No!”

I’ve also placed Universal No Symbols on student’s or class schedules when the Speech-Language Pathologist isn’t coming or when we aren’t going to the library as planned. I’ve also placed the Universal No Symbol directly on the computer when it’s not available or on those desks and cabinets that are off limits to students. Try it!

I would also recommend that you write a Social Story about when items or activities aren’t always available. The Social Story would help your student learn to have an improved understanding of events and expectations that may lead to more effective and prosocial responses. (See Resources.)

Let me know how things go, okay?

Ann

RESOURCES:

Universal No Symbols: Clear plastic symbols that come in three sizes and stick to laminated picture symbols to signal that the item is not available.www.adaptivechild.com or www.difflearn.com or www.pecsproducts.com

Social Stories:www.thegraycenter.org


  • “I want frozen yogurt! I want frozen yogurt!”

Question:

I’m a mom of a six year old with autism. It’s really difficult to run errands with my son. He understands when I tell him that he’ll get a frozen yogurt when we’re finished but for the whole trip he says over and over and over, “I want frozen yogurt! I want frozen yogurt!” Do you have any suggestions?

A Harried Mom


Answer:

I do have a few ideas that might help you and your son have a more enjoyable time running those errands. First, I want to commend you for offering your son a reward (i.e., frozen yogurt) for enduring those necessary errands. I hope you buy a frozen yogurt for yourself, too. You deserve it!

I’d like to suggest:

  • Write a Social Story about “Going on Errands with Mom.” Make sure to personalize the story about your errands and be sure to include that he’ll get a frozen yogurt. Read the Social Story to him right before you leave to go on your errands. You should ask your son’s Speech-Language Pathologist or Special Education teacher for assistance in developing this story. To learn more about Social Stories visit The Gray Center at www.thegraycenter.org.
  • Make sure that his individual daily schedule has “Go on errands with Mom” followed by “Get frozen yogurt” on it. And, like all schedules, refer to his schedule throughout the day so he can anticipate the activity. Talk to his teacher about adding this on his classroom schedule.
  • Develop a laminated mini activity schedule that depicts the sequence of the errands:
safeway
Safeway

THEN

gas
Gas
THEN
frozen yogurt
Frozen Yogurt

Place the mini activity schedule on the back of the front passenger seat so he can see it throughout your trip. After you have him seated, review it with him using simple language. For example, point to each picture and say, “We’re going on errands: first Safeway, then gas, then frozen yogurt.” Now he can see that he’s going to get his frozen yogurt throughout the whole trip and won’t (hopefully!) have to keep asking!

  • After you complete each errand you or your son can make an X over the errand so he can see that he’s getting closer to getting that yogurt. Remember to laminate the mini activity schedule so you can use a dry erase marker and reuse the schedule over and over!
  • Make a special effort to have the length of the trip be only as long as your son can tolerate. We all have our limits!
  • Provide your son with something enjoyable to do that keeps him occupied and calm. For example, let him bring his handheld video game, portable DVD player, his favorite “fidget”, book, music, etc. I’m sure you know just the thing!
  • Be sure to praise him when he’s demonstrating the desirable behavior. That is, when he’s engaged in his activity and/or referring to his schedule say, “Good job sitting and being quiet while we run our errands.”

Hope these ideas work!

Ann


  • What can I do to prepare these students for the workforce 12 years down the road?

Question:

Hello!

I teach for the Santa Clara County Office of Education and teach a K/1 class for students with autism. My class has some students who are high functioning. What can I be doing at this level to prepare these students for the workforce 12 years down the road? I don’t want them to be left out and want to already be thinking about their future.

Alison


Answer:

Dear Alison,

Kudos to you for asking this very important question! You are correct that it is never too soon to begin preparing our students with an ASD for adult living! A leader in the field of vocational preparation, Paul Wehman, states that for vocational preparation to be most effective, it should be viewed as a longitudinal process, beginning when students are in elementary school, proceeding through middle and high school and culminating in a paid job before the student leaves school.

Current statistics about employment of individuals with an ASD are alarming. Most adults with an ASD are unemployed or underemployed. And, more than half lose their jobs soon after becoming employed. So, although some individuals with an ASD are ‘high functioning’, it is imperative to understand that academic achievement does not offset poorly developed daily living and social communication skills. Barbara Bloomfield states that the following are major issues associated with poor employment outcomes:

• Difficulty in working independently

• Poor social communication skills and strategies

• Weak planning and organization

• Underdeveloped daily living skills, particularly grooming

Here are just a few examples of things I bet you’re already doing in your classroom to prepare your students for the future:

  • The individual schedule you have provided each of your students to help them transition from one activity to the next develops independence. As you know, a transition requires the student to stop an activity, move from one location to another, and begin something new. This process is difficult for individuals with an ASD but occurs all the time at school and eventually in the workplace. So, if you teach your student to use their schedule independently then they are less dependent on you or the classroom aides to give them verbal prompts which makes the difficult process of transitioning a little bit easier for them.
  • Visual supports such as mini-task schedules, if/then cards, TimeTimer, etc. assist your students to complete specific tasks more independently with minimal adult support. Remember, everything you do to help an individual with an ASD become as independent as possible helps lead to successful employment and adult living.
  • An activity such as snack time helps to prepare your students for success on the job. When you teach your students to wash their hands before snack, prepare their own simple snack, set the table, learn and practice good manners, carry on a simple conversation, clean up and put away items, you are preparing them to successfully participate in the break room at their future job many years later!

Diane Adreon and Barbara Bloomfield (see Resources) have done a nice job of listing ten skills to teach in preparation for life after high school; I’ve added a few things to this list, too:

  1. Schedule Use:
    • Provide and teach students to use and follow a schedule independently; this is one of the best predictors of employment success!
  1. Independence:
    • Teach students to start and finish work tasks independently; employ structured teaching methods and visual supports (e.g., activity schedules)
    • Teach students to go and return from places independently (e.g., send on errands to the office; go to a destination such as the speech therapist’s office; travel to and from the cafeteria and playground, library, etc.)
    • Support students in learning how to safely maneuver the school parking lot during drop off and pick up times; how to cross the street during class outings into the community
    • Encourage the family to develop independence at home and in their community whether it be walking, riding a bike, using public transportation, getting a food item a few feet away in the same aisle at the grocery store, getting ready for school, etc.
  1. Time Management:
    • Teach the student to use a clock or watch to monitor timed tasks; teach him/her how to set, activate, monitor and turn off the timer
    • Use a TimeTimer in a variety of activities (work and leisure tasks) to help the student grasp the concept of time
    • Use a ‘Count Down’ card to help the student understand ‘how much longer’
    • Employ a ‘one more minute’ card
    • Teach the student to wait by providing a ‘wait’ card
    • Encourage the parent to teach their child to awaken to an alarm clock
  1. Responsibility:
    • Teach the student to be responsible for their things by providing a specific location for their coat, backpack, lunch tote, school work,
    • Assign class and school jobs
    • Teach the parents how to have their child take care of their belongings at home; help their child remember to take home a favorite item that they may have brought to another’s house when visiting; to assign household chores, etc.
  1. Visual Cues:
    • Teach the student to learn to use visual cues to remember tasks
    • Label storage containers, cabinets, and work areas in the classroom
    • Employ TEACCH independent work systems
    • Help the parents use visual cues at home (e.g., parent could tape a note on student’s backpack “Remember lunch!”; label dresser drawers, use activity schedules on outings, etc.)
  1. Telephone Use:
    • Teach students how to answer the class telephone, how to take a message and relay the message
    • Help the parents carryover telephone use into their home
  1. Food Preparation:
    • Teach students how to prepare simple snacks that do not require cooking
    • Use picture recipes
    • Teach students how to use the microwave, wash dishes, set, clear and clean tables
  1. Leave Home Prepared:
    • Help the parent teach the student how to leave home with their backpack, homework, wallet, lunch tote, communication system, jacket, favorite fidget, etc.
    • Provide parent with a checklist that you have taught the student to use
  1. Personal Safety:
    • Teach student about boundaries (i.e., who to hug and kiss and when it is more appropriate to shake hands, wave.)
    • Teach the student about personal identification information and how and when to give it
    • Develop scripts and social stories for personal safety issues
  1. Grooming:
    • Teach independent hand washing and brushing teeth
    • Teach the student to wipe their mouth while eating
    • Teach how to use a tissue to wipe nose when necessary
    • Have student learn how to check in the mirror before going out
    • Teach the student how to comb/brush their hair
    • Encourage parents to teach their child how to bathe, comb/brush hair, brush teeth, select clean and appropriate clothes, etc. Provide parents with visual supports (e.g., activity schedules, social stories, video modeling)

Phew! As you can see, there’s a lot that you do and can do more of in your classroom to begin preparing your young students for life after school. Always remember to include the parents. Keep up the good work!

Ann

RESOURCES:

Diane Adreon, M.A., “Ten Skills to Teach Your Child in Preparation for Life After High School”, Autism Asperger Publishing Company, Winter 2005-2006 Newsletter, http://www.asperger.net/newsletter.htm

Barbara Bloomfield: From Pre-school to High School to Beyond School: How to Target and Teach Critical Skills that Lead to Later Employment Success from the Virginia Tech 5th Annual Autism Spectrum Disorders Conference, 2008, (Powerpoint Presentation.)

Ask A Specialist: Transition, http://www.askaspecialist.ca.gov/

Visual Supports :

TimeTimer: www.timetimer.com
WatchMinder: www.watchminder.com
Division TEACCH: www.teacch.com
Autism Internet Modules: www.autisminternetmodules.org
Use Visual Strategies: www.usevisualstrategies.com
IconTalk www.icontalk.com
Visual Recipes: www.amazon.com
A Cookbook for Non-Readers


  • I have a student with Autism who loves The Wiggles.

Question:

Help! I have a student with Autism who loves The Wiggles. Even though we have asked his family not to send any Wiggles toys with him to school he makes everything a Wiggle anyway! For example, we have a bulletin board with colored circles to teach the colors and he will go and grab the red, yellow, purple and blue circles and call them Wiggles. What should I do now?


Answer:

This is a great question and one that I’m asked a lot because strong interests are a characteristic of individuals with an ASD. The Wiggles, Sam (Yellow), Murray (Red), Jeff (Purple) and Anthony (Blue) and the characters they have created are now a part of the lives of so many children. I’m not surprised that your student with an ASD enjoys them, too. So what to do?

Well, you have already learned that your efforts to eliminate The Wiggles from the classroom didn’t work! Did you know that sometimes when you try to withhold an extremely strong interest you can actually increase the intensity of the interest? It’s sort of like when you’re on a diet and you tell yourself you absolutely cannot have any chocolate. What happens? Well, don’t you usually start dwelling on how much you want chocolate? Exactly!

Using special interests to motivate children with an ASD is actually a best practice! So go ahead and capitalize on the strong special interests that characterize individuals with an ASD to motivate them and help them learn. If they are interested in the subject matter they are more likely to pay attention for longer periods of time, and are more willing to learn because they will find it interesting.

Here are some ideas of how to incorporate a special interest:

  • Use the Wiggles as a reinforcer (e.g., First math, Then Wiggles).
  • Use the Wiggles as one of the choices during free time.
  • If the student gets upset, use the Wiggles on his self-regulation card as one of the choices he can choose to help calm himself.
  • Help him make a Wiggles book that he can share with a peer; use this book as a tool to teach social interaction, social communication skills and strategies and even reading.

Certainly, you will want to continue to provide him with opportunities to explore varied interests. However, I have found that if you provide opportunities for the student’s special interest to be incorporated and accessed throughout his day then you can more easily designate other parts of the day that don’t have the special interest. You can always write a Social Story about when he can play with and/or talk about The Wiggles as another strategy to moderate the student’s focus.

Have fun with The Wiggles!

Ann


  • Do you have any ideas on how I can get my aides the information they need?

Question:

I am a teacher of students with Autism. My classroom aides are eager to learn but they have limited opportunities to attend trainings and I don’t have hardly anytime to meet with them. Do you have any ideas on how I can get my aides the information they need?


Answer:

Your question came to me at a great time! I just learned about a project of the Ohio Center for Autism and Low Incidence (OCALI). They are in the process of developing the Autism Internet Modules (AIM). This project is designed to provide information to help those working and living with individuals with ASD to increase their knowledge and skill. By the time the AIM project is finished there will be a series of 60 topics such as evidence-based practices and interventions, assessment and identification, characteristics, transition to adulthood, and employment. The authors of the various modules include experts on ASD from across the nation.

Several Evidence-based Classroom Interventions learning modules are already completed that would be good for your aides to review: Structured Work Systems and Classroom Organization, Visual Supports, and Transitioning Between Activities. There are lots of photos to support the written information and a nice pre-assessment and post-assessment.

The best part? These modules are available at no cost to any computer or digital telephone user. Take a look! www.autisminternetmodules.org