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Autism Spectrum Disorder Archive 2010

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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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  • What therapies are helpful when a child is diagnosed with Autism at age 18 months?

Question:

Dear Ann,

I've learned that children can be diagnosed with Autism as early as 18 months, but are generally diagnosed at 2-3 years of age. When children are diagnosed that early in life how intense do therapies need to be and which therapies are most helpful?

Thank you,
Stefanie K.


Answer:

Great question, Stefanie!  I wish I could give you a simple and formulaic answer but I cannot!

Importance of Early Diagnosis

Yes, you are correct that an Autism Spectrum Disorder (ASD) can sometimes be detected at 18 months (or younger) and by age 2, a diagnosis by an experienced professional can be considered very reliable. However, many children do not receive a final ASD diagnosis until much older. The Centers for Disease Control (CDC) reports the median age of earliest ASD diagnosis is between 4.5 and 5.5 years; this means that young children may not get the help they need. Research shows that early intervention services can greatly improve a child’s development which is why it’s so important for families to talk to their child’s doctor as soon as possible if they think their young child has an ASD or other developmental problem. Studies have shown that about one third of parents of children with an ASD noticed a problem before their child’s first birthday and 80% saw problems by 24 months. All children should be screened for developmental delays and disabilities during regular well-child doctor visits at 9, 18, 24 or 30 months and this is a policy with the American Academy of Pediatrics. We know that treatment for particular symptoms, such as speech therapy for language delays, often does not need to wait for a formal ASD diagnosis. Remember, too, that while early intervention is extremely important, intervention at any age can be helpful.

Diversity of Individuals with an ASD

Due to the diversity of individuals with an ASD there is no single best treatment. Each person with an ASD is a unique individual and then they have a diagnosis of ASD. ASDs are “spectrum disorders” which are a group of developmental disabilities that can cause challenges in the areas of social interaction, communication and behavior.  
Here are some facts from the CDC:

  • It is estimated that about 10% of children with an ASD also have an identifiable genetic, neurologic or metabolic disorder. For example, studies show that 5% of people with an ASD are affected by Fragile X and 10% to 15% of those with Fragile X show autistic traits. One to four percent of people with ASD also have tuberous sclerosis.
  • A report published by CDC in 2009, shows that 30-51% (41% on average) of the children who had an ASD also had an Intellectual Disability (intelligence quotient <=70).
  • About 40% of children with an ASD do not talk at all and another 25%–30% of children with autism have some words at 12 to 18 months of age and then lose them. Others may speak, but not until later in childhood.

So, although individuals with ASDs share some similar symptoms, such as problems with social communication, social interaction, and behaviors, there are differences in when the symptoms start, how severe they are, and the exact nature of the symptoms. That’s why we have to really consider each person with an ASD as a unique individual. I think you can see how a treatment plan for an individual with a severe intellectual disability who is nonverbal would be very different from the treatment plan of an individual who is highly verbal and has low average intellectual abilities.

Treatment Selection Needs To Be Individualized and Evidence-Based

Determining the type and degree of treatment needs to be made after a comprehensive evaluation of the individual that includes input from the family. Treatment selection of evidence-based practices is a complex process that requires the knowledge and skills of a well-trained and experienced team of professionals, the family and health care provider(s). Professional judgment is extremely important in this process.

The National Autism Center’s National Standards Report, released in September 2009 (see Resources), provides comprehensive information about which treatments have been shown to be effective for children, adolescents and young adults (below age 22) on the autism spectrum. The report states that well-planned, structured teaching of specific skills is very important and that some children may respond well to one type of treatment while others may have a negative response or no response at all to the same treatment. So it will be critical to keep data to measure whether or not a selected treatment is effective. They suggest that intervention services should be comprised of the 11 Established Evidence-Based Treatments and should be delivered following the specifications outlined in the literature (e.g., appropriate use of resources, staff to student ratio, following the prescribed procedures, etc.) You can download this report at no cost to learn more about these researched-based treatments (see Resources.)

The National Research Council (see Resources) suggests the following guidelines for children less than 8 years of age:

  • Educational services begin as soon as a child is suspected of having an ASD
  • Minimum of 25 hours a week, 12 months a year, in systematically planned, educational activities toward identified objectives 
  • What constitutes these hours will vary according to a child’s chronological age, developmental level, specific strengths and weaknesses and family needs
  • Each child must receive sufficient individualized attention on a daily basis so that adequate implementation of objectives can be carried out effectively
  • The priorities of focus include:
    • functional spontaneous communication
    • social instruction delivered throughout the day in various settings
    • cognitive development and play skills
    • proactive approaches to behavior problems
  • To the extent that it leads to the acquisition of children’s educational goals, young children with an ASD should receive specialized instruction in a setting in which ongoing interactions occur with typically developing children

Stefanie, I wish you well in your endeavors to serve individuals with an ASD. You’ll do well if you consider each person with an ASD as a unique individual and design an individualized treatment plan comprised of evidence-based practices which are delivered with fidelity and incorporates regular assessment to measure effectiveness.
Best,
Ann

RESOURCES:
• Centers for Disease Control
http://www.cdc.gov
• National Autism Center’s National Standards Project Report
http://www.nationalautismcenter.org
National Professional Development Center on Autism                  
http://autismpdc.fpg.unc.edu
National Research Council
Educating Children with Autism, Committee on Educational Interventions for Children with Autism, Division of Behavioral and Social Sciences and Education. Washington, DC, National Academy Press


  • What can I do about a student who talks too loudly in class?

Question:

Hi Ann,

I need some help with one of my students who talks too loudly in class. Actually, he speaks loudly whether he’s in the library, on the playground, or in the cafeteria. He is in fifth grade, has Asperger’s Disorder and is high functioning. The other students get annoyed with him when he is in their cooperative work group because he is too loud and they know they’re supposed to talk quietly while they are working together. We have tried telling him, “Use an inside voice” but that doesn’t work for very long. We have also shown him a visual cue (picture symbol) of “Shh! Quiet” but that doesn’t seem to make sense because it’s really okay to talk but just not so loudly. We have also put our finger up to our mouth as a nonverbal gesture for “Shh!” but that doesn’t work for very long either. Do you have any other ideas?

Connie


Answer:

Thank you, Connie, for this great question. As you know, learning social skills and understanding how their behavior affects others is a challenge for many individuals with ASD. You discovered that giving verbal prompts such as reminding him to ‘Use your inside voice’ aren’t that effective. What can end up happening is that the individual may respond in that moment right after your prompt but won’t be able to sustain the more appropriate volume. The student may also become dependent on your verbal prompt and doesn’t really learn how to self-monitor and self-regulate his behavior. You are also correct that the visual cue (picture symbol) you implemented for “Shh! Quiet” is too absolute; that is, you didn’t want him to stop speaking completely, you simply wanted him to speak in an indoor voice.  And, although it’s good for our students to understand universal gestures (finger up to mouth for Shh!), your prompt doesn’t teach our student how to self-monitor and self-regulate his behavior.
I suggest that you try implementing a self-management visual support called the Incredible 5-Point Scale that can be used with ages preschool through adult (see Resources/References). This concrete visual system can be adapted for teaching many social skills and controlling emotional responses including controlling voice level, dealing with obsessive behaviors, understanding personal space,  to name a few. It’s important to remember that the majority of individuals with ASD are visual learners so the Incredible 5-Point Scale would be an effective evidence-based tool to try because it depicts behaviors by assigning them a number and/or color.
First, to develop a 5-Point Scale, you need to identify the behavior; in this situation the behavior would be the volume of the voice in various situations.  Ideally, a scale is designed with the student in a 1:1 situation by the teacher, speech-language pathologist (SLP), parent, etc. As part of the process, the levels are assigned a label. In the example given by the Incredible 5-Point Scale, the SLP developed a list of concrete behaviors representing each number of the scale so the student could understand how to rate his volume level and when or where to use each volume level (e.g., whispering to shouting, library to playground.)  If necessary, you can help your student equate the numbers of the scale with a more concrete concept. For example, 1 can be equated to the concept ‘little’ and 5 can be equated to the concept ‘big’. Once the scale is developed it should be practiced in a 1:1 teaching session (i.e., direct instruction).  

Volume Control


After it is clear that the student understands the rating and how to use the scale, it can be generalized to a real-life group situation. Remember, the Incredible 5-Point Scale can be implemented prior to an event to remind the student of acceptable behavior, during an event or situation to remind him of the target behavior, or after a situation to review behavior that occurred during the situation.
One way to generalize the scale is to have the full-sized scale easily accessible to the staff and student in the classroom or setting in which it is needed. The adult (or peer) can point to a specific number on the scale to show the individual where they happen to be on the scale.
Another way to generalize the use of the scale is to make small laminated scales for staff or parents to carry with them to prompt the student to remember the scale lesson. You can hold the small scale and touch the number you think the student is at, then slide your finger down the scale to the 2 or 3 level which is where the student should be.

5-4-3-2-1


Eventually, the goal is for the student to learn to use the scale to independently self-monitor. You might consider including a picture symbol on his daily individual schedule that reminds him to “Check Voice Volume” and have him rate how he has been doing for that time period and incorporate a positive reinforcement system.

I recommend that you visit the Autism Internet Modules and the Incredible 5-Point Scale website (see Resources) to learn how to implement the Incredible Five-Point Scale.
Good luck and do let me know how this strategy works with your student!

Ann

RESOURCES/REFERENCES:

  • The Incredible 5-Point Scale by Coffin, A. B., & Smith, S. M. (2009). Retrieved October 29, 2010 from the Ohio Center for Autism and Low Incidence (OCALI), Autism Internet Modules, http://www.autisminternetmodules.org
  • The Incredible 5-Point Scale by Buron, K. D., & Curtis, M. Retrieved October 29, 2010, from http://www.5pointscale.com

  • I have difficulty getting some of my students to go from their classroom to my speech therapy room.

Question:

Dear Ann,

I’m a Speech-Language Pathologist and I work with a lot of students with Autism. I have difficulty getting some of my students to go from their classroom to my speech therapy room. It usually ends up being somewhat of a commotion and the teacher or the aide ends up helping me. Do you have any suggestions?

Catherine


Answer:

Hi Catherine!

Thank you for your great (and frequently asked!) question. Transitions occur frequently, requiring students to stop an activity, move from one location to another, and begin something new. As you know from first-hand experience, this process is difficult for many individuals with an Autism Spectrum Disorder (ASD).
There are a number of transition strategies you can use to support your students during changes in or disruptions to activities, settings, or routines. These transition techniques can be used before a transition occurs, during a transition, and/or after a transition, and can be presented verbally, auditorily, or visually. Basically, the strategies are an attempt to increase predictability and to create positive routines around transitions. Transition strategies may include visual supports, timers, social stories and high probability requests.


VISUAL SUPPORTS:
It is important for the teaching team to continually assess how transitions impact students with ASD. Depending on the activity, the environment, and the specific needs and strengths of the individual, a variety of transition strategies may be appropriate.
Research tells us that using visual strategies help to establish attention and increase understanding.  I’m sure you already know that individuals with ASD have difficulty processing verbal language so it makes sense to pair your verbal language, “It’s time for speech” with a visual support that represents speech and language therapy. That way, after the verbal information is gone, the visual information stays there long enough for the student to see it, take in the information and respond to it.

  • Individual Schedule-Make sure that each student has an individual schedule of their day and that “Speech Therapy” is included on that schedule.  Make certain that the individual schedule is portable so they can take it to your speech and language therapy room. I can’t tell you the number of times I have seen that a student has a schedule posted on a wall but doesn’t have one that s/he can take with them when s/he goes out of the classroom to speech, library, cafeteria, etc. I have also noticed many times that a student may have a schedule but it isn’t meaningful and understandable to them. For example, some students may require an object schedule while other students would be better able to understand a pictorial schedule (e.g., photo or picture symbol). And, of course, those students who are able to read would have a written schedule. Make certain that the individual schedule is available to the student at all times, portable and referred to at each transition using simple language.  

If you are going to be coming at a different time or different day you absolutely have to make sure the student is aware of the change!  Ask the teacher to review the schedule with the student and indicate when there is a change in the schedule; we have found that when a student is informed of a change in the schedule ahead of time s/he is often better able to cope. Some teachers use a highlighter to indicate a change in the schedule or affix a ‘change arrow’ next to the activity that is different. Again, it is critical to review the change in the schedule with the student far in advance so the student has time to adjust.

  • TimeTimer-It may be helpful for your student to "see" how much time remains in an activity before s/he will be expected to transition to a new location or event (i.e., speech and language therapy.) Concepts related to time are abstract (e.g., "You’re going to speech in just a few minutes"), often cannot be interpreted literally (e.g., "Just a second", “Hang on for a minute”), and may be confusing especially if time concepts are not a mastered skill. So, representing time visually can help your student understand, and research indicates that the use of a visual timer (such as the Time Timer) can help a student transition more successfully. Have the teacher set the timer for 5 minutes (or whatever length of time would be beneficial for your student) and say, “You’re going to speech in 5 minutes” or “When the red is all gone, it’s time for speech.”  Adjust the language level according to your student’s receptive language comprehension.

 

  • Transition Objects- Providing a transition object associated with certain transitions can also be very helpful to prepare the student for the next activity. Examples of ‘transition objects’ include: ball to take out for recess, book to take to the library, backpack to go to the bus, etc. You are going to have to think of a transition object for speech and language therapy. If you play Connect-4, then perhaps you could have your student take the game piece or the game box from the class to your office. Another student may not need the actual object but a photo of the game to help remind him of where is going and what he is going to do. Another student may be given a written card that says, "Speech-Room 16”. When the student arrives at your office s/he may use the object in the first activity (i.e., chip to play Connect-4) or place the photo or word card in a designated spot.

  • Mini-Task Schedule:  You can alleviate anxiety by providing your student with a mini-task schedule of what s/he’s going to do in speech and language therapy. Make a simple mini-task schedule for your student using words or photos.

things i do in speech

 

SOCIAL STORY:
Prior to the transition to a new location such as Speech and Language therapy, it can be helpful to prepare the student for what to expect. There are several research-based ways that a student can be primed for an upcoming transition and one such strategy is to write a social story; in your case it would be about going to speech and language therapy. The story should briefly describe the upcoming transition and the activities that will occur. The story may include photographs or illustrations to assist the student in comprehending the information. The teacher or instructional aide should read the story to and/or with the student consistently over a period of days right before the student is scheduled to go to speech and language therapy.

VIDEO MODELING:
This evidence-based practice is a strategy to which your student may respond. Make a simple video about transitioning from class to speech. Then have the student watch this video several times over many days.

HIGH PROBABILITY REQUESTS:
Presenting a series of high-probability requests (e.g., "Give me a thumbs-up," "Say your name") prior to requesting that an individual transition to speech and language therapy (a low-probability request) may be a beneficial strategy for an individual with ASD during transition times. 

HIGH INTEREST ACTIVITIES:
Along with developing predictable and consistent transition routines, you may also need to consider adjusting the activities that individuals are transitioning to and from if transition difficulty continues. Take a look at the activities you are providing in your speech and language therapy and evaluate whether or not they are high interest and meaningful for your student. His difficulty in transitioning may be their way of communicating to you that they don’t want to come!  Or, it may be that it’s not your speech and language therapy s/he doesn’t like but the journey through the noisy and crowded hallways are what’s causing the resistance. If that’s the case, then perhaps your student could travel to your therapy room a little bit after the bell has rung and the other students are all back in their classrooms. And, it may be that your therapy session is right after snack or recess so asking the student to go from a highly preferred activity (snack/recess) to a less preferred activity (speech and language therapy) is the challenge. In this case, you’ll need to make sure that the activities you are providing are of high interest and motivating.

CHOICES:
Provide choice-making opportunities whenever possible. We know that research has proven that being involved in decision-making can help ease transitions for some students with an ASD. So rather than just giving a verbal directive, “It’s time for speech”, refer the student to their mini-task schedule and say, “It’s time for speech. Do you want to play Connect-4 or watch the DVD today?”
Through the use of these transition strategies, research shows that individuals with ASD can more easily move from one activity or location to another, increase their independence, and more successfully participate in activities at home, school, and the workplace.
Best of luck as you implement these strategies with your students with ASD.
Ann

RESOURCES:

Social Stories: To learn more about social stories visit www.thegraycenter.org  The  Center for Social Learning and Understanding, the “Official Home of Carol Gray and Social Stories” or www.autisminternetmodules.org

TimeTimer: To purchase a TimeTimer visit www.timetimer.com

Transitions: To learn more about transition strategies for individuals with ASD visit the free online learning module at www.autisminternetmodules.org

Video Modeling: To learn more about visual modeling for individuals with ASD visit the Evidence-Based Practice Brief for ‘Visual Modeling’ at the National Professional Development Center on ASD http://autismpdc.fpg.unc.edu/content/briefs

Visual Supports: To learn more about visual supports for individuals with ASD visit the free online learning module ‘Visual Supports’ at www.autisminternetmodules.org and the Evidence-Based Practice Brief for ‘Visual Supports’ at the National Professional Development Center on ASD http://autismpdc.fpg.unc.edu/content/briefs


  • Teaching a student the skill of standing in line.

Question:

Dear Ann,

I have a third grade student with ASD who has a lot of difficulty waiting in line. Sometimes he runs out of line or he’ll touch others around him or he’ll start stimming. I’ve tried writing a social story and have also used visual behavior rule cards. I’ve even given him part of his snack to positively reinforce him when he is standing in line appropriately. I went to your training and I learned about using a mini task schedule so I tried to make one for when he stands in line but nothing seems to really work. Do you have any other ideas? I’ll give anything a try!

Thanks so much.

Marie


Answer:

Gosh, Marie, you really have worked hard to try and find an effective strategy to teach your student the skill of standing in line. I want to affirm that teaching the skill of standing in line is not only an important skill for school but continues to be a very important skill that is required throughout one’s lifetime. As a matter of fact, I stood in line today at the grocery store, bank and at a restaurant! Kudos to you, too, for trying a variety of strategies with your student. As you have found, there won’t necessarily be one strategy that will work for every student with an ASD, as each individual is unique.

I have a strategy that I would like for you to try in order to teach your student the appropriate behaviors associated with waiting in line; it is called video modeling.

Video modeling is an evidence based practice (EBP) that uses video recording (e.g., hand held camera, computer technology) and display equipment (e.g., dvd, vcr, computer) to provide a visual model of the targeted behavior or skill. In other words, an individual watches a video of either himself or someone else engaging in an activity and then is able to imitate that activity or behavior—similar to watching a how-to or do-it-yourself project on the Internet. The research suggests that video modeling can be effectively implemented with learners from early childhood through middle school to teach communication, social, academic/cognition, and play skills. There are several types of video modeling:

  • Basic video modeling: someone besides the learner is recorded engaging in the target behavior or skill (i.e., models). The video is then viewed by the learner at a later time. 
  • Video self-modeling: the learner is recorded displaying the target skill or behavior and is reviewed later. 
  • Point-of-view video modeling : the target behavior or skill is recorded from the perspective of the learner. 
  • Video prompting: the behavior skill is broken into steps and then each step is recorded with pauses in-between during which the learner may attempt the step before viewing subsequent steps. Video prompting may be done with either the learner or someone else acting as a model.

There are a lot of benefits to using the evidence-based practice of video modeling as an intervention for individuals with ASD. It is easy to do and uses easily accessible technology. For individuals with ASD, it is consistent, structured, visual, motivating, and is a positive behavior support.

I would suggest that you learn more about video modeling at the website of the National Professional Development Center on ASD athttp://autismpdc.fpg.unc.edu/Select Evidence Based Practices and then select EBP Briefs. Once you have selected video modeling you will be provided with:

  • OVERVIEW OF VIDEO MODELING

A general description of video modeling and how it can be used with learners with ASD.

  • STEP-BY-STEP DIRECTIONS FOR IMPLEMENTATION:

Explicit step-by-step directions detailing exactly how to implement video modeling based on the research articles identified in the evidence base.

  • IMPLEMENTATION CHECKLIST :

A checklist to document the degree to which you are following the step-by-step directions for implementation, which are based on the research articles identified in the evidence base.

  • EVIDENCE BASE:

The list of references that demonstrate that the practice is efficacious and meets the National Professional Development Center’s criteria for being identified as an evidence-based practice.

  • DATA COLLECTION SHEETS:

Easy to use forms to keep data so you can determine if this is an effective practice for your student.

Marie, you know your student best, so you are the best person to decide if you want to employ Basic Video Modeling (i.e., you would record another student standing in line appropriately) or Video Self- Modeling (i.e., you would video him during periods of waiting in line and then carefully splice together segments of the videotape that shows him demonstrating the targeted behaviors for waiting in line). Provide your student with opportunities to view the video and, after watching the video over time, we’re going to hope that he will better understand the expectations and be able to wait in line without running away or stimming and without touching others around him!

Let me know how it goes, okay? And, if this strategy doesn’t work, then we’ll just keep working at it!

Ann


  • I’m not getting much guidance from my administrators! How am I supposed to figure out how and what to do?

Question:

Dear Ann,

I am a special teacher in a public school in California and I am getting more and more students with Autism in my classroom. I am also overwhelmed with the amount of information there is about how I’m supposed to educate my students and I’m not getting much guidance from my administrators! How am I supposed to figure out how and what to do? Any help you can provide to guide me would be very much appreciated!

Stephanie


Answer:

Thanks so much for your question Stephanie. I want you to know that you are not the only special education teacher who is getting more and more students with a diagnosis of Autism in their classrooms. Did you know that Autism is the fastest-growing special education eligibility category for public education in California and for the nation? The California Department of Special Education reported in the December 2008-2009 Reporting Cycle that there are 53,101 students ages 3-22 enrolled in special education with an eligibility of Autism (See References).

You are also not alone in feeling overwhelmed with the amount of information available about how to educate students with an ASD. On May 2, 2010 when I Googled ‘autism education’ there were 9,010,000 hits in 0.23 seconds! That’s a lot of information! Don’t worry! I have some resources that will be helpful to you.

  • THE NATIONAL STANDARDS REPORT

The National Autism Center recently released two important documents (see Resources for how to download these reports at no cost):

    • The National Standards Report : The National Standards Project—Addressing The Need For Evidence-Based Practice Guidelines for Autism Spectrum Disorders (Released September 2009)
    • Evidence-Based Practice and Autism in the Schools: A Guide to Providing Appropriate Interventions to Students with Autism Spectrum Disorders (Released January 2010)

The National Standards Report primary goal was to provide information about which treatments have been shown to be effective for individuals with ASD. A cross disciplinary group of experts over several years collaborated to generate this report. The findings were based on 775 published research studies in peer reviewed scientific journals about interventions for individuals below 22 years of age. The National Standards Report identified 11 Established Treatments, 22 Emerging Treatments and 5 Unestablished Treatments. Established Treatments are those for which several well-controlled studies have shown the intervention to produce beneficial effects. That is, there is compelling scientific evidence to show these treatments are effective. The following interventions are Established Treatments:

  1. Antecedent Package
  2. Behavioral Package
  3. Comprehensive Behavioral Treatment for Young Children
  4. Joint Attention Intervention
  5. Modeling
  6. Naturalistic Teaching Strategies
  7. Peer Training Package
  8. Pivotal Response Treatment
  9. Schedules
  10. Self-management
  11. Story-based Intervention Package


The Evidence-Based Practice and Autism in the Schools: A Guide to Providing Appropriate Interventions to Students with Autism Spectrum Disorders is a companion to the National Standards Report and is an educator manual that outlines relevant topics, including the current state of research findings, professional judgment and data-based clinical decision making, values and preferences of families, and capacity building. Each chapter sets a course for advancing the efforts of school systems to engage in evidence-based practice for their students on the autism spectrum.

I suggest that you to read the two reports by the National Autism Center as resources to help you plan your intervention program for your students with an ASD. I also recommend that you share these publications with your colleagues (e.g., administrators, service providers such as SLPs, OTs, APE teachers, School Psychologists, etc.) and the families of your students.

  • ASD: GUIDELINES TO EFFECTIVE INTERVENTION

The California Department of Developmental Services is nearly ready to release California’s version of the National Standards Report entitled ASD: Guidelines to Effective Intervention (see Resources for how to access this report). This report is in close alignment with the National Standards Report and adds additional information that is unique to the State of California Education Code, specific issues unique to California and an evidence-based review of Medical/Biomedical/Health Related Interventions conducted by a Stanford University team.

  • AUTISM INTERNET MODULES

After you have read these reports I encourage you to visit the online learning website developed by the Ohio Center for Autism and Low Incidence (OCALI). They are in the process of developing the free online 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 of evidence-based practices. 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. Several evidence-based classroom interventions learning modules are already completed that would be good for you to review: Reinforcement, Self-Management, Visual Supports, Transitioning Between Activities, just to name a few. There are lots of photos to support the written information and a nice pre-assessment and post-assessment to check how well you have learned the material. These are user friendly learning modules that you, administrators, family, paraeducators, IEP team members, etc. can benefit so that you can plan evidence-based programs to serve and educate your students with an ASD.

  • NATIONAL PROFESSIONAL DEVELOPMENT CENTER ON ASD

Lots of helpful information is available at the website of the National Professional Development Center on ASD (NPDC). For example, you may take a free extensive online course entitled “Foundations of ASD”, learn the specifics about 24 identified Evidence-Based Practices and access previously provided presentations by leading experts in the field of ASD.

  • MODEL ASD PROGRAMS IN CALIFORNIA PUBLIC SCHOOLS

The Diagnostic Centers, California Department of Education, UC Davis M.I.N.D. Institute and other agencies are working in partnership with the National Professional Development Center on ASD to develop three model public school programs for students with ASD. There will be one model program in the Northern, Central and Southern regions of the state and will be available for you to visit and observe at the beginning of the 2011-2012 school year.

  • DIAGNOSTIC CENTER TRAININGS IN CALIFORNIA

As a teacher in California you have the opportunity to attend trainings about educating students with an ASD that are provided by the Diagnostic Centers. There are three Diagnostic Centers that serve the entire state of California so be sure to visit the website of the Diagnostic Center that is in your region of the state to find out about when and where trainings are being offered about evidence-based practices for students with ASD (See Resources).

I wish you the best of luck as you continue to learn about how to best educate students with an Autism Spectrum Disorder. And, as you already know, you may always submit a question to me at Ask A Specialist-Autism!

Ann

RESOURCES AND REFERENCES:

  1. Autism Internet Modules:
    • Free online learning modules that are 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. www.autisminternetmodules.org
  2. California Department of Special Education Special Education Enrollment by Age and Disability, December 2008-2009 Reporting Cycle:
    • Information about the number of students with Autism in California public schools can be found at: www.cde.ca.gov/ds
  3. California Department of Developmental Services: “ASD: Guidelines for Effective Intervention”
  4. Centers for Disease Control:
  5. Diagnostic Center Trainings, California Department of Education:
    • Scheduling information about trainings provided to educators in California about ASD can be found at:

    Diagnostic Center, Northern California: www.dcn-cde.ca.gov

    Diagnostic Center, Central California: www.dcc-cde.ca.gov

    Diagnostic Center, Southern California: www.dcs-cde.ca.gov

  6. National Autism Center:
    • The National Standards Project Report and Educator Manual: Evidence-Based Practice and Autism in the Schools can be downloaded free at:www.nationalautismcenter.org
  7. National Professional Development Center:

  • Do you have any ideas on how I can manage my classroom staff and keep my classroom running smoothly?

Question:

Dear Ann,

I have a Kindergarten through second grade special day class for students with Autism. I have 9 students, 4 paraeducators and me. As you can see, there are a lot of adults in my classroom and although this should be a good thing it’s also really difficult to schedule staff breaks and tell them which student they are with when and what to do when someone calls in sick. I sometimes have even the same amount or even more adults than students in my class if you count the Speech Therapist, Occupational Therapist, APE teacher, and Behavior Specialist ! This list doesn’t even include our grandma and grandpa program, peers from other classrooms, and, well, the list goes on! I feel like all I’m doing is telling everyone what to do and who they’re supposed to be with! Also, as I’m sure you know, not every day is the same! Some days we have assemblies, we have a short day one day a week, and holidays. My whiteboard is covered with various schedules of different staff but it’s hard to read. Don’t even get me started on when I need to get a substitute and try to explain all this to them! Do you have any ideas on how I can manage my classroom staff and keep my classroom running smoothly? Any ideas you have would be very much appreciated.

Marie


Answer:

Marie,

What a great question and one that I am asked frequently!

Most teachers are indeed surprised to learn that s/he is required to do more than just be a teacher of the students in their program but s/he will also be the manager of a small staff! Most teachers learn “on the job” how to engineer their classroom for success and to maximize the productivity of all the human resources dedicated to the students in the classroom. That means the teacher will learn how to work collaboratively with many related services specialists (e.g., speech and language therapy, occupational therapy, physical therapy, adaptive physical education, etc.), gain understanding about union rules for breaks that must be provided for various employment levels of instructional assistants, figure out a way to meet with the team members about the needs and issues of the students to help create a successful learning environment for staff as well as for students and, the list goes on!

First things first! Let me advise you to develop a daily visual schedule for the classroom. A well-developed and information-packed classroom schedule can solve a lot of the logistical challenges and allow more time to be dedicated to teaching the students instead of “directing traffic” in your classroom!

GUIDELINES TO DEVELOP A CLASSROOM SCHEDULE:

  • Use a large hanging nylon pocket chart with sentence strips (see Materials List)
  • Display the schedule in the front of the classroom so all can see
  • Refer to the schedule throughout the day and especially before transitions of each activity
  • Include the beginning and ending time of each activity
  • Make sure to name each activity
  • Depict all teacher, aides and related services (SLP, OT, PT, APE, etc.) student assignments, their roles and responsibilities and location during each activity of the day
  • Use appropriate visuals (e.g., picture symbols or photos); just make sure it’s at the level that all students can understand
  • Depict all staff breaks. Strategically design staff break times that work for the students. Avoid scheduling staff breaks during those less structured school times which are more difficult for students with ASD and require more support (e.g., recess, snack, lunch, assemblies, etc.) Or, make sure you incorporate your Specialists during those times when your aides are on their 10, 15 or 30 minute break!
  • Denote changes and reassignments when students or staff are absent
  • Laminate your sentence strips and use Dry Erase markers so you can make changes easily, quickly and temporarily; everyday in a classroom is different! Remember, although students with ASD typically don’t like change they can cope better when they are prepared ahead of time.

Here’s an example of a daily classroom schedule for a K-2 classroom of students who were capable of understanding picture symbols:

Schedule Overview

Schedule Activities Components

Staff Assignments

Staff Schedule Flexibility

Developing this schedule takes awhile but once made it is well worth the time, effort and energy! You’ll do a whole lot less talking across the room telling everyone who to work with and what to do and where. Your substitute will have a visual support to supplement your lesson plan and, when your principal walks in, it will be an easy reference to see what’s happening.

And, of course, each student in your class will also have their own individual schedule in addition to this classroom schedules. The classroom schedule will ensure a structured, predictable routine as much as possible and when things change, you have a way to note that! And, your whiteboard? Erase it and use it for teaching!

Email me if you have any questions!

Ann

MATERIALS NEEDED:

  • Large hanging nylon pocket chart
  • Sentence strips
  • Scissors
  • Permanent marker in a variety of colors including black
  • Dry Erase markers in a variety of colors including black
  • Small Post-Its
  • Laminating capability (laminator, laminating material)
  • Ability to create and print Picture Symbols or Photos if needed (e.g., Mayer Johnson Boardmaker, digital camera, Internet access/color printer)
  • 5 large manila envelopes, one for each day of the week, in which to keep all sentence strips and visuals.
  • Planning time and help to make the schedule!

  • I’ve heard that there are more and more children with Autism. Is this true? Why?

Question:

Dear Ann,

I’ve heard that there are more and more children with Autism. Is this true? Why?

Jan


Answer:

Dear Jan,

Your question is quite timely because the Centers for Disease Control and Prevention (CDC) just released new data in December 2009. The study shows the average total ASD prevalence in 2006 (children born in 1998) was 1 in 110 children (about 1 %).

The CDC states that more people than ever before are being diagnosed with an ASD and it is unclear how much of this increase is due to a broader definition of ASDs and how much to better efforts in diagnosis. However, a true increase in the number of people who have Autism and Related Disorders cannot be ruled out. The CDC report goes on to say that it is likely that the increase in the diagnosis of ASDs is due to a combination of these factors.


These new results reflect data collected by CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network (see Resources) in multiple communities throughout the U.S. in 2006. Data for the study used health and education records from reporting communities that includes eight percent of the U.S. population of eight year olds. The reason that all children in the studies were eight years old was because previous research has shown that most children with an ASD have been identified by this age for services.

The CDC also lists the following as what has been learned:

  • All ten communities participating in both the earlier 2002 and 2006 study years observed an increase in identified ASD prevalence ranging from 27 percent to 95 percent, with an average increase of 57 percent.
  • Increases were found among boys in nine communities and among girls in four communities. ASD prevalence was 4 to 5 times higher for boys than for girls. These estimates report that one in 70 boys and one in 315 girls have an ASD. The average increase for boys was 60% while the average increase for girls was 48%.
  • Data show a similar proportion of children with an ASD also had signs of intellectual disability, averaging 44% in 2004 and 41% in 2006.
  • Concerns regarding development before the age of 36 months were noted in the evaluation records of most children, but the average age of earliest ASD diagnosis was much later at 54 months.  

Thanks for your great question. I would suggest that you visit the CDC website to read the full report and the other great information have available about ASD.

Ann

RESOURCES: