For toys, games & material designed for children and youth with Autism, visit:
For information on nutritional supplements & their effects on the behavior of children & youth with Autism, Click here
Author: Dorota Koczewska
The word ‘autism’ derives from the Greek word ‘autos’, meaning self. Indeed, the child seems to exist in his or her own world, a place characterized by repetitive routines and profound difficulty in communicating with others. The labels and criteria for diagnosing autism and similar disorders have changed a number of times since "autism" was first indentified more than 60 years ago. The diagnostic criteria found in the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-IVtr, DSM5 in 2014) for autism is the most widely accepted outlining of the condition in the US, Canada, UK and Australia. Autism is a lifelong neurodevelopmental disorder that is believed to be due primarily to a genetic origin. It is widely assumed, however, that
there are multiple etiologies, and subtypes of autism. The term "Pervasive Autism is a" behavioral syndrome". The definition and diagnostic critera depend on the display of patterns of behaviors. DSM IV-TR Diagnostic Criteria for Autistic DisorderA diagnosis of autistic disorder is made when the following criteria from A, B, and C are all met.
Autism is complex neurological developmental disability that typically appears during the first three years of life. It effects the functioning of the brain and presents itself in behaviors such as withdrawal from human contact, ritualistic behaviors, and impaired social and communication abilities.
Autism is one of the “pervasive developmental disorders”. The Diagnostic and Statistical Manual of the American Psychiatric Association (DMS-IV), a diagnostic handbook, lists specific criteria to diagnose Pervasive Developmental Disorder (PDD). Children who are diagnosed under the PDD umbrella exhibit similar characteristics in communication and social skills, but differ in terms of specific characteristics and severity. Within the subcategory known as Autism there are different levels from mild to severe. Some children are very bright and do well at school, but have problems with social adjustment. Those children may be able to live independently when they grow up. However, at the other end of the scale mental retardation is commonly accompanies with autism.
Below are some of the PDD categories and their distinguishing characteristics. Autistic Disorder Asperger’s Disorder (This diagnosis has been discontinued in the DSM as of May 2013. The note below was written in 2011.) Rett’s Disorder * It is expected that Rett's Disorder will not be included in the next edition of the DSM (DSM 5 in 2013). For more information, CLICK HERE.
What causes Autism? What are the often-seen symptoms of Autism?
How is Autism treated? What strategies can teachers use in classrooms? Summary Resources for More Information *Clicking on the images of the books that you see below, will take you to Amazon.com where you can preview the texts and decide whether to purchase them.
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Shirley Cohen Targeting autism: What we know, don't know, and can do to help young children with autism and related disorders.
Jan Handleman and Sandra Harris (Eds.) Preschool education programs for children with autism. DeAnn Hyatt-Foley & Matthew Foley (2002). Getting services for your child on the autistic spectrum. New York, Jessica Kingsley Publishers (www.jkp.com) Strategies to help students with autism.’ Today Volume 8, Issue 8 (April/May) 2002. Luke Jackson (2002). Greaks, geeks and Asperger Syndrome: A user guide to adolescence. New York, Jessica Kingsley Publishers
Lynn Kern Koegel Overcoming Autism
Fiona Marshall Living with Autism Rebecca Moyes Addressing the challenging behavior of children with high-functioning Autism/Asperger Syndrome in the classroom: A guide for teachers and parents.
Bobby Newman Parents' education as autism therapists: Applied behaviour analysis in context.
Ashley Stanford Asperger syndrome and long-term relationships.
William Stillman Demystifying the autistic experience: A humanistic introduction for parents. Turnbull, Rud, et al. (2002). Exceptional Lives: Special Education in Today’s Schools. Upper Saddle River: Pearson Education.
Green & Stephen Behavioral Interventions for Young Children with Autism: A Manual for Parents and Professionals. Austin, Texas: Pro Ed. Peter Vermeulen I am special: Introducing children and young people to their autism spectrum disorder.
Liane Holliday Willey Asperger syndrome in the family: Redefining normal.
Liane Holliday Willey Asperger syndrome in adolescence: Living with the ups, the downs, and the things in between.
Maria Wheeler. Toilet Training for Individuals with Autism.
Matt Winter Asperger Syndrome: What teachers need to know.
Veronica Zysk & Ellen Notbohm. 1001 Great Ideas for Teaching and Raising Children with Autistic Spectrum Disorders Web Sites http://www.aacap.org/publications/factsfam/autistic.htm http://www.dotolearn.com/welcome/areas/autism.htm Dorota Koczewska isubmitted this paper while a graduate student in the Behavior Disorders Program in Department of Special Education at Hunter College of the City University of New York. She is a teacher of students with autism and behavioral disorders in Brooklyn, NY. Thanks Dorota!
Intervention Strategies for
Children with Autism
Author: Cynthia Moy
Introduction
Teaching children with autism can be quite challenging, given that we are working with students who have very limited expressive and communication abilities. It is very important to realize that when teaching or working with a child with Autism, anytime a behavior occurs (i.e. tantrumming, screaming, hitting, pushing, etc.) the child is trying to express his/her wants and/or needs. The child may display one of these behaviors because s/he wants or does not want something or possibly because something in the environment is bothering him/her. For them, behavior is coded communication which we must decipher.
The first step to understanding any behavior is to perform an FBA (functional behavior assessment). An FBA is a process of gathering information from observations of the student’s behavior and analyzing the information with regard to the accompanying circumstances that affect or happen as a result of the student’s behavior. For more information on Functional Behavior Assessments and how to conduct them; go to: http://www.behavioradvisor.com/FBA.html .
One major step in completing an FBA is to complete an ABC chart. An ABC chart examines a. what happens before (The “A”: Antecedents) the action; b. what exactly/specifically is the behavior (the “B”) in question; c. what are the actions that follow as a result of the behavior (The “C”; Consequences). It is important for educators to train themselves to take notice of these facets of a student’s actions. By becoming aware of the ABC’s (antecedent, behavior, consequence) of your student, you will have a better chance at understanding the function or cause of the child’s behavior.
After completing an ABC chart, you must analyze your data to find a common stimulus or a common consequence. The discovery often surprises us. For example, sometimes removal from the classroom can actually be a reward for the child, which helps to maintain the behavior we are trying to extinguish. Oddly, even correcting some children can be reinforcing for them in that their behavior has brought our attention to them. Sometimes even the act of engaging in the misbehavior is reinforcing in and of itself in that it provides stimulation or relaxation. Consider a child who runs from the room after whom we have to give chase. The child may think it is fun to make adults chase after him/he, or the child may just enjoy running really fast. We have to discover the motivations for the behaviors. Once you have found the either or both of the antecedent or consequence, sit down and devise a plan to address the issue.
This paper is written in an attempt to provide answers to several common questions from the www.BehaviorAdvisor.com Bulletin Board, which have been posted over a 3 to 4 year period of time. It is also a culmination of suggestions gathered from the various replies to these posts, accompanied by many of my own suggestions that are based on my own personal experience of teaching children with Autism. The suggestions are general guidelines. They will not apply to all students, and therefore are not guaranteed to work. Different children respond differently to different situations. This paper is written as a guide to help teachers and parents become more aware of the causes of behaviors and become better able to serve individuals with Autism. These strategies are primarily for teachers or parents who work with children and pre-teens, but can be modified to meet the needs of the adults with Autism.
1. Instruction: How can I promote learning?
a. It is important to use a multi-sensory approach to learning. Many individuals with Autism learn best when touch and movement are included in lessons. For example, letters can be taught through the manipulation of plastic forms or sandpaper cut-outs. You might have students write on freezer bags filled with colored hair gel, which leaves an indentation image of their markings, much like an etch-a-sketch pad. Singing and using movement also help students learn new concepts. Any kind of hands-on learning or use of manipulatives is beneficial for teaching students with Autism.
b. Be sure to reinforce good behavior (and attempts to do well) and correct answers to questions through the administration of tangibles (i.e. food, toys, other tangible objects) accompanied by verbal praise. For more advanced students, verbal praise alone may suffice.
c. It is important to be consistent in displaying a calm and supportive demeanor. Being unswervingly supportive and kind provides the predictability that our students need in their environment in order to relax and be able to focus.
2. Why isn’t my student responding to my reinforcers or consequences?
a. The reinforcer we were using no longer seems to be be reinforcing to this student.
- A reinforcement survey should be conducted to determine if there is a different or stronger reinforcer for this youngster. Reinforcement surveys should be administered at least every month or so. It is common for our students to lose interest in things that they previously valued. For an example of how to conduct a reinforcement survey; go to: http://www.jimwrightonline.com/pdfdocs/rftassessment.pdf .
b. The student isn’t motivated by anything! Nothing motivates this youngster.
- Some children with Autism may not yet have a strong interest in things. If there is a limited awareness of the environment, it may take a while for this individual to find and develop an interest with which we can reinforce.
- Although the pupil does not have a strong interest in any identifiable item or activity, s/he may have a highly non-preferred activity. The student could be offered a choice between the non-preferred activity and the target activity (i.e. Completion of work or participation in an activity). For example, if the child dislikes sewing string through lacing blocks and is not participating in morning circle activities, state the demand, i.e. “Wave hello.” (one of the morning rituals). If the child refuses, tell him/her “Wave hello or do lacing blocks.” If the child does not “wave hello,” then take him/her to the table to lace the blocks. After a few times of engaging in the consequence, the child will usually agree to participate in the requested activity in order to avoid the highly non-preferred activity/task (“Negative reinforcement”).
c. The child does not appear to have any likes or dislikes.
- Some children do not respond to edibles, toys, movies, songs, tickles, hugs, etc. Usually, these children can be reinforced by avoidance behavior (i.e. running out of the classroom, leaving morning circle to run around). Thus the youngster could earn several minutes of running as a reward for participating in morning circle.
- Let an individual earn the opportunity to engage in self-stimulatory behavior (i.e. twirling a string, lining up building blocks, spinning). Often times, while it may be something in which teachers or parents do not want the child to engage, this action is the most reinforcing activity for the individual at that point in their development. If the self-stimulatory behavior is the only thing for which the child will motivate the student, then we are obliged to allow it… as long as the behavior does not hurt others or interfere with their functioning.
d. The child tantrums or hits in an attempt to gain a reinforcer.
- The child may not understand that s/he must complete a requirement first in order to earn the reward. The use of a visual aid may help the child understand this requirement. It is important to pair the reinforcer with a picture of it so the child can make the association between the image and the actual item/activity. Kids with Autism tend to work better when visuals are used. Visual representations of things help these individuals better organize the world around them. If a picture of the item is placed up on a schedule or a board, they can see that they will actually get the reinforcer. You can create a “First-Then” chart. When using a “First-Then” chart, a picture of the activity you want the child to complete will be placed under the word “First” and a picture of the activity or object s/he will earn goes underneath the word “Then”. For an example of a “First-Then” chart; go to: http://www.cesa7.k12.wi.us/SPED/autism/structure/str11.htm
- The child may not have associated the reinforcer with the picture of the item. It is important to show the picture when telling the student what s/he is working for. It is even more important to show the picture when you give the reinforcer to the student. The best way to ensure that the child pays attention to the picture is to show the picture side-by-side with the actual item, while saying the reinforcer’s name. For example, hold the picture of the cookie in one hand, a real cookie in the other hand, and say, “Wow! You get cookie!” Repeat the word “cookie” while handing the cookie to the child.
Why is it important to pair the reinforcer with a picture of the reinforcer if the child already has the reinforcer? Many times when using the “first-then” board or a schedule board, or even when we verbally state the reinforcer, depending on the functioning level of the student, some kids like objects but do not know the label or name for the object. If you pair pictures of objects with actual items, the pictures become meaningful. Often, teachers place pictures of objects on the student’s “PEC”s board, believing that the youngster recognizes the image. Even though the picture may be an actual photograph of the reinforcer, some children do not realize that the picture is the same object as the reinforcer. The realization of this association may take time, which is why it is important in the beginning to pair the picture with the actual item.
3. Why do these youngsters “stim”? (Self-stimulatory behaviors such as hand flapping, spinning, rocking, humming, lining things up, etc.)
a. Perceptions of the world
Individuals with Autism fail to see the world as a series of reoccurring events, the way normal functioning individuals perceive it. To individuals with Autism, life is a series of random events. These individuals develop repetitive and self-stimulatory behaviors to shut out seemingly surprise events or unexpected occurrences in their daily life or routine. Individuals with Autism thrive on routines, repetition, and structure. It helps them understand the world around them while reducing the threat of “surprise”. These behaviors are within their control, and may also provide to them visual, physical, oral, vestibular, or other types of stimulation. Many occupational therapists believe that engagement in self-stimulatory behavior helps these youngsters to focus and better reorganize themselves by providing the sensory input that they are craving. These self-stimulatory behaviors may also act as a means to calm the individual. For more information on self-stimulatory behaviors go to: http://www.autism.org/stim.html .
- Many teachers believe that children with Autism need to engage in the self-stimulatory behavior so that they can remain engaged in their learning. Their classroom environment may not be providing the sensory stimulation that the student needs in order focus on the task at hand. In this case, they allow the child to engage in the self-stimulatory behavior, but try to identify and promote other, more socially acceptable behaviors that provide the same sensory input that the child is craving. (A procedure known at “Differential reinforcement of alternative behaviors”) For example, if the student is hitting oneself for sensory input, you might teach him/her to compress a squeeze toy instead. If the pupil is stomping his/her feet, you might consider placing weights on his/her ankle to provide pressure on the feet (which would give similar sensory stimulation to the feet stomping). If you are unsure which socially acceptable behaviors and interventions can provide the same sensory input as the self-stimulatory behavior, ask your school’s Occupational Therapist. Occupational Therapists are very knowledgeable regarding sensory input and sensory integration. Then seek administrative and parental approval for these options.
4. Is there a “best way” to arrange the classroom environment?
When decorating the classroom there are several things to consider:
a. Arrangement of Furniture
- Children with autism generally have difficulty fully understanding their environment. They cannot easily visually discriminate where things begin or end, or understand what happens in each area of the classroom. When spaces are too open or cluttered, a child can become visually confused. When arranging furniture, be sure that it visually divides the classroom space. For example, if you have centers, kitchen furniture should only be in the kitchen play area, art materials should only be in the art area, and morning circle materials should only be near the rug where you conduct morning circle. If you are working with children in an
b. Classroom Decoration
- Keep the classroom free of extensive visual distractions. Keep decorations simple. Walls and spaces that are too busy can be very distracting and visually over-stimulating for a youngster with autism. For example, I once used a bulletin board border that had a repeating pattern of tiny shapes. One of my students kept going over to the board and would sit there staring at the pattern on the border while repeatedly running his finger over each shape. He was visually (over)stimulated by the border pattern.
- Avoid painting rooms with vividly colored paint. Many schools for students with autism use muted colors such as beige, eggshell, or dull pastels such as baby blue or yellow.
- Cover cluttered bookshelves with cloth in order to reduce visual distractions. For example, my classroom had a large amount of toys stored on the shelves; I used inexpensive fabric and velcro to cover the bookshelf. The fabric served as a curtain to hide the toys from the children’s view.
- Equipment (i.e. computers, TV, VCR) that is rarely used should be stored outside the classroom environment. Make use of natural light instead of florescent lighting (a source of irritating stimulation for many youngsters with autism). If natural light cannot be used, move the student’s seat closest to the window and away from the ceiling lights.
- Children with autism need to be protected from loud sounds that may overwhelm their auditory channels. The most common sounds that cause problems are: school bells, announcements over PA (Public Address) systems, buzzers on scoreboards in the gym, and possibly things scraping on the floors or walls. Cover PA speakers with a cloth or foam to reduce the loudness, ask the office to reduce the number and length of announcement, and ensure that the volume levels of computers or radios are attenuated.
- For more information go to: http://www.cesa7.k12.wi.us/SPED/autism/structure/str10.htm .
5. Why does the student have such problems switching to the next activity?
Transitioning from one activity to another can be a major challenge for children with autism. To make changes occur more smoothly, consider the following:
a. Picture schedules.
- Make use of large picture schedules. Children with autism do not understand the world in the same way as normally functioning people. The use of a picture (drawn or photographed) schedule helps them to better understand the order of events in their day, avoiding unpredictability and apparent randomness that can cause a behavior “meltdown”. The student can refer to the schedule to see what will happen next. For more information and visual examples of various picture schedules, visit: http://www.cesa7.k12.wi.us/SPED/autism/structure/str11.htm
b. Timers.
- Pair your schedule with the use of a timer and/or verbal reminders of how much time is left in the present activity. For example, set the timer for 5 minutes when the activity is about to end, and verbally tell the child that 5 minutes remain before closure. In addition to the verbal cue and the timer, the use of hand signing with a verbal statement can also be help to communicate an upcoming transition. You can sign “finished/all done” when it is time to wrap up the activity.
c. Use of songs and movement.
- Another method that many children love is the use of songs when ending and beginning activities. These routines add predictability to the environment and assist transitioning. The songs do not have to be complex; you can sing popular children’s songs, play recorded versions, or devise you own.
Below is a list of examples of songs I use during my instructional day.
1. “Clean up, clean up, everybody, every where. Clean up, clean up, everybody do your share.” I sing these two lines repeatedly until the children have put away all the items.
2. “Circle Time (or other activity) is finished now, finished now, finished now. Circle Time is finished now, its time for (next activity).” I sing this song at the closing of each activity, preparing the students for the next one. I also use the sign for “finished/all done” while singing.
3. When there is a delay in the next activity due to uncontrollable events (i.e. lunch being delivered late, the computer needing to be restarted), I sing, “We’re waiting, we’re waiting. We’re waiting for (desired outcome) . We’re waiting, we’re waiting. We’re for (desired outcome) .” I repeat these lines until the outcome (i.e. delivery of lunch or readiness of computer) happens.
4. While walking from one place to another I always sing songs. Two examples of songs I use when walking to and from various places in the school: “Hi-ho, hi-ho, it’s off to _____ we go. Hi-ho, hi-ho… Hi-ho, hi-ho, its off to _____ we go!” or “We’re walking to the _________. We’re walking to the _________. We’re so excited ‘cause we’re walking to the _________!” I repeat each verse as often as necessary, until we reach our destination. For higher functioning students, we practice our listening skills. I play a modified version of the “Simon Says” game while walking to and from various places in our school. All commands are to be followed, not just the ones prefaced by “Simon says”. For example: I’ll say: “Simon says run, run, run.” After a short sprint, I hold up a toy stop sign and say “Stop!” The students follow the command. I continue with various commands such as, “Simon says…” (baby steps, hop, giant steps, crawl)”. The game continues until the class reaches its destination.
6. What do I do when the student tantrums? (i.e. throwing oneself on the floor, screaming and kicking, etc.).
There are many reasons for tantrums. An individual might tantrum when: Avoiding a non–preferred activity; feeling confused and/or failing to understand what is happening; a change in schedule or routine occurs; in need of attention; a need or want is not met; or something in the environment is irritating him/her.
a. Create an ABC chart and conduct an assessment of the behavioral incident(s). More information on this procedure can be found at www.behavioradvisor.com inside the link titled “Figuring out why kids misbehave”.
b. Once you have determined the antecedent of the behavior, there are several ways to handle the tantrumming behavior.
Strategy 1: Adapt your instructional style.
Strategy 2: Conduct a reinforcement survey; use a choice between non-preferred and target activities; allow a child to earn the opportunity to engage in self-stimulatory behavior; use a “First-Then” chart or picture schedule; use PECS (Picture Exchange Communication System).
Strategy 5: Use songs, picture schedules or timers to allow for smooth transitions.
Strategy 7: Be consistent with DRO (Differential Reinforcement of Other behaviors). More information can be found on this BehaviorAdvisor.com site inside the page titled “Differential Reinforcement”.
7. What about other undesirable behaviors (i.e. singing, spitting, screaming, hitting, kicking, throwing, etc.).
a. Make use of DRO (Differential Reinforcement of Other behaviors). For more information on DRO go to: http://www.behavioradvisor.com/DRO.html . When using DRO, you ignore the undesired behavior while reinforcing the child when s/he withholds the undesired behavior for a designated period of time. The technique is positive in nature because it focuses on rewarding the child when s/he withholds the undesired behavior. There are typically no negative consequences involved with this strategy.
- It is very important when using this technique to be consistent. Often times, teachers do not realize that paying attention to the undesired behavior can reinforce it. It is imperative to follow through with planned ignoring consistently, and to reinforce only when the undesired behavior is withheld for the designated period of time.
Cynthia Moy is a special education teacher in the New York City Board of Education. This paper was written while she was a student in the Graduate Program in the Behavior Disorders Program in the Department of Special Education at
Thanks Cynthia!
Source: www.BehaviorAdvisor.com |
