Intro to ASD for Individuals with More Complex Needs

Jen Quaranta Author

04/06/2020 Added

16 Plays

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2020 ASD Network Conference Session

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[00:00:01.780]All right, I think I see a thing flashing
[00:00:03.590]that it's recording.
[00:00:04.690]All right, so welcome, guys, to our conference via Zoom,
[00:00:09.620]and I'm so excited that you guys are here.
[00:00:12.020]Our session today is an Introduction to Autism
[00:00:15.150]for Individuals with More Complex Needs
[00:00:16.800]Who Have Limited Verbal Skills.
[00:00:18.470]So, it's a very long title,
[00:00:20.300]and what it really means is that we're gonna focus
[00:00:23.770]on those students who have the more typical
[00:00:26.440]or classic autism.
[00:00:30.200]So, we'll get started on that.
[00:00:33.600]Our objectives today is that you'll have an understanding
[00:00:36.680]of the difference between an educational verification
[00:00:39.100]and a medical diagnosis for autism.
[00:00:41.320]I encounter that a lot in schools,
[00:00:43.550]where people might have gotten a medical diagnosis
[00:00:46.680]and then they're not understanding why their child
[00:00:48.390]doesn't receive supports in the school system,
[00:00:51.130]but sometimes we also get a student
[00:00:52.700]who gets that educational verification first
[00:00:55.420]and, because of that, they go back to the doctor
[00:00:57.920]and then work towards that medical diagnosis.
[00:01:00.800]So, it doesn't have to happen one before the other,
[00:01:04.010]and just because you receive one
[00:01:06.120]doesn't mean that you will have the other.
[00:01:10.350]Another thing that we'll be able to do is identify
[00:01:12.390]at least one way to support the needs
[00:01:14.070]of a student with autism,
[00:01:15.300]and hopefully I'll give you several different strategies
[00:01:17.350]throughout the day that you'll know
[00:01:19.730]that we really want you to use all of them,
[00:01:21.470]but if you can't do all of them
[00:01:23.060]that you're at least doing some of that with your students.
[00:01:25.900]Sometimes you just need a spot to get started with,
[00:01:28.610]and so these are some ideas to help get you started.
[00:01:31.750]And that you'll be able to identify some resources
[00:01:34.560]to learn more.
[00:01:35.530]It's only a real quick introduction.
[00:01:37.620]We do workshops that are entire day long
[00:01:40.280]to discuss some of the things
[00:01:41.410]that we are just doing a quick intro to here.
[00:01:45.510]One thing that I forgot to do was introduce myself, right?
[00:01:47.790]I just said, "Hey, thanks for joining us,"
[00:01:50.260]so I'll go back and do that.
[00:01:51.480]I'm not great at remembering to do all those things, right?
[00:01:53.970]So, my name's Jen Quaranta.
[00:01:56.140]I serve as the regional coordinator
[00:01:58.270]for the Southeast region of the ASD network,
[00:02:00.330]so that's the bottom corner,
[00:02:02.470]and I am only in the second year in this role,
[00:02:06.640]but I absolutely love what I get to do
[00:02:09.040]and working closely with teachers and families and students.
[00:02:12.810]My educational journey or my first experiences
[00:02:15.840]working with individuals with autism go back to high school.
[00:02:19.000]I worked at a disability camp.
[00:02:20.930]I ended up being there for 10 years,
[00:02:22.530]and I started there just in high school as a lifeguard
[00:02:26.700]and didn't realize that I was gonna actually be working
[00:02:29.030]13-hour days for the whole summer.
[00:02:31.370]They only had lifeguard as this much of my job description,
[00:02:33.760]and I did all the other things as well.
[00:02:35.540]So, that's when I first encountered
[00:02:36.730]an individual with autism,
[00:02:38.640]and I don't know that I even realized at the time
[00:02:41.230]what autism was.
[00:02:44.010]The prevalence rate was well under the...
[00:02:47.820]One in 150 is when I started my teaching career,
[00:02:50.290]and I didn't even start teaching for quite a number of years
[00:02:52.910]so I don't even know what the prevalence rate was.
[00:02:55.340]What I do know was that the students
[00:02:57.230]that we are talking about today
[00:02:59.200]used to have education verifications
[00:03:01.260]of emotionally disturbed,
[00:03:03.000]and I remember being at an IEP meeting with a family
[00:03:06.040]when they first started talking about moving it to autism.
[00:03:09.460]My first teaching experience, I worked in Arizona
[00:03:12.890]in a self-contained room for kids with autism
[00:03:15.310]who would be very much like the learners
[00:03:17.250]that we're gonna talk about today.
[00:03:19.340]They were learners who, because of their needs,
[00:03:22.800]it was determined that the least restrictive
[00:03:24.660]environment for them was not in a general education class.
[00:03:28.120]And, in fact, every one of my students attended my program
[00:03:33.290]and only one of them it was their home school.
[00:03:36.300]They were bused to a specialized program in my school.
[00:03:40.870]It was a great opportunity
[00:03:42.210]in the fact that I got a lot of wonderful supports,
[00:03:45.270]a lot of professional development related to autism
[00:03:48.030]because I had a specialized program,
[00:03:49.610]but there were a lot of downsides to it, too.
[00:03:52.050]My students didn't have opportunities
[00:03:53.950]to really interact with their peers and things like that.
[00:03:56.313]I worked really hard during the years that I was there
[00:03:58.390]to change the model,
[00:03:59.630]and I got kids fully integrated by educating staff
[00:04:03.110]and parents and things like that.
[00:04:05.420]So, anyway, it is a passion,
[00:04:07.760]working with this group of individuals.
[00:04:11.850]Again, the just real quick summaries
[00:04:14.300]is that we are going to be talking
[00:04:15.930]about people with autism.
[00:04:17.120]We're gonna be talking in person first.
[00:04:19.790]We wanna remember that these individuals are not defined
[00:04:23.010]by the fact that they have autism.
[00:04:24.920]Autism is a part of who they are.
[00:04:27.350]It's important to help us understand
[00:04:29.050]what some of their needs are,
[00:04:30.510]but we should never be looking at it first as,
[00:04:33.040]well, they have autism
[00:04:34.180]and then using the autism to explain away
[00:04:37.200]or excuse behaviors and things like that.
[00:04:41.010]It was so sad to be in a middle school setting
[00:04:43.882]and be introduced to a student,
[00:04:46.240]and his first words to me
[00:04:47.880]after he said his name was, "And I have autism.
[00:04:49.897]"You know what that means, right?"
[00:04:51.410]And every time I would talk to him about something,
[00:04:54.010]he always just said, "Well, I have autism,"
[00:04:56.420]and so he very much had become defined by the diagnosis
[00:05:01.380]and not as an individual.
[00:05:02.910]So, we always wanna remember,
[00:05:04.470]they're an individual first.
[00:05:07.090]We're also gonna talk about that early detection
[00:05:09.250]and intervention is super important.
[00:05:10.807]I know it says on here it's life-changing.
[00:05:12.870]It really it.
[00:05:13.850]The sooner we can get interventions into place
[00:05:16.100]for individuals with autism, the better the outcomes are,
[00:05:19.570]so it is important that we know what the characteristics are
[00:05:23.290]and that we are referring families
[00:05:26.070]to at least get this evaluated
[00:05:28.100]and something to be considered as early as we can.
[00:05:32.210]And we also want people to understand
[00:05:33.690]that autism is a lifelong disability.
[00:05:37.060]People can improve, we can have coping strategies,
[00:05:40.220]we can have supports that are gonna help them be successful,
[00:05:44.350]but it's not something that you outgrow,
[00:05:46.520]and at this point in time,
[00:05:47.880]it's not something we're even saying there's a cure for,
[00:05:50.140]even though there are celebrities out there
[00:05:52.370]who will tell you that there are.
[00:05:54.410]It's not true.
[00:05:55.243]We haven't found that to be the case,
[00:05:58.000]so be cautious when you're reading
[00:06:00.180]about things that are the cure now for autism
[00:06:03.460]or things like that.
[00:06:05.210]Like I said, we will find strategies
[00:06:07.450]and skills and things like supports
[00:06:10.030]that will help the individual be more successful,
[00:06:12.700]but we are not curing autism.
[00:06:16.200]All right, so here is where I had wanted the,
[00:06:18.800]to do one of those polls
[00:06:20.130]where you would just have to answer,
[00:06:21.470]but apparently I don't know how to do that right.
[00:06:23.340]If you guys just take a moment in your chat box
[00:06:26.270]so that I kinda understand who is in my audience today.
[00:06:29.290]I have some of the roles, not necessarily all of the roles
[00:06:33.140]that would be present in our audience today.
[00:06:36.680]So, just pull that out.
[00:06:40.980]So, the para, ECSC, oh, prenatal to age three, wow.
[00:06:46.881]AAC teacher, classroom service coordinator,
[00:06:51.550]paras, school psych, services coordinator.
[00:06:57.830]So, it looks like we have a nice mix of individuals in here.
[00:07:01.350]One of the other things that I would like to know
[00:07:03.430]is kind of what is your experience
[00:07:05.700]working with individuals with autism?
[00:07:08.800]Is this something that is a newer topic for you?
[00:07:11.970]Is this something that you feel pretty confident in
[00:07:14.040]but you just wanted to kinda get a refresher?
[00:07:16.040]If you guys have a moment to kinda tell me
[00:07:18.070]what drew you to this session,
[00:07:19.270]'cause there were a lot of really good competing ones.
[00:07:28.670]All right, someone who did say, "I'm new to this,"
[00:07:30.740]and that is just fine.
[00:07:34.390]Someone who's preparing for next year, that's great.
[00:07:39.660]Understanding strategies for challenging behaviors.
[00:07:41.760]So, I won't address necessarily how to address,
[00:07:45.170]deal with challenging behaviors once they've happened,
[00:07:48.200]but many of these strategies are actually
[00:07:50.720]what we call antecedent strategies.
[00:07:52.140]These are gonna help prevent
[00:07:53.490]some of those problem behaviors from occurring
[00:07:56.680]in the first place.
[00:07:57.750]Some are just here as a refresher, which is great.
[00:08:02.410]Working with somebody who's pretty young, a two-year old,
[00:08:04.950]and isn't verbal at all.
[00:08:07.320]Never had great training on autism.
[00:08:10.100]Yeah, I think that that is common, even in this day and age.
[00:08:15.020]It's been a little while since I was in college,
[00:08:17.310]but I am very excited about the campuses and things
[00:08:21.480]who have invited even some of us coordinators
[00:08:24.360]to come and speak about it,
[00:08:25.900]but oftentimes it's a one-hour guest lecturer
[00:08:28.680]who we get for this topic,
[00:08:30.170]and there's so many more things
[00:08:31.850]that we could learn along the way.
[00:08:35.910]Thanks for sharing that information with us, guys.
[00:08:39.100]My husband always asks,
[00:08:40.097]"Why are you going to another conference?"
[00:08:42.130]and it's always because there is something new to hear
[00:08:44.930]in a new way or to apply to a student
[00:08:47.520]in a way that I haven't thought about before.
[00:08:49.640]And so somebody had mentioned in there
[00:08:51.740]it's just been a while or I wanted a refresher
[00:08:53.770]and so that's great as well.
[00:08:56.130]Throughout, I know they said
[00:08:57.670]save your questions until the end,
[00:08:59.490]but that's just not how I am as a presenter in person,
[00:09:02.040]and it's hard not even having faces as we present,
[00:09:05.780]so if you do have a question along the way,
[00:09:07.980]go ahead and put it in
[00:09:09.010]and, if I'm able to,
[00:09:10.310]we'll go ahead and ask, answer that as we go, okay?
[00:09:14.620]All right, let's see.
[00:09:16.610]So, oh, that was supposed to come in later but that's okay.
[00:09:19.600]So, how common is autism?
[00:09:22.020]Like I said, when I first started my teaching career
[00:09:24.420]it was one in 155.
[00:09:27.620]So, that could, if you wanna go back and look that up,
[00:09:29.950]you can see how long that's been,
[00:09:31.600]but that is a very drastic change
[00:09:33.580]to go from one in 155 to one in 59.
[00:09:36.720]Now, this number here comes from a study.
[00:09:40.590]It was released by the CDC,
[00:09:42.780]but it comes from a very specialized study.
[00:09:45.160]They look at 16 sites across the United States
[00:09:49.030]to collect this data on a very consistent basis,
[00:09:52.270]and so they do look at that information
[00:09:54.640]and update it very regularly.
[00:09:56.700]But their, when they've looked at it
[00:09:58.630]and then when they've reported it
[00:09:59.890]is always in the rear, of of course, right?
[00:10:01.560]It's not like the current, it's like, okay,
[00:10:04.220]this is looking at the data from two years ago
[00:10:06.190]now that we've had the time to compile it
[00:10:07.800]and share it with you.
[00:10:09.290]So, I have this slide completely ready to go.
[00:10:12.808]One in 59
[00:10:15.060]is what the rate of autism was,
[00:10:18.300]and that comes from that ADDM study
[00:10:23.060]and then put out by the CDC.
[00:10:25.850]But here is the information you may have missed last week.
[00:10:30.470]The CDC, just last week, updated it to one in 54 children
[00:10:35.890]who has a diagnosis of autism.
[00:10:39.660]I saw very little about this being talked about in the news
[00:10:43.460]because there were just some other topics
[00:10:44.980]that were going on.
[00:10:46.150]So, if you see in just a two-year period,
[00:10:48.190]we went from one in 59 to one in 54,
[00:10:51.600]so that number just keeps getting smaller
[00:10:53.870]and smaller and smaller and smaller.
[00:10:55.950]And so what does this mean?
[00:10:57.170]Well, if one in 54 children have autism,
[00:11:01.640]then pretty much every district
[00:11:04.670]will have at least one student who has autism.
[00:11:07.370]Even in my smallest schools that I'm supporting,
[00:11:10.290]there is a child there with autism.
[00:11:12.850]Now, when I first started my career,
[00:11:14.260]to even say the word autism, people didn't understand it.
[00:11:16.920]They didn't know about it.
[00:11:18.030]They would think I was say artistic
[00:11:20.010]and I was like, "No, that's not what I'm saying."
[00:11:22.760]But now pretty much most people who you've met
[00:11:25.950]know some person who has autism,
[00:11:29.810]whether that's a family member, a neighbor, or somebody.
[00:11:33.520]But most educators are going to be
[00:11:35.920]working with a student who has autism,
[00:11:37.740]so, again, for us to advocate
[00:11:39.940]that we need more training in this.
[00:11:42.890]This study, also, it was only looking at eight-year olds,
[00:11:45.750]so that is plenty of time to
[00:11:49.940]have a student with the classic needs kinda be presented,
[00:11:54.030]but it's still not uncommon
[00:11:56.010]for kids to be much older than eight years old
[00:11:57.940]before they receive that first diagnosis of autism.
[00:12:01.060]Sometimes it'll be other disabilities
[00:12:03.810]that are explored first and maybe a different diagnosis,
[00:12:07.810]and then as more pieces of the puzzle are put together,
[00:12:11.400]it leads to a different diagnosis for a student,
[00:12:14.830]which might be autism.
[00:12:17.120]So, I usually don't love reading off of quotes
[00:12:20.830]that are already on the screen for you,
[00:12:22.270]but this is one that is important.
[00:12:24.620]So, it says there is often nothing
[00:12:27.930]about how people with autism look
[00:12:31.070]that sets them apart from other people,
[00:12:33.370]but people with autism may communicate, interact, behave,
[00:12:37.830]and learn in ways that are different from most other people.
[00:12:40.940]And this came from the CDC,
[00:12:43.620]and I do think that that's super important
[00:12:45.640]for us to remember.
[00:12:48.420]Some other disabilities, it's pretty obvious at birth
[00:12:52.160]or pretty early on because there are characteristics
[00:12:55.890]and features that may lead us to understand that,
[00:12:59.330]such as a child who has Down's syndrome.
[00:13:01.360]There's definitely facial characteristics
[00:13:03.490]that set that student apart from others, right?
[00:13:07.640]But for autism, there's not really a facial characteristic
[00:13:11.840]or anything like that that you would look at the individual
[00:13:14.490]and say, "Wow, it looks like they have autism."
[00:13:16.970]And that can also be difficult then because
[00:13:23.900]people will make statements such as,
[00:13:25.317]"Well, he doesn't look autistic," right?
[00:13:27.630]And it's like, well, there is no such thing.
[00:13:30.190]Then the last part of that quote is
[00:13:32.600]that the thing that does set a child with autism apart
[00:13:35.920]or an individual with autism apart
[00:13:37.680]is the way they communicate, interact, behave, and learn.
[00:13:43.210]And it's not that any of those way are wrong,
[00:13:45.520]it's that it's different.
[00:13:46.880]And that's what I appreciate
[00:13:48.040]about this quote from the CDC, too,
[00:13:50.200]is that it's, we just have to remember
[00:13:53.210]that they learn different ways,
[00:13:55.330]they communicate differently,
[00:13:57.130]and we have to understand what those different ways are
[00:14:00.300]so that we can better support the individual.
[00:14:07.990]When we speak about autism,
[00:14:09.610]we talk about it being a spectrum disorder,
[00:14:12.230]and what that really means
[00:14:13.470]is that the way it impacts one individual
[00:14:15.410]is gonna be different than the way
[00:14:16.690]that it impacts other individuals,
[00:14:18.690]even though they have the same diagnosis, okay?
[00:14:22.550]And then there's the quote that we hear and say often,
[00:14:25.100]if you've met one person with autism,
[00:14:26.780]you've met one person with autism.
[00:14:28.920]And I say that that is so true.
[00:14:31.400]I've worked with hundreds of individuals
[00:14:33.440]over the years who have autism,
[00:14:35.447]and there are no two who are the same.
[00:14:37.470]I've even worked with twins and they are so different.
[00:14:40.930]And so we have to take what we know about autism
[00:14:45.350]and then apply it to that particular individual.
[00:14:48.850]So, I'll go through just a little bit of this quickly
[00:14:51.890]'cause we'll go more in depth
[00:14:53.090]into each of those characteristics
[00:14:56.850]later in the presentation.
[00:14:58.920]So, the first one is about social interaction,
[00:15:01.350]and there is definitely a misnomer
[00:15:03.600]that individuals with autism don't want to be social.
[00:15:06.710]And what we actually know is that they do want to be social
[00:15:10.660]but many times they have failed
[00:15:13.460]and they haven't been successful with being social
[00:15:16.560]and so there's kind of a learned helplessness
[00:15:18.750]that comes with it,
[00:15:20.420]that if I put myself out there and I've tried to be social
[00:15:23.320]and I didn't do it correctly and I failed,
[00:15:25.460]then why would I want to try it again
[00:15:27.340]because I'm just gonna fail again, right?
[00:15:29.860]And sometimes it's that they're not
[00:15:31.100]applying the skills correctly,
[00:15:32.400]they're not reading the cues that are going on
[00:15:34.310]in the environment and things like that.
[00:15:37.130]So, sometimes people will describe individuals with autism
[00:15:42.580]as being in their own world,
[00:15:44.260]and that can happen from time to time
[00:15:46.220]that the individual is really into,
[00:15:48.510]let's say, a movie character or something like that
[00:15:51.040]and they get trapped into the world
[00:15:52.380]of imagining and playing that
[00:15:54.140]and then they seem like they don't understand
[00:15:56.490]that other things are happening
[00:15:57.660]outside of that little world,
[00:15:59.530]and so that can happen,
[00:16:01.890]but they are still aware
[00:16:02.920]that others are in their environment,
[00:16:04.270]that mom and dad are there,
[00:16:05.320]that the teachers who they like are there
[00:16:08.090]and things like that.
[00:16:09.480]And then we have our individuals
[00:16:10.610]who are active but unsuccessful,
[00:16:12.150]and those are the ones who are putting themselves out there
[00:16:14.350]and it's just not working well for them, right?
[00:16:18.270]They're not applying the strategies correctly.
[00:16:21.320]Now, communication, as we're talking about our students here
[00:16:23.980]we said who are mostly non-verbal,
[00:16:26.300]that is the population that most of this information
[00:16:29.110]is going to be applying to today.
[00:16:31.530]But what we want to understand, too,
[00:16:33.100]is that non-verbal doesn't mean
[00:16:34.440]that they don't have anything to say.
[00:16:36.750]Or, actually, it should probably just say non-vocal
[00:16:39.530]because there are other ways of communication
[00:16:42.980]besides vocal language.
[00:16:49.187]Oftentimes we are talking about students
[00:16:50.876]who have very limited communication.
[00:16:53.275]They may not even have sign or AAC use
[00:16:56.325]or things like that quite yet,
[00:16:58.428]and a lot of time is spent developing communication
[00:17:02.268]for those individuals.
[00:17:03.976]And then we have the session from yesterday
[00:17:06.067]where we were talking about students who have higher skills
[00:17:09.990]who have a lot of verbal output
[00:17:13.750]but it's inept.
[00:17:14.700]So, they're missing things like idioms
[00:17:16.810]and figurative language and things like that.
[00:17:21.550]The next one is restricted,
[00:17:22.510]repetitive behaviors and interests.
[00:17:24.800]And so for individuals who
[00:17:29.180]have more of an impact of their autism,
[00:17:31.480]you may see things like the hand-flapping
[00:17:33.270]that's happening for that individual.
[00:17:36.470]You may see
[00:17:38.810]spinning or using items in a way
[00:17:41.480]that you wouldn't think is appropriate way,
[00:17:46.160]so like a student who likes cars
[00:17:48.720]but not because they like to roll the car down the ramp
[00:17:52.410]and things that the other kids do.
[00:17:53.620]It's because they wanna sit and spin
[00:17:55.220]and play with the wheels, right?
[00:17:56.840]So, that is definitely a repetitive behavior for them.
[00:18:01.520]There's a very interesting webinar
[00:18:03.160]that we have on the ASD Network website
[00:18:06.690]that is about these restricted, repetitive behaviors,
[00:18:09.560]but it is in terms of autism in girls
[00:18:12.860]and why oftentimes girls are not diagnosed
[00:18:16.560]at the same rate as boys,
[00:18:18.060]and it's because some of these things
[00:18:19.970]like the restricted interests seem age appropriate.
[00:18:23.300]So, it's okay for girls to like ponies
[00:18:26.270]and, I'm trying to think, Disney characters, right,
[00:18:30.500]all those princesses and things like that,
[00:18:32.530]but it is to the intensity in which those interests
[00:18:38.020]become all they do.
[00:18:39.340]So, everything revolves around horses and princesses,
[00:18:42.870]and if you try to talk about something else,
[00:18:45.210]they can bring that subject right back
[00:18:47.670]to horses and princesses.
[00:18:49.690]So, if you have some time in the next couple of weeks,
[00:18:53.180]I highly suggest getting onto the ASD Network
[00:18:56.200]webinars that are archived
[00:18:57.560]and look for the one about autism in girls
[00:19:00.130]because it'll talk about some of the reasons why
[00:19:03.040]we miss that diagnosis in girls.
[00:19:06.120]And then I think we just had a really wonderful session
[00:19:09.300]that talked a little bit also about sensory experiences
[00:19:12.010]so I don't wanna go too far in depth into that right now,
[00:19:15.730]but we do have individuals who are highly, highly sensitive
[00:19:18.980]to things that are going on in the environment,
[00:19:21.530]whether that is the temperature in the classroom,
[00:19:26.340]the noises that are going on outside of the classroom,
[00:19:29.930]or for, for myself, I'm not an individual who has autism
[00:19:35.310]but I can tell you that fragrances are the thing
[00:19:38.320]that I am super highly sensitive to.
[00:19:40.650]Somebody can walk into the room and I'm gonna be like,
[00:19:42.657]"What is that and get outta here."
[00:19:44.130]My kids are not allowed to put hand sanitizer on around me
[00:19:47.290]because it will just get me worked up.
[00:19:50.500]And so when I had that classroom for students
[00:19:53.860]that was the self-contained room for students with autism,
[00:19:56.720]it said, 'cause we had the sub du jour, you know?
[00:19:59.680]We could never keep everybody there
[00:20:01.640]and we always had whoever was available
[00:20:03.230]for the substitute para for the day,
[00:20:06.190]and in the notes that went out
[00:20:08.430]about working in that classroom,
[00:20:09.740]it said no fragrances must, can be worn.
[00:20:12.670]And everybody assumed it was about my students,
[00:20:14.587]and it really was just about myself.
[00:20:16.990]But being sensitive to understanding that that might be
[00:20:19.810]where some of those behaviors could be coming from
[00:20:24.050]is the fact that there is something in the environment
[00:20:27.900]that the student is responding to,
[00:20:29.640]the flickering light of those fluorescent light bulbs
[00:20:33.690]and things like that.
[00:20:36.230]There was something else I wanted to say about this slide,
[00:20:38.420]and I am not remembering 'cause I went off on my tangent
[00:20:41.530]about those high sensitivity to sensory experiences.
[00:20:45.600]Sorry, guys.
[00:20:46.433]I think, too, when you work in the field long enough,
[00:20:49.570]you start to see it and experience some of that
[00:20:51.901]and start to have some empathy for what's going on
[00:20:54.830]and sometimes seeing things that other people miss
[00:20:58.240]that are going on in the environment for them.
[00:21:00.490]So, if I think about it,
[00:21:01.970]I'll come back and tell you what that other thing was
[00:21:03.720]on this slide.
[00:21:07.202]So, some myths about autism.
[00:21:09.680]Autism is not a mental illness.
[00:21:11.490]So, as I said in the beginning
[00:21:13.670]is that many of these students
[00:21:16.520]were diagnosed with other disabilities in the past,
[00:21:19.200]and so when we do talk about the rates of autism changing,
[00:21:22.670]some of that could be because
[00:21:25.620]an individual might have been diagnosed
[00:21:27.570]with only one disability previously,
[00:21:30.180]and that might have been considered
[00:21:32.250]that emotional disturbance
[00:21:33.410]which was a mental illness, right?
[00:21:37.125]It is not just unruly kids who are choosing to misbehave.
[00:21:40.710]It's not because they want to be naughty kids.
[00:21:44.900]They don't sit there at night and say,
[00:21:46.567]"Hmm, I wonder how I can make that teacher mad tomorrow.
[00:21:50.857]"I know, when she presents me with a task,
[00:21:53.727]"I'm just gonna throw it and see what she does," right?
[00:21:56.260]It's not them choosing to misbehave.
[00:21:58.120]There's something else in the environment
[00:21:59.460]that is causing that student to do that,
[00:22:01.130]so we need to look at what's going on in the environment
[00:22:04.750]and what we can do to shape and change that.
[00:22:08.710]It's absolutely not caused by poor parenting,
[00:22:11.620]and I remember being in high school
[00:22:13.540]and learning about autism
[00:22:15.510]just as I was starting that role
[00:22:16.930]working at the disability camp,
[00:22:18.560]and they talked about how people thought
[00:22:20.730]of refrigerator moms.
[00:22:23.220]And last year when I presented that at the conference,
[00:22:25.680]it showed my age because a lot of people said
[00:22:28.020]they had not heard of that phrase refrigerator moms.
[00:22:31.290]But it was not that long ago that individuals thought,
[00:22:35.120]and even professionals, doctors, well-meaning people
[00:22:39.350]felt that autism was because of something in the environment
[00:22:43.010]that the mother had done,
[00:22:44.300]that the mother was really cold
[00:22:45.920]and not giving enough love and affection to their child.
[00:22:48.380]That was causing their child to withdraw and retreat,
[00:22:50.990]and it was the mom causing the autism.
[00:22:53.780]And so then, the best advice that they were giving
[00:22:58.410]was for parents to just
[00:22:59.950]institutionalize their children, right?
[00:23:02.220]So, thankfully, we have found so many more things.
[00:23:06.150]We've discovered that this is not due to parenting style.
[00:23:09.600]Kids with autism can learn and should be in schools,
[00:23:13.500]but sadly, it's only a short time
[00:23:15.990]that we've been doing this.
[00:23:17.350]30 years, right?
[00:23:18.320]That's a short time to me.
[00:23:21.160]Autism is not always associated with mental impairment.
[00:23:24.540]One of the things that was in that study
[00:23:27.100]that I referenced just a moment ago
[00:23:28.880]about that rate and prevalence
[00:23:30.700]was actually that about 30% of individuals with autism
[00:23:34.210]do have some sort of a mental or a cognitive impairment,
[00:23:38.970]but we have many who have average to above-average IQs,
[00:23:43.687]and so we can't assume that because a child
[00:23:47.130]received that diagnosis of autism
[00:23:51.060]that they would have a mental impairment, right?
[00:23:55.160]And unfortunately, when our students have less language,
[00:23:59.550]we, as a society,
[00:24:02.370]then assume a mental,
[00:24:06.330]what their mental capability is, right?
[00:24:08.690]So, "Oh, they're non-verbal.
[00:24:10.217]"They must be mentally impaired as well,"
[00:24:13.710]and those two do not go together.
[00:24:15.970]We have many people who are non-verbal
[00:24:19.780]and they are very, very bright,
[00:24:21.930]so we need to make sure
[00:24:23.010]that we are dispelling that myth for people
[00:24:25.350]and not underestimating what our students can do.
[00:24:30.910]Many times, autism is associated or people put together
[00:24:36.310]the fact that there might be behavioral challenges,
[00:24:39.080]but that is not one of the diagnostic criteria, right?
[00:24:43.360]So, I sometimes hear this spun the other way.
[00:24:46.470]When a child is having difficulties with behavior,
[00:24:49.300]I'm told, "Well, he has autism,
[00:24:50.973]"and kids with autism have behavioral challenges,"
[00:24:53.820]or they have behavior problems,
[00:24:55.570]and those are not...
[00:24:58.120]That's not one of the criteria to be diagnosed with autism
[00:25:01.270]is that you need to have behavioral challenges.
[00:25:03.540]Behavioral challenges happen because
[00:25:05.910]we don't have all the right supports in place yet, right?
[00:25:08.970]So, I wanna make sure that we are not ever excusing behavior
[00:25:12.230]just because the child has autism.
[00:25:14.450]We'll find the reasons why those behaviors are happening,
[00:25:16.850]and we'll address those things
[00:25:18.010]to help the student learn a new skill or things like that.
[00:25:22.750]And then the other one is that autism is not diagnosed
[00:25:27.160]by a single medical test or a brief observation.
[00:25:30.180]So, there is currently no way to just
[00:25:34.305]take a quick sample of the blood
[00:25:35.670]and say, "Yep, you have autism," or not.
[00:25:37.920]Now, there are some forms
[00:25:40.730]where now they're starting to find some genetic links,
[00:25:43.100]and so there are people who I have worked with
[00:25:45.800]who they've found through chromosome analysis
[00:25:50.440]and things like that that they have a form of autism
[00:25:52.890]or they have characteristics similar to autism,
[00:25:55.920]but they're not saying flat-out, "Oh yes.
[00:25:58.537]"We can test for autism in a standard way," quite yet.
[00:26:03.180]And it's definitely not a brief observation.
[00:26:05.190]It's difficult if a family thinks
[00:26:07.430]that they're gonna just go to the doctor,
[00:26:09.120]the doctor's gonna look at them,
[00:26:10.210]have a 30-minute appointment,
[00:26:11.330]and then say, "Yep, this is autism."
[00:26:13.280]There's gonna be questionnaires that are a part of it.
[00:26:15.770]There should be some observations to see
[00:26:17.830]how that behavior is being impacted in the environment
[00:26:22.010]and things like that for the individual.
[00:26:26.427]All right, so we'll talk just a little bit now.
[00:26:28.500]This was one of those objectives
[00:26:29.700]is to be able to understand the difference
[00:26:30.950]between an education verification and a medical diagnosis.
[00:26:36.960]So, I did talk about that need
[00:26:38.600]to get early intervention in place for an individual.
[00:26:41.970]The better outcomes are when we get
[00:26:45.810]earlier diagnoses for individuals.
[00:26:48.160]So, according to that same report
[00:26:49.940]that is released by the CDC,
[00:26:52.360]of the children identified with autism,
[00:26:55.050]so remember they had the one in,
[00:26:57.420]well, now it's one in 54 but one in 59 before.
[00:27:03.590]It says of those children identified with autism,
[00:27:06.190]about 85% had concerns by the age of three
[00:27:11.230]but only 42% of those actually had
[00:27:15.020]any type of comprehensive developmental evaluation
[00:27:18.310]by the age of three.
[00:27:19.670]So, that is really kind of disheartening
[00:27:23.080]to know that families and educators and others
[00:27:27.190]had concerns about the kid,
[00:27:29.140]they said, "Yeah, something just isn't
[00:27:30.787]"quite going right here, we're worried about it,"
[00:27:34.050]but then of those people who had concerns
[00:27:37.010]only 42% actually were evaluated.
[00:27:40.850]So, some of that can be limited resources.
[00:27:44.040]Sometimes there is
[00:27:47.040]a mismatch, too,
[00:27:47.970]where maybe the school is seeing something
[00:27:51.430]and they haven't shared the concerns yet with the parents
[00:27:55.020]or the parents have heard it
[00:27:56.880]but they're not ready to pursue it yet,
[00:27:59.300]and that does happen.
[00:28:01.440]That's important for us to understand and to recognize
[00:28:04.500]is that when a family's told,
[00:28:07.050]maybe by another family member or somebody who they know,
[00:28:10.537]"Hey, something just doesn't seem right.
[00:28:13.067]"I kinda wonder if your kid has autism,"
[00:28:15.760]or anything like that,
[00:28:17.870]there can be a little bit of a grieving process
[00:28:20.570]before they've even gotten any type of a diagnosis, right?
[00:28:23.580]So, the family might be thinking to themselves,
[00:28:26.837]"Huh, I wonder if this normal.
[00:28:29.137]"Oh, I don't remember the older sibling doing these things."
[00:28:32.300]So, they are already comparing in the environment
[00:28:35.190]their child to other children who they've observed,
[00:28:37.870]but it's not until they've heard it from somebody else
[00:28:41.340]that that becomes a reality, right?
[00:28:43.210]So, they've heard it
[00:28:44.380]or they've been thinking it, they've been thinking it,
[00:28:45.990]but they're like, "Nah, I'm just overreacting.
[00:28:47.987]"I don't really need to worry about that,"
[00:28:50.087]but the moment somebody else says it,
[00:28:52.340]then they're like, "Oh, you see it too," right?
[00:28:55.170]So, some people are ready to just jump right in
[00:28:57.480]and go in and get that evaluation done,
[00:29:00.510]and others are like, "Well, maybe they'll outgrow it,"
[00:29:04.670]and so then they wait.
[00:29:05.940]So, if you are somebody who supports
[00:29:09.730]in those very young ages
[00:29:10.990]and you are suspecting that there could be,
[00:29:13.850]I think it's important to start broaching the subject,
[00:29:15.910]to at least say, "Hey, here are some warning signs
[00:29:19.797]"that I'm seeing or things that I'm concerned about.
[00:29:22.617]"What do you think about it?"
[00:29:24.710]Sometimes we're afraid that parents aren't ready to hear it,
[00:29:28.680]but ready sometimes,
[00:29:29.580]sometimes it's not that they're not ready to hear it.
[00:29:31.330]It's that they're not ready to act on it yet,
[00:29:33.600]but the more times that they hear somebody else say,
[00:29:35.997]"Hey, I've got a little bit of a concern,"
[00:29:38.220]then they may be more ready to do that, right?
[00:29:41.490]So, anyway, that was all to say that
[00:29:45.610]if you think that there's a concern,
[00:29:47.570]we need to start pursuing what that concern is
[00:29:50.100]instead of waiting.
[00:29:51.180]Because like I said, it's a lifetime disability.
[00:29:53.910]It's not gonna go away.
[00:29:55.300]It's not going to get better, right?
[00:29:59.170]So, why is it important?
[00:30:02.460]When we can get those
[00:30:05.860]verifications early on,
[00:30:07.910]it means that we can get into intervention.
[00:30:10.430]And unfortunately, because there's so much need
[00:30:13.720]and so few opportunities for services and things like that,
[00:30:17.380]there are criteria for getting those services, right?
[00:30:20.270]And so you can't just say,
[00:30:23.427]"Oh, yeah, I want ABA therapy in my house," right?
[00:30:26.120]You have to have a need for that.
[00:30:27.750]So, if you don't get the verification,
[00:30:30.210]then you're not eligible for those services.
[00:30:32.420]So, we definitely want the verifications as soon as we can
[00:30:35.390]so that they would be able to access that.
[00:30:39.470]Now, one thing that's important for us to know, too,
[00:30:41.880]is this next one, active engagement in intensive instruction
[00:30:45.480]for at least 25 hours a week, 12 months per year, okay?
[00:30:50.420]So, there are some of you who said
[00:30:51.510]that you were in-home providers
[00:30:53.160]or early childhood and things like that.
[00:30:55.140]When you think about intensive instruction
[00:30:57.680]25 hours a week, 12 months out of the year,
[00:31:01.070]that's not what our preschool programs are
[00:31:02.950]and definitely not the birth to three programs,
[00:31:05.350]but the important part about this
[00:31:07.300]is not about us having to provide 25 hours a week.
[00:31:11.210]It's about helping families understand ways
[00:31:13.350]that they can engage their child at home, right?
[00:31:15.640]So, I'm not gonna be providing
[00:31:17.030]a verbal behavior session at home.
[00:31:19.320]I'm not following that kid home,
[00:31:20.850]but how have I taught parents about why I'm using
[00:31:23.800]verbal communication strategies at school
[00:31:26.320]and how can they do that at home?
[00:31:28.260]Finding toys that their child likes, holding them,
[00:31:31.290]waiting for the child to be able to request it
[00:31:33.590]before you give it to them
[00:31:35.380]rather than just anticipating their needs
[00:31:37.920]and giving it to them.
[00:31:39.110]It's much easier for us to anticipate their needs
[00:31:41.850]and give them what they want
[00:31:43.170]so that we don't have that behavioral problem happening,
[00:31:46.270]but what ends up happening is we're not teaching the child
[00:31:49.290]those critical skills of communicating and so
[00:31:55.150]we need to keep working
[00:31:56.370]on those critical skills for them, right?
[00:31:58.540]So, we wanna just make sure that we are
[00:32:00.630]helping families understand when it's bath time,
[00:32:02.680]what can you do,
[00:32:04.290]when it's time for a meal, what can you do,
[00:32:06.340]and things like that.
[00:32:10.860]Let's see, what else do we have?
[00:32:13.080]We want repeated, planned teaching opportunities
[00:32:15.430]with sufficient opportunities for them to practice it.
[00:32:19.310]So, what this means, too, is that we want skills
[00:32:21.910]that are gonna be important for that child.
[00:32:24.000]So, hand washing, super important skill, right?
[00:32:28.090]And so they can practice that several times a day.
[00:32:32.690]We're gonna look at what they need
[00:32:34.360]in that sequence of washing hands to be taught
[00:32:37.360]so that we can teach that skill towards them.
[00:32:40.910]And then systematically planned
[00:32:42.530]developmental appropriateness
[00:32:45.310]aimed towards identified goals.
[00:32:47.000]So, again that is what is my main goal?
[00:32:50.020]If I'm gonna do an activity with my child at home
[00:32:52.620]or in the classroom,
[00:32:54.040]what am I working towards?
[00:32:55.690]Is it just a time filler in my classroom or at my house,
[00:32:58.870]or is there something I can directly target
[00:33:01.700]related to communication at that time or things like that?
[00:33:04.687]And I'm gonna pause 'cause I do see one in the chat box.
[00:33:07.300]Let me take a moment to read that.
[00:33:09.930]Okay, so, as long as a student is identified early,
[00:33:12.920]say under the category of developmental delay,
[00:33:16.040]is that still early intervention,
[00:33:18.750]assuming we're provided services based on needs?
[00:33:21.480]Does the label of ASD have to be there?
[00:33:23.620]So, actually, Regina, we'll talk about that
[00:33:26.120]in just a little bit, too, when we're talking about services
[00:33:29.890]and eligibility and things like that.
[00:33:33.120]It is okay for a student to start getting those services
[00:33:35.390]under developmental delay.
[00:33:37.430]So, if I end up repeating that,
[00:33:38.990]just bear with me, guys, right?
[00:33:40.590]So, it's okay for a student to start services
[00:33:43.330]under developmental delay.
[00:33:44.460]Sometimes we don't know.
[00:33:46.530]Sometimes what looks like it could be autism
[00:33:50.500]is just the student hasn't been exposed
[00:33:52.830]to very structured things yet.
[00:33:54.400]They haven't had those same opportunities for learning
[00:33:58.770]and things like that.
[00:33:59.603]So, coming into a program and receiving some services
[00:34:02.340]based on the current needs that you're seeing
[00:34:04.440]might tweeze it all out to just say, "You know what?
[00:34:06.647]"It was just lack of exposure," right?
[00:34:08.990]But what we're talking about for that early intervention
[00:34:10.970]is those kids who we are like, "Ooh, boy,
[00:34:13.817]"does that kid look like a kid who has autism?"
[00:34:16.240]The one that you're spotting from across the room
[00:34:17.720]and you're like, "Oh, he is spinning everything.
[00:34:20.127]"Oh, he's doing this," right?
[00:34:21.700]And you have every red flag under the sun.
[00:34:24.330]If that is the kid that you are working with,
[00:34:26.710]then we really urge you to start having those conversations
[00:34:28.970]about autism versus just saying
[00:34:31.110]it's a developmental disability
[00:34:32.750]because we have seen parents who thought
[00:34:34.690]that it was just a little speech delay.
[00:34:36.760]That's all that that is, right?
[00:34:38.330]And then we start trying to have this conversation
[00:34:41.330]about it being something else entirely.
[00:34:44.370]So, if you're suspecting it,
[00:34:47.350]then at least we're starting
[00:34:48.230]to bring up those conversations.
[00:34:49.730]So, hopefully that answers that
[00:34:52.400]and then we'll talk about that just a little bit more.
[00:34:55.130]It might even be a repeat when we get to that slide.
[00:34:59.190]All right, so another quick thing
[00:35:01.080]about the difference between a medical diagnosis
[00:35:03.180]and an education verification.
[00:35:05.210]So, when we're looking at a medical diagnosis,
[00:35:07.790]it is coming from the medial field, right?
[00:35:09.920]It's given by a doctor or clinical psychologist.
[00:35:13.110]You go in for an appointment,
[00:35:14.830]they use diagnostic criteria to look at it,
[00:35:18.690]and they use criteria set up by the DSM-V,
[00:35:23.970]and that says an individual who has this characteristic,
[00:35:27.320]this is the disability.
[00:35:28.740]If this is the characteristic, it's this disability.
[00:35:31.180]So, they just try to tweeze out
[00:35:33.170]what you're reporting as a parent
[00:35:34.930]and what the medical field says that it could be, right?
[00:35:39.590]So, they use a very medical model
[00:35:42.070]where they come in an interview and do observations.
[00:35:44.370]They might have you use some scales,
[00:35:46.430]rating scales and things like that.
[00:35:48.940]An educational verification is a process
[00:35:51.870]where we're bringing together
[00:35:53.800]different professions and people.
[00:35:56.110]So, you might have an occupational therapist,
[00:35:58.280]you might have a speech language pathologist,
[00:36:00.650]you might have the classroom teacher
[00:36:03.210]all working together to determine
[00:36:05.010]if the student has a disability
[00:36:06.870]and plan for services that address those needs
[00:36:09.540]in a school setting, right?
[00:36:12.850]The identification will reflect the fact
[00:36:15.990]that it is multidisciplinary team,
[00:36:17.870]so we're gonna give you an overall view of
[00:36:20.580]this is what communication looks like,
[00:36:22.580]this is what maybe some of those self-help skills,
[00:36:25.660]occupational therapy kinds of things look like
[00:36:28.400]for the individual.
[00:36:29.473]It's very much an educational model for it.
[00:36:33.000]We'll go a little bit more into this in a moment.
[00:36:36.230]So, for our younger people,
[00:36:38.660]this is where that category of developmental delay comes in.
[00:36:42.380]So, when we are looking at a developmental delay,
[00:36:44.810]it's used for children who include those,
[00:36:49.220]including those who have autism, right?
[00:36:51.140]So, once we've decided that they are eligible,
[00:36:54.390]we would gather some more information to determine
[00:36:57.750]why that individual's receiving some services, right?
[00:37:03.600]It just means that there's a delay or some lag
[00:37:07.490]in comparison to the other development
[00:37:10.810]compared to peers of those same age, right?
[00:37:12.920]And so this one really looks at
[00:37:16.340]how they're progressing in their developmental milestones.
[00:37:20.660]The last one on here, too,
[00:37:21.700]although a diagnosis by a medical professional
[00:37:23.600]is not required to receive that,
[00:37:27.930]is not required for a child to be verified
[00:37:29.550]under the autism category and to receive services,
[00:37:32.960]if a medical diagnosis has been made,
[00:37:35.760]then that should be considered by the school team
[00:37:39.450]for eligibility for services as well.
[00:37:42.010]So, if the family has come in and said,
[00:37:44.737]"Hey, we have a diagnosis of autism,"
[00:37:47.200]then that is really helpful for the schools,
[00:37:49.560]but there are times that families don't wanna share
[00:37:51.810]that information yet.
[00:37:53.060]They haven't shared it with other people,
[00:37:56.950]and we've even seen students who
[00:38:02.090]the family hasn't shared it with them,
[00:38:03.390]and they're in middle school and high school yet
[00:38:05.160]and they don't know yet.
[00:38:06.870]They know that there is something
[00:38:08.090]about them that's different,
[00:38:08.980]but they don't know yet that it's autism.
[00:38:10.920]So, sometimes families don't wanna share yet
[00:38:13.530]because they're worried about what's going to happen
[00:38:16.150]if their child is known to have autism,
[00:38:18.750]so sometimes we just need to work with
[00:38:21.110]helping families understand
[00:38:22.160]that we are there to support them
[00:38:23.540]and that we're here to help them and that the,
[00:38:27.350]again, that diagnosis doesn't change what we do
[00:38:30.300]but it helps us to understand
[00:38:31.450]and program based on their needs a little bit better.
[00:38:36.720]For our school-aged children,
[00:38:39.230]we're gonna look at some other things as well,
[00:38:42.380]but based on saying that the child has autism,
[00:38:47.030]we then also need to show,
[00:38:48.990]and this is why this is in bold and underlined,
[00:38:51.110]the school team considers whether the child's disability
[00:38:54.140]has an adverse effect on their education.
[00:38:57.980]So, what that basically means
[00:38:59.910]is that a child could have autism.
[00:39:01.970]It could be medically diagnosed,
[00:39:03.690]it could be through a school educational verification.
[00:39:07.440]Schools don't diagnose, they educationally verify, okay?
[00:39:11.090]So, the school team can say, "Yeah, they have autism,"
[00:39:14.420]but they have to show how that autism
[00:39:17.530]is impacting the child's educational needs.
[00:39:20.530]And so if the student has autism
[00:39:23.110]but they're able to go to all the classes,
[00:39:25.290]they're understanding things
[00:39:27.470]and getting their grades are satisfactory,
[00:39:31.150]they don't have a lot of problems
[00:39:32.600]with their interactions with peers,
[00:39:34.140]the school may say,
[00:39:35.047]"Yeah, it's not impacting their education."
[00:39:37.970]I think that's pretty hard to say
[00:39:39.410]with this group of students who we've already said
[00:39:41.670]that they have limited communication,
[00:39:44.080]limited self-help skills and things like that,
[00:39:46.100]so most of the students who we are talking about
[00:39:48.780]for that more classic autism
[00:39:51.480]usually do qualify as a student
[00:39:54.710]with an educational verification in a school setting.
[00:39:57.120]It's more that group who has
[00:39:59.600]that average to above average IQ
[00:40:01.140]that sometimes you have to fight a little bit more
[00:40:02.970]to show that there is an educational impact for the child.
[00:40:07.440]So, does anybody have any questions about that,
[00:40:10.480]educational verification versus medical?
[00:40:12.730]Because I do see it come up quite a bit
[00:40:15.940]in meetings and things like that.
[00:40:18.490]I'll take a second in case anybody wanted
[00:40:20.070]to type something in the chat for that.
[00:40:33.890]Okay, I don't see one, so I'm gonna move on.
[00:40:36.520]This isn't really for me to help you understand Rule 51,
[00:40:39.850]but it's just to let you guys know,
[00:40:42.420]especially if this is a newer
[00:40:44.230]topic for you or things like that.
[00:40:45.710]Rule 51 is how we decide eligibility
[00:40:49.250]for special education services for our school-aged students,
[00:40:53.119]and it just looks at what is the qualification for autism.
[00:40:56.930]To qualify for autism, the child must have significant...
[00:41:01.420]Their disability impacts their verbal
[00:41:03.010]and non-verbal communication and social integration,
[00:41:05.760]it's generally evident before the age of three,
[00:41:08.450]it adversely affects their educational performance,
[00:41:12.280]and they may also have the things
[00:41:14.290]like the repetitive activities, stereotype movements,
[00:41:17.170]resistance to environmental changes,
[00:41:19.070]and daily routines, right?
[00:41:21.330]If it doesn't apply, if it's not, wait, sorry.
[00:41:24.440]Autism does not apply if a child's educational performance
[00:41:27.410]is adversely affected because of an emotional disturbance.
[00:41:30.660]So, that was important, too, right,
[00:41:33.480]is that if it's autism, this is the primary eligibility
[00:41:39.430]is then all those other things.
[00:41:41.690]All right, I'm gonna pause
[00:41:42.560]'cause I do see something's come up.
[00:41:44.490]Is there an age where you feel
[00:41:45.830]it's really too early to diagnose with autism?
[00:41:48.460]I've seen it as early as 18 months medically.
[00:41:51.060]Yeah, actually, there...
[00:41:54.960]They're always looking for ways
[00:41:56.430]to be able to diagnose it much sooner,
[00:41:59.020]and so the hope is that we are catching those individuals
[00:42:01.900]before the age of three
[00:42:02.800]because it says that it's generally evident
[00:42:05.010]by the age of three.
[00:42:06.950]So, they're working on that.
[00:42:08.540]I have seen, like you've said as well,
[00:42:10.860]as early as 18 months that they are able to diagnose it,
[00:42:16.110]but I do think that sometimes
[00:42:17.360]it is most appropriate in a school setting
[00:42:19.250]to just go with that developmental disability.
[00:42:22.240]I'll tell you from one of my own experiences
[00:42:24.790]and because I don't think it'll (laughs)
[00:42:26.990]is that I had a,
[00:42:29.150]I had a family member whose child was recently diagnosed,
[00:42:33.640]and I really, in my heart,
[00:42:35.460]don't know that that is the correct diagnosis.
[00:42:38.380]I do believe it's just a developmental disability
[00:42:40.640]and once the child is in a school setting,
[00:42:43.610]with structure, routine, and things like that,
[00:42:45.650]many of the problems will be,
[00:42:48.020]will not be as evident for them.
[00:42:51.170]And, in fact, the family has a medical diagnosis,
[00:42:54.820]and the school said, "You know what?
[00:42:56.237]"But we're just gonna hold off a little bit.
[00:42:57.657]"We'll just keep serving it under DD.
[00:42:59.717]"We wanna see how things pan out once they get to school."
[00:43:06.280]That's why, too,
[00:43:07.113]sometimes you can have that medical diagnosis
[00:43:09.210]and if it's not impacting their education,
[00:43:10.770]the child won't get an educational verification.
[00:43:13.200]So, I've had to try to work with the family to say,
[00:43:14.757]"Yes, but in the school setting do you see
[00:43:16.747]"they're able to follow classroom routines,
[00:43:18.367]"they're able to do all these other things."
[00:43:22.150]Okay, so what would a educational assessment look like?
[00:43:27.520]So, we talked a little bit about the medical one,
[00:43:29.470]you're gonna go in and do that,
[00:43:30.740]but the educational ones,
[00:43:32.730]they might ask a little bit about some health history.
[00:43:35.240]Again, we wanna rule out that this disability
[00:43:38.360]isn't a result of something else,
[00:43:39.830]or the suspected disability, right?
[00:43:41.660]So, I've had students who,
[00:43:44.010]when we started to do this comprehensive
[00:43:45.760]evaluation about their health history,
[00:43:47.550]we ended up finding out something like,
[00:43:49.790]oh, well, when he was little,
[00:43:52.460]he fell and then three months later
[00:43:55.210]the garage door fell on him and he hit is head
[00:43:57.990]and so we were like, "Oh, this might not be autism.
[00:44:01.247]"This might actually be a traumatic brain injury," right?
[00:44:04.120]So, as much as it might seem like,
[00:44:06.760]wow, they're trying to get really personal
[00:44:08.200]and know about this health history of my kid,
[00:44:10.800]it's really just so that we can make sure
[00:44:12.560]that we're making the most informed decision
[00:44:14.260]about what could be impacting the individual.
[00:44:17.160]We also wanna rule out things like hearing and vision
[00:44:20.330]for the individual.
[00:44:23.370]I have seen times where
[00:44:25.630]an individual was diagnosed with autism,
[00:44:28.380]and when they did just a little further investigation,
[00:44:31.050]they found out that nobody had checked out their hearing
[00:44:35.240]and so the people weren't attuning
[00:44:36.610]to things in the environment because they couldn't hear,
[00:44:39.420]but it also made it look like autism, right,
[00:44:41.440]because they were not...
[00:44:43.990]Maybe because their hearing was impacted,
[00:44:45.620]they were doing some of the back and forth movements
[00:44:48.000]and rocking and things like that too, right?
[00:44:50.190]So, we have to understand the health history a little bit.
[00:44:53.860]There might be some cognitive evaluations,
[00:44:57.220]just to figure out if there's a cognitive disability
[00:45:00.450]at all for the individual.
[00:45:02.700]A great comprehensive educational assessment
[00:45:05.010]will also look at language.
[00:45:07.600]We're gonna look at a couple different things for language.
[00:45:10.130]We're gonna look at the expressive language,
[00:45:12.080]so what the student is able to say,
[00:45:15.610]whether that's vocally or through picture exchange
[00:45:18.600]or some other way,
[00:45:20.000]but we're also gonna look at how well
[00:45:21.600]they can understand language
[00:45:23.400]and then if there's any difference
[00:45:24.560]between those two skills for them,
[00:45:26.350]and then the pragmatics is just the stuff like
[00:45:29.240]using their nouns and tenses and things like that, right?
[00:45:35.030]We're also gonna look at how they're doing
[00:45:37.190]in performing educationally and making academic achievement.
[00:45:41.180]Remember, we talked about there has to be
[00:45:42.450]an educational impact,
[00:45:44.020]so we can't decide that if we don't go back
[00:45:46.390]and look at that history of the student.
[00:45:48.870]The adaptive behaviors,
[00:45:49.910]looking at things like self-help skills.
[00:45:52.100]Do they need assistance with toileting, washing hands,
[00:45:55.500]feeding themselves, grooming?
[00:45:57.570]And it's super important that we as educators
[00:46:00.720]don't make assumption about that.
[00:46:02.600]Just because the child comes to school very well prepared
[00:46:06.890]and nice clothes, hair's done very well,
[00:46:10.450]doesn't mean that their parents
[00:46:11.970]aren't struggling with that at home, right?
[00:46:13.860]And so I've even had those individuals
[00:46:15.760]who we say are on the higher end of the autism spectrum,
[00:46:19.600]and those adaptive behaviors are only there
[00:46:21.680]because they are being prompted by family members
[00:46:24.680]to do those steps all the time.
[00:46:27.950]And then many educational assessments will look at sensory.
[00:46:31.560]Not all, right?
[00:46:34.103]But many will look at those kinda things.
[00:46:36.690]I just wanted you to be familiar
[00:46:38.170]with just a couple of the diagnostic tools.
[00:46:40.260]The ADOS is one that is commonly used,
[00:46:43.680]but you don't have to use an ADOS
[00:46:45.570]for an educational verification.
[00:46:46.970]And that is one thing that sometimes
[00:46:48.810]schools aren't sure about.
[00:46:51.030]The ASD Network does offer a training about diagnostic tools
[00:46:56.260]for educational verification.
[00:46:58.030]I know in my region we didn't have enough people sign up,
[00:47:00.340]so we ended up having to cancel it,
[00:47:01.730]but we want people to understand
[00:47:02.940]that there are many different ways
[00:47:04.980]that you can get an educational verification,
[00:47:07.170]so a couple of the other ones are listed on here as well
[00:47:10.470]for you to see.
[00:47:13.840]So, here are some characteristics
[00:47:15.420]and some common school supports,
[00:47:17.470]and then I just said
[00:47:18.780]these may not be needed for all students
[00:47:21.440]but they really are a best practice
[00:47:23.240]and so I would find it hard to say
[00:47:27.040]that a student shouldn't have one of these in there,
[00:47:30.590]but you're gonna look at the need of your student.
[00:47:34.270]And sometimes, too,
[00:47:37.020]teachers can be overwhelmed, right?
[00:47:38.550]If there's a system that worked in the previous grade level,
[00:47:41.110]they should continue trying to use
[00:47:42.880]that same kind of thing,
[00:47:44.000]but sometimes they just don't even know where to get started
[00:47:46.300]and so they might pick one strategy and start doing that
[00:47:49.620]and then build in the next strategy.
[00:47:51.520]So, that's part of why I say
[00:47:53.810]you might not see them all
[00:47:54.890]but it doesn't mean the student doesn't need them all.
[00:47:58.740]All right, so when we think about
[00:48:00.080]some social characteristics.
[00:48:03.810]The individual with autism may show some
[00:48:06.010]or all of the following deficits in social skills,
[00:48:08.830]and a deficit just means it doesn't come naturally.
[00:48:11.000]It has to be directly taught, right?
[00:48:12.640]So, our students are not gonna be the ones
[00:48:14.180]who are just gonna be looking around the environment
[00:48:16.610]and saying, "Oh, that's what I need to do," right?
[00:48:18.970]They're gonna have to have direct instruction in it.
[00:48:20.870]So, they're gonna have difficulty understanding
[00:48:23.160]the social rules and relationships.
[00:48:27.129]That can be when I go to a conference,
[00:48:30.390]what are my social rules, right?
[00:48:31.980]It's usually I can't just interrupt the speaker
[00:48:34.950]or things like that, right?
[00:48:37.300]But not, you're usually not taught all of those rules.
[00:48:39.960]Some of that just comes very naturally to us, right?
[00:48:43.600]They'll have inconsistent use of non-verbal language,
[00:48:46.550]difficulty with spontaneously sharing experiences,
[00:48:49.780]even with if you say, "What'd you do this weekend?"
[00:48:53.440]That is too open of a subject for many of our individuals,
[00:48:57.680]but if you say, "Oh, I heard you went to the zoo.
[00:49:01.087]"What was your favorite animal?"
[00:49:02.800]then that might help focus right into that
[00:49:07.650]answer for them, yeah.
[00:49:09.690]That lack of social reciprocity,
[00:49:11.700]that's kinda where we were talking earlier
[00:49:13.580]about how it's not that they don't want to be social.
[00:49:16.890]It's just that it's difficult for them
[00:49:19.530]because they haven't experienced success with that as well.
[00:49:23.620]And then unconventional, awkward,
[00:49:24.960]inappropriate methods of interaction,
[00:49:27.470]that could be how they are interacting with objects,
[00:49:30.970]how they interact with people.
[00:49:32.690]So, I've heard the phrase about people as tools, right?
[00:49:36.790]So, if the individual wants something to drink
[00:49:39.670]and they're lacking the communication
[00:49:41.800]to be able to say that they're thirsty
[00:49:43.440]or that they want something to drink,
[00:49:46.680]they'll take your hand, they'll guide you there,
[00:49:48.310]they'll put your hand on that thing.
[00:49:51.050]And so that is person as a tool, right?
[00:49:54.150]So, they're using your hand to get the thing that they want
[00:49:56.517]and so we wanna try to work on communication
[00:49:58.970]for that student.
[00:50:02.220]So, some supports that you may see
[00:50:04.000]in a school setting for social needs.
[00:50:06.640]The first one here is social stories.
[00:50:09.160]It's a real important strategy that we use.
[00:50:11.480]It's to try and help the individual see
[00:50:13.540]what's going on in the social situation
[00:50:16.180]and why it's important.
[00:50:17.670]Why is it important that we greet others?
[00:50:20.040]Why is it important that we ask questions?
[00:50:24.120]Why is it important that we stay home right now, right?
[00:50:27.040]So, we have to help build their background information
[00:50:30.050]about that social situation.
[00:50:31.870]What's expected in this social situation?
[00:50:34.180]What do you do and how do you respond?
[00:50:36.950]Okay, so that is that second part,
[00:50:38.440]that it helps provide some of those
[00:50:39.920]appropriate social responses in it.
[00:50:42.980]It should be used as a pre-teaching skill
[00:50:45.580]for our students, right?
[00:50:47.000]So, social stories are best used right before you think
[00:50:50.850]that that skill will be needed.
[00:50:52.700]So, for example, if the student is having difficulty
[00:50:56.510]lining up after recess,
[00:50:58.180]then you would read the social story
[00:51:00.610]about lining up at recess before you go to recess.
[00:51:04.790]You wouldn't read it at the beginning of the day
[00:51:06.730]and then there's gonna be hours in between
[00:51:08.900]when that skill actually has to be applied.
[00:51:10.880]It's most appropriate in the moment
[00:51:13.080]before it's going to happen,
[00:51:14.310]so it's a pre-teaching strategy,
[00:51:16.360]it's a antecedent strategy, right?
[00:51:18.270]It's before the behavior happens.
[00:51:20.330]When I see social stories go wrong,
[00:51:22.850]it's because the team has made a social story for a student
[00:51:26.860]and then they wait until that mistake happens
[00:51:29.110]and then they bring the social story out
[00:51:30.890]as the consequence, right?
[00:51:32.270]So, the student didn't line up,
[00:51:33.700]so now they need to go read their story about lining up.
[00:51:36.590]So, the student starts to see that every time
[00:51:38.700]that social story comes out, they're in trouble,
[00:51:41.170]and so they don't want that intervention anymore
[00:51:44.160]and they show that through their behavior.
[00:51:46.030]And then when I go and I consult with the school team,
[00:51:47.710]they're like, "Well, those don't work.
[00:51:48.897]"It causes them to get angry."
[00:51:50.720]Well, guess what, I'd probably get angry too
[00:51:52.690]if every time I saw that one thing
[00:51:54.250]I was getting into trouble.
[00:51:55.430]So, we need to be careful about how we're doing that.
[00:51:58.700]And the social stories need to be individualized
[00:52:00.900]to the student to meet their needs and their interests.
[00:52:03.510]So, really great social stories
[00:52:05.380]might include a familiar character.
[00:52:09.080]SpongeBob washes his hands.
[00:52:10.840]Why does SpongeBob do that even though he lives
[00:52:12.720]under the sea in the Bikini Bottom, right?
[00:52:15.610]He does it to keep his germs off of his hands.
[00:52:18.140]And so the student will wanna engage with those things
[00:52:20.840]because it's more motivating.
[00:52:23.090]But the other thing to think about it is their needs.
[00:52:25.100]So, if a student has very low language skills,
[00:52:30.700]I don't want a social story that is so full of language.
[00:52:34.810]I'm gonna keep it very simple, a couple words,
[00:52:38.500]lots of pictures in there.
[00:52:39.970]But I also wanna consider things like
[00:52:42.000]am I gonna put some cartoony type of pictures
[00:52:45.940]or am I gonna use real images?
[00:52:48.570]I've found a lot of success with social stories
[00:52:50.980]using pictures of that individual.
[00:52:54.020]They're very motivated to look at pictures of themselves,
[00:52:57.070]so that's a really great way
[00:52:59.240]to get them to use social stories.
[00:53:01.770]Now, I did put in a website for you.
[00:53:05.340]the Kansas ASD Network.
[00:53:07.890]They have some really great resources for social stories,
[00:53:12.510]so you can look it up by topic.
[00:53:13.840]So, why do I, do I need one about going to the bathroom?
[00:53:17.160]Do I need one about fire drills, right?
[00:53:18.920]And so they have a bank of them.
[00:53:21.370]But there's that caution, again.
[00:53:23.850]It's a nice starting point.
[00:53:25.820]It gives you some ideas.
[00:53:27.510]Even on that share site that we were talking about
[00:53:31.030]during our opening this morning,
[00:53:33.300]there are great starting points,
[00:53:35.410]but it doesn't mean it's going to meet the needs
[00:53:37.490]of your child.
[00:53:38.730]The other thing that I think is super important
[00:53:40.580]about social stories is that
[00:53:43.620]we have to understand why the behavior's occurring
[00:53:45.580]so we can write the best social story for that situation.
[00:53:48.890]So, I go into one of my failures as a coach is I came in,
[00:53:53.680]and oftentimes I don't see a team
[00:53:56.200]for several weeks at a time
[00:53:57.540]just because that's the nature of it.
[00:53:59.380]So, I was working with a team,
[00:54:00.930]and I came in and, "How's the general update?
[00:54:03.527]"How's it going?" and stuff like that,
[00:54:05.200]and they said, "Oh my gosh, we need a social story.
[00:54:08.627]"He keeps grabbing women's breasts."
[00:54:10.940]And I was like, "Oh my gosh, yes, we can't have that.
[00:54:12.677]"He's a middle school boy.
[00:54:13.757]"It must be hormones, right?"
[00:54:14.889]We always blame everything on hormones, right?
[00:54:17.410]So, I was like, "Yes, let me get started
[00:54:18.857]"on that social story," and I start typing it up.
[00:54:21.330]And I was like, "So, when is he doing this?"
[00:54:23.280]And they're like, I said,
[00:54:24.417]"Is he doing this all day or what?"
[00:54:26.170]And they said, "No, it's usually just during PE."
[00:54:29.910]And I was like, "Okay, well, just during PE.
[00:54:33.027]"Well, teenage boy just during PE?
[00:54:37.217]"Yep, I betcha there's some running going on
[00:54:39.317]"and things that are making this little boy excited,
[00:54:41.197]"so I'm gonna write about good touches and bad touches,
[00:54:44.127]"and, yeah, I'm gonna write this social story for you."
[00:54:46.750]And then as I started talking a little bit more,
[00:54:49.190]what came out was that when they go to PE
[00:54:52.560]he takes his communication device
[00:54:54.760]and he puts it to the side
[00:54:56.290]'cause it's really hard to play kickball
[00:54:57.630]and things like that when you've got your device with you.
[00:55:00.210]And so what he was doing
[00:55:03.360]was he was doing whatever activity, interacting,
[00:55:06.550]and then he had no way to communicate,
[00:55:09.120]so he was coming up to women
[00:55:11.200]'cause it was all female paraprofessionals, educators,
[00:55:13.923]every adult there was a female,
[00:55:16.270]and in order to get their attention,
[00:55:18.040]he was grabbing their breasts.
[00:55:19.940]Well, he certainly got their attention every single time,
[00:55:22.240]but did he get his communication need met?
[00:55:24.530]Absolutely not.
[00:55:25.830]So, if I had written a social story
[00:55:27.150]about good touch/bad touch,
[00:55:28.800]it would not have changed his behavior at all.
[00:55:31.210]In fact, it could have even made it worse
[00:55:34.150]and he wouldn't have gotten his needs met.
[00:55:35.930]But by understanding that I actually
[00:55:37.950]needed to write a social story that said,
[00:55:39.847]"When I'm in PE and I want to get people's attention,
[00:55:43.177]"I can tap them on the shoulder.
[00:55:45.217]"Then I'll go get my device,"
[00:55:47.250]I was much better able to
[00:55:50.270]address the real need for the student.
[00:55:52.190]So, that is something that I really urge people to consider
[00:55:55.020]is what do I really need the student to know,
[00:55:59.410]and why is this behavior even happening?
[00:56:01.620]And I don't think we talk about that
[00:56:03.190]very often in social stories.
[00:56:04.770]It was because of that experience with the boy in PE
[00:56:07.860]that I really started thinking about,
[00:56:09.810]ooh, what am I really teaching them
[00:56:11.960]and why am I teaching that in the social story?
[00:56:16.443]And then it just says on there
[00:56:17.300]that this is an evidence-based practice
[00:56:18.860]by the National Professional Development Center
[00:56:20.980]on Autism Spectrum Disorders,
[00:56:22.750]so there is a report that goes through
[00:56:25.280]evidence-based practices for supporting students with autism
[00:56:28.570]and so that's what tells us that social stories should work.
[00:56:32.340]They've done the research.
[00:56:33.580]They tell you it works for this age group
[00:56:35.460]and this age group and this age group, right?
[00:56:37.240]It works for a variety of different things.
[00:56:39.840]And so if it's not working,
[00:56:41.320]we have to be considering why is it not working?
[00:56:43.890]So, in the one case I told you
[00:56:45.070]it was because we were doing the story
[00:56:46.430]at the wrong time of the day.
[00:56:47.360]They're reading it the first time of the day
[00:56:48.680]because that's when they had a staff member available,
[00:56:50.920]but recess was so later in the day that it didn't apply.
[00:56:54.130]So, I needed to tweak and change that.
[00:56:55.870]Oh, well, right before we go to recess,
[00:56:57.260]why don't you have a peer read the story to them, right?
[00:56:59.750]Oh, we weren't writing a social story for the right need.
[00:57:02.520]The kid didn't need to know about good touch/bad touch.
[00:57:04.700]He needed to know how do I get people's attention
[00:57:06.790]when my communication device is gone?
[00:57:08.560]So, any of these things that we know are evidence-based,
[00:57:11.600]if they're not working, we don't get rid of the strategy.
[00:57:14.270]We try to figure out why that strategy's not working.
[00:57:18.390]Another one that is used a lot,
[00:57:20.250]and you guys can do just a quick
[00:57:22.570]yes, I'm using that or I heard of it in the chat box,
[00:57:25.020]that's just fine so I can see some of those,
[00:57:26.810]is Circle of Friends.
[00:57:28.640]There is research to indicate that Circle of Friends
[00:57:30.830]can absolutely help our individuals
[00:57:34.240]who have disabilities including autism.
[00:57:37.590]It is a opportunity to have increased social interactions,
[00:57:41.620]but it's in a coaching type of a model too,
[00:57:43.860]so we're helping not just the student who has autism
[00:57:47.780]but other, the peers
[00:57:49.420]know how to naturally support that individual.
[00:57:52.810]And I've seen some really wonderful Circle of Friends things
[00:57:56.020]that are going on, even in my rural communities,
[00:57:58.530]where it ends up being that the Circle of Friends peers,
[00:58:02.610]it's not just a lunchtime get together
[00:58:05.330]for the sake of doing that,
[00:58:06.310]but they really are building some great friendships
[00:58:08.150]and then they're going out even to restaurants together
[00:58:10.770]and things like that.
[00:58:12.400]So, it is something that we've provided a lot of coaching
[00:58:15.700]and support for Circle of Friends
[00:58:16.990]here in the state of Nebraska.
[00:58:18.580]We're very fortunate that we've had some grant opportunities
[00:58:21.570]to help schools get these things put into place.
[00:58:25.060]Because, I can tell you, that was absolutely missing
[00:58:26.890]in that first school setting that I worked at in Arizona.
[00:58:30.410]We had our own lunchtime.
[00:58:32.830]And I'm not talking about oh, first grade goes at this time
[00:58:35.530]and second grade goes at this time.
[00:58:37.330]We were in the cafeteria when nobody else went,
[00:58:40.800]and we had to be out before anybody else came in,
[00:58:43.130]and I was told it was because it's loud in there.
[00:58:45.423]And, really, we had just our very own separate time,
[00:58:48.470]but we started doing some of these types of activities
[00:58:51.350]with Circle of Friends.
[00:58:52.610]Wasn't called that,
[00:58:53.490]but we were really trying to help the peers understand
[00:58:57.120]how to best support, right?
[00:59:01.000]I love that second one.
[00:59:02.510]It's true social inclusion, right?
[00:59:05.140]So, we have a lot of our students who have more needs
[00:59:09.340]and so the academics aren't necessarily
[00:59:12.970]the right fit for them.
[00:59:14.320]And so, especially in our elementary school,
[00:59:17.560]what ends up happening in some cases
[00:59:20.280]is that the child with a disability,
[00:59:23.470]including a child with autism,
[00:59:25.010]may not be anywhere near where their peers are
[00:59:27.800]for academic skills,
[00:59:29.460]but they're physically present in the same classroom
[00:59:32.020]but they're doing their own separate curriculum.
[00:59:34.370]And so that's really
[00:59:36.730]sad if what's truly happening
[00:59:38.572]isn't communicated with the parents
[00:59:40.010]because the parents think their child
[00:59:41.940]is being fully included and things like that,
[00:59:44.180]and then when some of those structures change
[00:59:46.700]as the kid moves into middle school,
[00:59:48.120]the parents think that those opportunities
[00:59:49.920]for inclusion were gone
[00:59:51.550]when inclusion wasn't really happening.
[00:59:53.860]There was no social interactions happening.
[00:59:55.820]It was the child and a para working together on one thing
[00:59:59.040]and the whole rest of the class
[01:00:00.030]was doing something completely different, right?
[01:00:01.800]So, we need to be mindful
[01:00:04.350]in being honest with what's happening in there, okay?
[01:00:08.370]And I love that it teaches social skills
[01:00:11.620]to the two, both groups of individuals,
[01:00:15.130]the child with the disability as well as the peers.
[01:00:18.950]So, some things to think about.
[01:00:21.040]Well, actually, I wanna go back, too, and say social needs.
[01:00:24.200]So, I can tell you that right now
[01:00:26.470]in this time of social distancing
[01:00:28.610]that we still need opportunities
[01:00:30.930]to interact with one another,
[01:00:32.420]and I have school teams that are working
[01:00:34.240]on Circle of Friends right now
[01:00:35.550]and they've even talked about,
[01:00:38.190]with parent permission, right?
[01:00:39.710]Parents already gave permission
[01:00:41.130]for their child with a disability
[01:00:43.760]to be a part of Circle of Friends,
[01:00:45.630]and then the parents whose kids are the peers
[01:00:48.080]have already given permission,
[01:00:49.530]so now they worked on some new permissions
[01:00:51.870]that they could do some Zooms together
[01:00:53.900]and so that the kids could still see each other,
[01:00:56.250]and I thought that that was a really neat way
[01:00:58.830]that they're making sure that Circle of Friends
[01:01:00.440]is still happening, even during social isolation.
[01:01:03.680]And my own daughter has a friend
[01:01:05.530]who has a traumatic brain injury,
[01:01:08.740]and we usually do, on Fridays,
[01:01:11.060]we've been doing lunch dates with that friend.
[01:01:13.040]And the first day it was really hard for her.
[01:01:14.570]She didn't understand that
[01:01:16.360]it was just gonna be through a computer
[01:01:18.340]that they were gonna get together,
[01:01:19.820]but definitely this last week,
[01:01:21.590]I saw a complete difference in her understanding
[01:01:25.100]of what was happening with our interactions
[01:01:27.140]and stuff like that.
[01:01:27.973]And it was just real sweet to see that the girls could still
[01:01:31.410]see each other during this time.
[01:01:34.290]All right, so when we talk about
[01:01:35.123]some of the communication characteristics,
[01:01:37.410]often there's the delay or absence of spoken language.
[01:01:39.670]That is usually our first red flag
[01:01:41.670]for our kids with our classic autism.
[01:01:43.510]They are not speaking.
[01:01:45.590]They are not understanding
[01:01:46.680]some of the non-verbal communication that we are doing.
[01:01:49.810]We'll talk about things like echolalia.
[01:01:51.520]That's where I say something
[01:01:52.900]and they repeat back what I am saying,
[01:01:55.130]and so that is not a typical development either.
[01:01:58.650]So, these are the ones that we typically see
[01:02:01.300]and that are our first red flags
[01:02:03.580]that the individual may have autism.
[01:02:07.120]So, some way that we help to support that for our students
[01:02:11.560]in the school will look different
[01:02:14.370]based on the needs of the child,
[01:02:16.010]but absolutely we wanna work on communication
[01:02:18.850]for our children.
[01:02:19.770]So, we need to identify how communication will be targeted
[01:02:23.700]across the day, across all activities,
[01:02:25.940]across all environments.
[01:02:27.340]And there was a really great session yesterday
[01:02:29.600]about teaching communication using AAC,
[01:02:33.530]so when you get those chances to go back
[01:02:35.420]and review some of the sessions you weren't able to attend,
[01:02:38.210]I highly recommend that.
[01:02:39.280]I helped facilitate that one yesterday,
[01:02:41.000]and it was great.
[01:02:42.680]In a school setting,
[01:02:43.540]you may hear things like the ABLLS, the VB-MAP.
[01:02:47.380]That's one of the ways that we are able to assess
[01:02:49.580]what communication skills are already present
[01:02:52.550]for that individual.
[01:02:54.130]With the ABLLS-R, it's an assessment
[01:02:55.800]of basic language learner skills,
[01:02:57.650]so it's not all just focused
[01:02:59.820]on the words that are being produced,
[01:03:01.780]but it's also things like how well do you attend,
[01:03:06.280]how long can you look at the individual,
[01:03:08.580]how long can the student work before they have to receive
[01:03:11.420]some sort of reinforcement,
[01:03:13.970]and the VB-MAP is very similar to that same thing.
[01:03:17.270]Pivotal Response Treatment, PRT,
[01:03:18.920]that might be another way in which we're going to
[01:03:21.680]target communication in a very natural environment
[01:03:24.150]for the student.
[01:03:25.740]I was fortunate enough a few years ago
[01:03:27.420]to get some training specific on PRT from the Koegel family,
[01:03:32.020]who helped to develop this whole thing,
[01:03:34.100]and it was amazing because I can sit
[01:03:36.440]and do a very intensive teaching session using an ABLLS,
[01:03:39.540]but then if I'm out on the playground,
[01:03:40.930]I'm not gonna be pulling out cards
[01:03:42.270]and working with a kid.
[01:03:43.340]And it's just more natural, seems almost like play,
[01:03:46.530]but you gain a lot of skills.
[01:03:49.650]If you target one skill,
[01:03:50.540]you're gaining a whole bunch of other ones for free
[01:03:53.130]with Pivotal Response Treatment,
[01:03:54.960]so that's definitely one that I would encourage you guys
[01:03:56.760]to learn a little bit more about as well.
[01:03:59.260]But it's also important,
[01:04:00.210]even at this very young age, that we,
[01:04:02.620]or really with an individual with autism
[01:04:06.460]I guess they can even be older,
[01:04:07.750]so this isn't just about that early intervention stuff.
[01:04:10.730]We have to have a way for them to communicate.
[01:04:13.210]It has to go beyond a yes/no kinda thing
[01:04:15.780]'cause if your entire life was a yes/no,
[01:04:17.670]that would be very difficult for you as well.
[01:04:19.830]And so we need to find what is the way
[01:04:22.340]that this individual is gonna communicate with others?
[01:04:24.830]So, there is picture exchange,
[01:04:28.000]and so the individual learns to initiate first.
[01:04:31.880]They don't learn to answer questions first.
[01:04:33.780]They learn to initiate first and that is so important.
[01:04:36.790]So, they give you the card, they get something from you.
[01:04:39.680]They give you the card, they get something from you.
[01:04:42.240]Then, later, they'll start answering questions from you.
[01:04:44.770]So, there's an entire way to teach that picture exchange,
[01:04:47.990]and it's important to know that
[01:04:49.060]so that you can do it well with the individual.
[01:04:52.800]Picture exchange is good for people
[01:04:54.210]who can scan, who can see a difference,
[01:04:56.610]who can do some visual discrimination and things like that.
[01:05:00.900]And maybe it might be a good fit for somebody who
[01:05:03.950]something like sign language
[01:05:05.050]where you have to be able to do modeling
[01:05:07.680]isn't as great of a fit for them.
[01:05:10.920]Sign language is real important for many of our individuals,
[01:05:14.460]but sign language, of course,
[01:05:16.040]each of these have pros and cons.
[01:05:17.930]Sign language, you need to be one step ahead of the kid
[01:05:21.520]in knowing your signs.
[01:05:22.850]And so sometimes sign language,
[01:05:24.420]we don't put that out as an option for our kids
[01:05:26.950]because we know that there's not as many people
[01:05:29.250]who are going to understand it,
[01:05:31.030]but I have seen some kids who are amazing
[01:05:33.870]and they do so well with sign language.
[01:05:36.010]It's actually the best way for them to communicate
[01:05:39.970]and then, sadly, they move to the next grade level
[01:05:41.780]and the next person doesn't know that
[01:05:43.360]when they move to middle school
[01:05:44.220]so then they try to go back to some other format.
[01:05:46.470]If you know that this is how the student communicates,
[01:05:48.610]then honor that, respect that, and you need to learn it now.
[01:05:52.370]So, that's kinda my soapbox on that one.
[01:05:55.450]But it's beautiful.
[01:05:56.670]I actually, in that first classroom with my kids
[01:05:59.280]who had more classic autism, self-contained,
[01:06:03.010]we struggled with reading.
[01:06:04.290]I had a student who could tell me his name,
[01:06:07.240]he would spell out every letter of his name,
[01:06:09.370]but if you showed any of those letters in isolation
[01:06:11.540]couldn't tell me those letters.
[01:06:13.450]Had worked on it all through early childhood,
[01:06:15.610]had worked on it for two years with me, couldn't do it.
[01:06:18.750]Couldn't read words, any sight words or anything like that.
[01:06:22.560]We weren't making progress on that.
[01:06:23.890]We weren't making progress on phonics,
[01:06:27.250]and I started teaching sign language with the Dolch nouns,
[01:06:30.670]and he did amazing with that.
[01:06:33.020]So, don't underestimate sign language.
[01:06:36.350]And then communication devices are in there as well.
[01:06:41.280]Restricted patterns of behavior,
[01:06:43.650]many of our kids need that sameness and those routines.
[01:06:46.810]It helps with predictability.
[01:06:48.440]That's what that is mostly about is that sense of security
[01:06:52.440]and things like that.
[01:06:53.530]So, when they have no control, there is anxiety,
[01:06:57.810]so being able to help them understand
[01:07:00.490]what's going to be happening next is super important.
[01:07:04.510]We do that through things like visual schedules,
[01:07:06.950]and it's important that we understand
[01:07:08.930]that what type of visuals are being used
[01:07:11.980]will really depend on the need of a student.
[01:07:14.860]While we might jump towards something like the visuals,
[01:07:18.620]that icon one, it's 'cause it's easy for us,
[01:07:22.590]it doesn't have meaning for some of our students.
[01:07:25.540]That's a very arbitrary or it's not arbitrary,
[01:07:28.680]but we understand that that's a picture of a toilet.
[01:07:31.060]Our student might need to have something like toilet paper.
[01:07:34.830]But if it's a boy who wears pull-ups,
[01:07:36.660]they're probably not experiencing toilet paper very often.
[01:07:39.920]They might need an object that is a pull-up itself.
[01:07:42.980]So, again, when we're making these things,
[01:07:45.500]we need to think about the learner and their needs.
[01:07:48.250]Think about how many icons can they handle
[01:07:51.540]and things like that.
[01:07:52.560]That is super important as well.
[01:07:54.540]So, we do an entire workshop on these
[01:07:56.650]about visual schedules and things like that.
[01:07:58.680]I know we have some webinars about visuals,
[01:08:02.470]and please feel free to reach out to me,
[01:08:04.210]and I can help you with that as well.
[01:08:06.420]I just loved this picture, too.
[01:08:08.620]The whole world is overwhelmed
[01:08:10.100]by a sudden change of routine.
[01:08:11.980]It's not that easy, huh?
[01:08:13.760]And it just says World Autism Awareness Day.
[01:08:16.600]So, I did get this from Autism Action Partnership
[01:08:18.860]last night on their website,
[01:08:20.110]but I've seen it across social media as well.
[01:08:22.950]Any kind of changes, we need to help our individuals
[01:08:26.100]understand what is changing in their environment.
[01:08:30.750]I did wanna make sure you guys had a resource.
[01:08:33.460]Tobi Dynovox does send out newsletters on a regular basis,
[01:08:36.536]and just in yesterdays,
[01:08:37.800]and I can forward this to any of you guys,
[01:08:39.970]I just wanna make sure to give you the direct links
[01:08:42.010]rather than just forwarding.
[01:08:44.220]They sent their newsletter yesterday,
[01:08:45.900]had some social stories about what is COVID,
[01:08:48.080]why am I not going to school, things like that.
[01:08:50.890]They had some first/then schedules
[01:08:52.570]and they had icons that would most be used
[01:08:55.510]in a homeschooling situation.
[01:08:57.860]So, if you have families that you are helping
[01:08:59.490]to support right now,
[01:09:00.680]that student had a visual schedule in your classroom
[01:09:03.890]and now you're wondering, "How do I do this
[01:09:05.607]"and make it for school?
[01:09:06.937]"How do I have time for making these things,"
[01:09:09.530]use this resource.
[01:09:10.650]It'll really be helpful for you.
[01:09:13.290]We talk about structured work areas.
[01:09:15.190]Again, this is something that we offer
[01:09:17.180]a full two-day workshop on,
[01:09:19.490]and with looking at my time, again, talked way too much.
[01:09:24.730]Again, this is about predictability
[01:09:26.760]and routines for our individuals,
[01:09:29.170]and there's actually a five part series
[01:09:32.210]on structured work routines that is on our webinars.
[01:09:35.660]So, again, if you've got some time,
[01:09:38.120]that's one that you can dive into further
[01:09:40.050]and find out about structured work areas
[01:09:42.020]and work tasks and things like that.
[01:09:46.390]Let me see, oh my goodness.
[01:09:48.560]See, I am so bad.
[01:09:50.430]I don't manage my time well, guys.
[01:09:52.110]Sorry about that.
[01:09:54.115]Reinforcers are super important.
[01:09:56.310]Again, I know we've got webinars completely on that,
[01:09:59.750]but definitely we wanna work with families
[01:10:02.180]to identify reinforcers and for students.
[01:10:06.330]And then sensory characteristics
[01:10:08.210]we talked about this morning.
[01:10:10.770]These are some common things that you might see,
[01:10:13.010]but it's super important.
[01:10:14.380]I can't stress this enough.
[01:10:15.740]You are working with the occupational therapist
[01:10:17.960]to determine what is needed.
[01:10:19.600]This past Christmas, weighted blankets were all the rage.
[01:10:22.550]Guess what, for it to be a truly therapeutic thing,
[01:10:25.920]the student needs it to be a certain weight
[01:10:28.170]compared to their body weight.
[01:10:29.840]So, you can't just find tools
[01:10:31.260]and assume that you can use them for the student.
[01:10:33.620]It might not be the right match.
[01:10:35.630]And then for assistive technology,
[01:10:37.800]I'll put in a little plug.
[01:10:38.970]There is an assistive technology session
[01:10:41.700]after our lunch today,
[01:10:43.080]and so you can learn about some of the tools
[01:10:45.220]that would be really beneficial for our students.
[01:10:50.940]I will leave, sorry,
[01:10:52.270]two minutes, I guess, only for questions.
[01:10:56.170]See, Abby, I was worried I wasn't gonna have enough slides.
[01:10:59.560]Ha, that's what happens.
[01:11:02.440]Are there any service or supports
[01:11:03.620]a child is guaranteed to receive
[01:11:05.320]on the IEP with the ASD diagnosis
[01:11:07.410]that they would not otherwise have guaranteed?
[01:11:10.810]And then they might not see this
[01:11:13.950]as a positive or negative depending on them.
[01:11:15.710]Okay, so, really, any IEP that we are doing,
[01:11:19.390]we are first discussing needs,
[01:11:21.280]and then after we have discussed needs,
[01:11:23.230]we would start talking about those services
[01:11:26.300]or supports or the assistive technology,
[01:11:28.760]what classroom accommodations.
[01:11:30.510]So, the needs actually should drive the IEP
[01:11:33.520]and not the diagnosis.
[01:11:35.460]Does that make sense?
[01:11:40.140]All right, perfect.
[01:11:41.250]Yeah, but I have seen that case where people come in
[01:11:43.920]and they say, "My child has autism.
[01:11:45.257]"They need this, this, this, this,"
[01:11:46.630]and it's like, but wait, that's not what their need is.
[01:11:49.420]Let's look at their need
[01:11:50.370]and then we can talk about services,
[01:11:51.860]we can talk about goals.
[01:11:53.160]So, always look at that needs first.
[01:11:56.550]Anything else guys?
[01:12:01.630]Sorry for spending so much time on some of the sections
[01:12:04.470]and not enough on the others probably.
[01:12:07.680]Jen, it was great.
[01:12:08.710]You're good, don't... Okay.
[01:12:12.128]They have access to all the slides,
[01:12:13.530]and if there's anything that Jen or I could help you with,
[01:12:16.010]please don't hesitate to reach out to either one of us.
[01:12:19.957]Yes, absolutely, my email address is in there
[01:12:23.550]for you guys to be able to reach out to me.
[01:12:27.308]I'd love to help you guys out.
[01:12:28.877]It's a little different coaching right now
[01:12:31.060]than what it's been,
[01:12:32.180]so let us know how we can help support you.
[01:12:34.940]We have been sending resources out to school teams,
[01:12:38.250]but I also feel overwhelmed as a parent
[01:12:40.810]getting too many things from my child's school
[01:12:42.780]where it's like I get 100 resources for reading.
[01:12:44.880]I would like the two that you would recommend, right?
[01:12:46.413]I don't need 100.
[01:12:47.890]And so we do have some resources
[01:12:49.650]that are websites that we commonly use,
[01:12:52.750]things that we feel are super important.
[01:12:54.840]If you were like, "Hey, I need some visuals,"
[01:12:57.360]I have some information about visuals.
[01:12:59.150]If you say, "Hey, I need some sensory ideas,"
[01:13:01.190]then we can give you some ideas on sensory,
[01:13:02.880]but sometimes it's just a little bit too much.
[01:13:07.490]Absolutely. All righty.
[01:13:11.290]Yeah, Miranda, if you wanna reach out to me through email
[01:13:14.840]then we could maybe talk through some of that as well, okay?
[01:13:19.710]'Cause it's super hard, it's super hard to, yeah,
[01:13:22.890]just read a little tidbit about a kid
[01:13:24.837]and offer advice and stuff like that.
[01:13:28.130]All right, well, everybody,
[01:13:29.740]I hope you guys have a great lunch.
[01:13:31.150]My lunch yesterday disappointed
[01:13:33.090]compared to normal conference food.
[01:13:34.560]We always have such amazing food at the conferences.
[01:13:37.380]And, again, a special.

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Intro to ASD for Individuals with More Complex Needs

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