Autism Spectrum Disorders: Making Your Student`s

Transcription

Autism Spectrum Disorders:
Making Your Student’s Daily
Program Meaningful
The Myth of Developmental
Milestones
 Behaviors do not inherently change or
develop as our children get older
 Tolerance for their behaviors changes
Elementary: Time out
Middle/High School: School removal
 Adulthood: Incarceration
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
Brenda Smith Myles, Shawn A. Henry
Ohio Center of Autism and Low Incidence (OCALI)
www.ocali.org
Barry G. Grossman, Ph.D. and Ruth Aspy, Ph.D.
The Ziggurat Group
http://www.texasautism.com
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Risk Factors and What They Can
Lead To
A Study in Contradictions
 22% of individuals with HFA or AS have IQs
 Inability to modulate
 Cannot read nonverbal cues
 Hyper- or hypo-sensitive to the environment
in the superior to superior range
 12% are employed full-time**
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2
1% of this 12% are employed in an area in
which they were trained/educated
 Desire to have friends
 Use of pseudo-logic
 Lack of understanding of the hidden curriculum
 Misdiagnosis
**most did not have interventions at a young age
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Inability to Modulate
Inability to Modulate
 Withdraws from the environment
 Does not venture outside his home or small
 Becomes depressed
 Cannot discern minor from major negative
events
 Is always on hyper-alert waiting for something
to happen
 Is accused of overreacting to “small things”
 Cannot concentrate on schoolwork
 Cannot concentrate on making friends
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circle of trusted people
Tantrums and cycles as he cannot self-calm
Is perceived to start fights
Is removed from class
Is placed in a class with students with
behavior disorders where he learns “new”
skills
 Is removed from school
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CEC O7; Aspy, Grossman, Henry, Myles
1
Hyper- or Hypo-Sensitive to the
Environment
Cannot Read Nonverbal Cues
 Avoids certain foods, sounds, touch, smells
 Isolates self from others/environment
 “Over-reacts” to situations
 Perceives individuals with resting faces as being
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aggressive
Aggresses against others to protect himself
Misses out on content of conversations and lectures
Does not make friends as he does not understood
what they say or what they do
Approaches peers, but is rejected
Becomes a loner
Is bullied
Because he cannot predict who is going to assault
him, he withdraws, attacks, seeks revenge
 May seek input that she cannot receive from
the environment
 Aggresses when someone moves to touch
him
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Problem Solving
Desire to Have Friends
 May develop learned helplessness as a result of not
 Does not understand how to make or keep
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being able to problem solve
May generate solutions and, without skills to
evaluate, select wrong solution that would
compromise the student
May be talked into “doing anything”
May make bad choices
Maybe perceived as impulsively acting upon a whim
friends
 Is seen as vulnerable by peers
 Can be “set up” by peers and “won’t tell on
them” if asked not to
 May choose to be bullied, if that is the only
way seen to get friends
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Use of Pseudo-Logic
Does Not Understand the Hidden
Curriculum
 Is extremely logical, but the logic is very
 The set of unwritten rules that no one has
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unique based on that student’s perspective
Is often misunderstood
Assumes he is right
Does not ask questions
Assumes his logic is the same as others
May be perceived as argumentative
been directly taught, but everyone knows.
Violations of these rules can make an
individual a social outcast.
 Phrase associated with hidden curriculum:
 “I shouldn’t have to tell you but … “
 “Everyone knows that … “
 “It’s obvious … “
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Outcomes
 Outcomes with support
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Well-adjusted
Employed
Contributing member
of society
Model citizen
Innovative and
“different” thinker
Proactive Programming
 Outcomes without support
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Our worst fears could
become a reality
Loss of someone who
could have made a
difference!
 Adequate Yearly
Progress
 Standards
 Positive Behavior
Supports
 Response to
Intervention
http://www.pbis.org
 Inclusive Practices
 Individualized
Education Program
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Adequate Yearly Progress
State Standards
 NCLB requires students perform at a certain
 Standards have been refined based on NCLB
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requirements
level
Districts and schools are responsible and
accountable for that level of performance.
"The dollar" follows appropriately performing
schools
Nationally, meeting AYP is a priority
To meet AYP, schools need to become adept
at meeting needs of all students
 Meeting "state standards" is used by districts and
states as a verification of meeting AYP
 Participation in state testing (based on standards) is
mandated
 Success on standardized tests is equated with
success in schools.
 Again, schools need to become adept at meeting the
needs of all students to accomplish
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Positive Behavior Supports
Response-to-Instruction
 Nationally, there is a movement toward implementing
 Focus on meeting the needs of children through
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school-wide PBS
Results in decreased discipline issues, retention of
students in the classroom to participate in AYP, state
standards
Current trend is to look at literacy/academics along with
with behavior in the PBS triangle
Again, standardized testing is used to determine
success
Need to address needs of all children within the three
levels of the PBS triangle
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differentiated instruction (child specific interventions)
 Uses assessment data to determine intervention
need
 Fits the intervention to the child, not the child to the
intervention
 Sets as a goal: meeting the needs of all students
 Fits nicely with AYP, Standards, and PBS' focus on
behavior and literacy.
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3
Inclusion
IEP
 Now let's talk about students with disabilities
 Accountability is required as part of the IEP
 National push is to include all students in the
process
least restrictive environment of the general
education classroom
 Desire to meet the needs of all students
within this environment
 We need to address primary, secondary, and
tertiary levels of intervention within the
inclusive environment if we are going to meet
AYP, etc.
 Individualized programming is part of that
process
 We need to help teachers meet all these
needs in a comprehensive and systematic
fashion if we are going to include students,
meet AYP, etc…
 This leads us to why we are here today ...
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Organizational Matrix: Building
Supports for Individuals with ASD
Access to Core Curriculum
Strategies Embedded
Throughout the School Day
Effective Inclusion Practices:
How, When, Why?
Strategies Targeting the
Core Deficits of ASD
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Why Was CAPS Developed?
 Teams were
changing and
training would be
needed again each
year.
 During transitions
knowledge was not
shared.
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What Does CAPS Do?
 Students often move
and new teams have
to get to know these
students, reinventing
the wheel is not fair
to the student or the
teacher.
 Simply, what works
for the individual
was not being
shared.
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Provides a venue for individualized team planning combining
effective and diverse strategies as needed.
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Provides consistency of programming across time and setting
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Bridges IEP with core curriculum to effectively use daily
teachable moments.
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Facilitates targeted professional development
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Facilitates transition at the end of school year
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Provides structured flexibility across methodologies.
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The Ziggurat Model
Who Is involved in CAPS?
 Sensory and Biological
 Suggested Team Members
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Needs
Parents
General Education Teacher
Special Education Teacher
Para-professional
Speech Language Pathologist
Occupational Therapist
School Psychologist
School Based Administrator
Regional Educational Support Personnel
 Reinforcement
 Structure and
Visual/Tactile Supports
 Task Demands
 Skills to Teach
www.asperger.net
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Ziggurat n:
Why was the Ziggurat Model
Developed?
(zig·gu·rat) from Assyrian ziqquratu, height,
pinnacle
 Difficulty “Seeing the Autism”
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a temple having the form of a terraced pyramid of
successively receding stories, erected by the
ancient Assyrians and Babylonians
 Tendency to apply one strategy to address all
needs
 Tendency to ignore critical areas when
designing an intervention
a framework for designing comprehensive
interventions for individuals with autism
spectrum disorders
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Intervention Ziggurat
Skills to Teach
“The last thing one knows in
constructing a work is what
to put first”
-Blaise Pascal
Task Demands
Structure and Visual/Tactile Supports
Reinforcement
Sensory Differences and Biological Needs
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© Ruth Aspy, Ph.D., Barry G. Grossman, Ph.D.
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Sensory - Key Points
 Sensory dysfunction influences all aspects of
an individual’s life.
 There are seven types of sensory dysfunction
 Interventions need to occur in ALL of the
individual’s environments.
 Assessments must be completed and
interventions must be supervised by a trained
occupational therapist.
“If there is no reinforcer,
there is no lesson”
-Andrew Bondy
Reinforcement
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Reinforcement Reminders
Reinforcement Reminders
Bixler, 2006
 Involve students in the process of selecting
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reinforcers
Start with high rate of reinforcement for new skills
Use variable rate of reinforcement for maintenance
Reinforce practice
Reinforce prompted behavior
Reserve some reinforcers to maintain their
effectiveness
“You may not have
to look any further
than your child’s
special interest to
find the perfect
reward”
-Sakai,
2005, p. 52
33
“And it is best if you know a good
thing is going to happen, like an
eclipse or getting a microscope… And
it’s bad if you know a bad thing is
going to happen like having a filling or
going to France. But I think it is worst
if you don’t know whether it is a good
thing or bad thing which is going to
happen.”
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“Just imagine your most
stressful day that you’ve
ever, ever had . . . your
worst day is his best day”
-Parent of child with
Asperger’s
- From: The Curious Incident of the Dog in
the Night Time, by Mark Haddon, 2003
Structure and Visual Supports
Task Demands
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6
Changing the Environment to
Match Needs
Task Demands
Easy
Challenging/Emerging
(independent skills(possible with
with or without
assistance)
modification and
structural supports)
Zone of Proximal
Development
Level of
Demand
Too demanding
“… a shift from viewing behavior support as a
process by which individuals were changed to
fit environments, to one in which environments
are changed to match the behavioral needs of
people in the environments”
-Horner et al., 2002, p. 425.
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Everything Needs to Be
Adapted
“Almost everything we think, do, say,
and plan needs to be adapted”
“The teacher who does not
understand that it is
necessary to teach autistic
children seemingly obvious
things will feel impatient and
irritated”
- Gill, 2003, p. 200
-Hans Asperger
Skills to Teach
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The Seemingly Obvious
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Strengths of the Ziggurat Model
 What is it about the situation that comes
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naturally to everyone else but is missing for
this person? Why is it that others do not
show the same behavior?
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 What is it that has not occurred to me to
Provides a process and framework for designing an
intervention plan
Addresses underlying characteristics of ASD
Emphasizes and enhances evidence-based
strategies
Facilitates comprehensive intervention design
teach?
“Make everything as simple as possible
but not simpler”
- Albert Einstein
That is the seemingly obvious. That is the
thing to teach.
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Strengths of the Ziggurat Model
General Intervention Plan
 Incorporates assessment
 Emphasizes positive
UCC
approach/reinforcement
 Underlying Characteristics Checklist
 ABC Iceberg
. . . an informal assessment tool designed specifically to identify
characteristics across a number of domains associated with [ASD]
for the purpose of intervention. It is not designed for diagnosis.
The results of the UCC are used to develop a comprehensive
intervention incorporating each of the five levels of the Ziggurat.
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Aspy, R., & Grossman, B., 2007, p.51
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The UCC Areas
Additionally, the UCC…
 Provides a “snapshot” of how autism is
 Social
expressed for an individual
 Can be completed by multiple respondents
 Provides a tool for assessing
progress/change
 Restricted Patterns of Behavior, Interests,
and Activities
 Communication
 Sensory Differences
 Cognitive Differences
 Motor Differences
 Emotional Vulnerability
 Known Medical or other Biological Factors
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Ginny
Baseline CAPS
 Baseline look at structure and services in
 About Ginny
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Age 8
Grade 2
Very few social interactions
Tested in the “below average” range
Uses PECS, limited generalization with staff, none with
peers
place prior to any UCC or Ziggurat
intervention.
 Observation of strategies and supports that
are currently being utilized across the
student’s day.
 About her program
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Full day resource in K and 1st grade
Inclusion was only “specials”
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Ginny’s UCC
UCC
(Ziggurat Worksheet)
After gathering information on the UCC,
teams complete the Ziggurat Worksheet
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Designing a Global Intervention
 Prioritize UCC areas of concern
 Select UCC items to address
 Develop interventions for each level of the
Ziggurat
 Ensure that intervention is complete
Ginny’s Ziggurat Worksheet
Ginny’s Ziggurat Worksheet
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Skills to Teach
1.
UCC
2.
(Ziggurat Worksheet)
3.
CAPS
 Characteristics
 Intervention
Design
 Implementation
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Ginny - CAPS
Task Demands
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Structure and Visual/Tactile
Supports
 Priming
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Preparing the child for what is going to happen
next
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Structure and Visual/Tactile Supports
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Overviewing a visual schedule
Looking at a test
Looking at a book
Playing a game
Looking at a model of an assignment
Previewing a script
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10
Structure and Visual/Tactile
Supports
 Video modeling
Videotape of a routine
Videotape of a new experience (priming)
 Videotape in a play scheme
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Using the child himself/herself
Using another child
Using the child’s vantage point
Reinforcement
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Sensory Gang
from Asperger Syndrome and Sensory Issues: Practical Solutions for Making Sense of the64
World by Myles, Cook, Miller, Robbins, & Rinner (www.asperger.net)
Proprioceptive Dysfunction
Proprioceptive Dysfunction
 Child does not have a
 When children engage in self stimulatory
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good sense of where
her body is in space
Often bumps into
people or objects
Appears clumsy
Holds objects too tightly
or too loosely
Has difficulty with the
concepts of heavy or
light
 Walks on toes
behavior, such as hand flapping or injurious
behavior to themselves or others such as
hitting, pinching or biting, they are often
seeking proprioceptive input
 Hangs on people or
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furniture
Enjoys falling without
regard to personal
safety
Props to support self
Chews firmly on eraser
on end of pencil
Sits with front two legs
of chair on top of feet
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Proprioceptive Strategies
 DEEP PRESSURE OR HEAVY WORK
 Proprioceptive activities are a good place to start
 Putting a stretch or a push on muscles tends
 Most effective input is to the major joints, shoulder,
when creating a sensory diet
to assist in organizing to the nervous system
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spine and hips
Many children also like input in the hands and feet
Input into the jaw (chewing) can also be calming
Do not provide input into the neck
Avoid input if child has lax joints or joint disease
Use a weighted blanket
Wrap in a yoga mat
Sit in a beanbag chair
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 Lay under a beanbag chair or be sandwiched
 Have child place chairs on desk at the end of the day
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 Move furniture around the room
 Carry books with both hands hugging the book to
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between two bean bag chairs
Have child lay on floor as you “steamroll” him with a
therapy ball
Have the child open the door and hold door for others
Stand with arms straight and push down on the top of
their desk
Do chair or wall push ups
Stand on tiptoes and reach for the ceiling
Have the child return a stack of books to the library
and remove them in the morning
yourself
 Wash desks, tables or boards using both hands with
lots of pressure
 Water plants using a watering can
 Provide with resistive material such as play dough,
silly putty, theraputty, theraband
 Use a weighted pencil, grease marker, weighted
spoon
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Wear hand or leg weights
Squeeze clothespins
Scooping or pouring sand, beans or rice
Pour from a pitcher
Sharpen pencils with a hand held or wall mounted
sharpener
Staple papers
Use a three hole punch
Have child carry trash can around room during clean
up after snack or art activity
Have child run an errand
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Wheelbarrow walk, crab soccer
Animal walks: crab walk, bear walk, duck walk
Jump on mini trampoline; ride a tricycle or bike
Bear hugs
Carry equipment to and from the playground
Hang from the monkey bars
Play tug-of-war, arm wrestle or row boat
Play catch with a large therapy ball
Throw bean bags at a target
Propel self on scooter board using hands and feet
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Ginny - CAPS
Comprehensive Process
Designed to
meet the
needs of
students,
primarily at
the
secondary
and tertiary
levels.
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Student Description
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Baseline Data for Leah
 Data taken over three class periods
 Each period Leah was compared to different
Student: Leah
Age: 9 years
Grade: 3rd
Brief History
 Nonverbal until approx. 5 years of age
 Many tantrums per parent an teacher report
 Very little social interactions
 Tested in the below average range
 Educated in special education and part-time inclusive education
settings (PE, Music, Lunch).
 Little, if any, initiations
peer in number of verbal interactions
 Total of interaction
Leah =2
Peers = 21
 Both of Leah’s interactions were with very
familiar peers
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75
Comprehensive Program Planning
Time*
8:00
Activity
•Recording
hot and cold
lunch
Targeted
skills to teach
•Initiate
conversation
with peers
•Greetings
•Names of
classmates/
staff
Structure/
Modifications
•Scripting
•Clipboard with names
and p hotographs of
students
•Expectations with visuals
•Trained peers
Reinforcement
• S ocial:
interactions with
peers
Sensory
Strategies
• None at this
time
Social Skills/
Communication
Data
Collection
•Initiation
•Greeting
•Ending conversation
•Checklist of hot
or cold lunch
Generalization
Plan
•Game playing
•Recess
•Passing our
class work
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Attendance Scripted - Lunch
Count
 Leah asked the students if they have home or
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school lunch.
125 additional peer interactions per week
Teacher uses for attendance
Natural classroom job
Integrated into daily routine
Compliments to and from peers
Additional conversations
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Leah’s Program Planning
Academic Task: Classroom Surveys
Time
 Scripted surveys in conjunction with core
11:30
curriculum
Activity
•Lunch
Targeted Skills to
Teach
•Topic Maintenance
•Commenting
•Social Interaction
•Initiate conversation
with peers
•Greetings
•Names of classmates
 Academic extension activities (graphing, write
up results)
Structure and
Modifications
•Scripting
•Checklist
•Systematic
prompting for
independence
•Trained peers
•Priming activities
•Role playing
•Adult facilitator
Reinforcement
•Questions/
Comments from
•Tally system for
initiations
Sensory
Strategies
Social Skills
•Teach Me
Language book
•Scripted forms
•Topic maintenance
• Initiation
•Greetings
•Commenting
•Active listening
Data
collection
Generalization
Plan
•Quiet room
•Few outside
distracters
•Lunch room
with group
•Game playing
•Recess
 50 additional social interactions per week
 Additional social conversations
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Scripting for Lunch Bunch
Group
Social Skills Priming for Lunch
Bunch
Scripting is having something printed
or in pictures to help guide
communication exchanges between
two people.
 Motivating topics chosen by student
 Generated questions to ask peers to initiate
conversation
 Rehearsed comments she could make on the
topic
 Reviewed with multiple team members
Teacher: “What did you do last summer?”
 Goals include self monitoring of topic
Leah: “I went swimming.”
maintenance
Teacher: “Wow, great fun!”
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Leah’s Program Planning
Trained Social Peer Group
 Develop “lunch bunch” with chosen peers
 Define new skill for student (i.e., topic
Data
collection
Instructional
Materials
Communication/Socia
l Skills
Sensory
Strategies
•Initiate
conversation
with peers
•Greetings
•Names of
classmates/
staff
•Scripting
•Checklists
•Systematic
prompting for
independence
•Trained peers
•Attend.
sheet
•Tally system
for add.
interaction
•Clipboard
•Checklist with
students names
•Pencil
•Initiation
•Greeting
•Compliment
•None at this
time
•Game
playing
•Recess
•Passing our
class work
11:30
•Lunch
•Topic
Maintenance
•Commenting
•Initiate
conversation
with peers
•Scripting
•Trained peers
•Priming activities
•Role play
•Adult facilitator
•Questions/C
omments
from
•Tally system
for initiations
•Teach Me
Language book
•Scripted forms
•Topic maintenance
• Initiation
•Commenting
•Quiet room
•Few
outside
distractions
•Lunch room
with group
•Game playing
•Recess
maintenance, giving compliment)
83
Specially
Designed
Instruction
•Attendance
Activity
 Demonstrate how peers can encourage and
demonstrate social skills during “lunch
bunch”
 Generalize skills throughout day
Targeted
skill
short-term
objective
8:00
Time
Generalization
Plan
•Active listening
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Michael’s Modified CAPS (M-CAPS_
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Impact of the Hidden Curriculum
 School
 Community
 Vocation
 Legal system
 Home
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An Overwhelming Task
 One a day
 At home
 At school
 In the community
 Grab the teachable
moment
 Real Simple
 Idioms and metaphors
Bringing Up Parents: The
Teenager’s Handbook
•The Hidden Curriculum
–Calendar
–Book
–DVD
89
How Rude! The Teenagers’
Guide to Good Manners,
Proper Behavior, and Not
Grossing People Out
Alex J. Packer
90
15
The Amelia Bedelia
Treasury
by Peggy Parish
A Little Book of Manners …
by Bob and Emilie Barnes
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92
Practical
Solutions to
Everyday
Challenges for
Children with
Asperger
Syndrome
More Help! Another
Absolutely Indispensable
Guide to Life for Girls
by Haley Myles
The Care & Keeping of You:
The Body Book for Girls
The American Girl Library
93
No B.O.!: The
Head-to-Toe
Book of
Hygiene for
Preteens
by Marguerite
Crump
94
Resources / PowerPoint Handouts
 For more information regarding the Ziggurat Model, contact
Dr. Ruth Aspy and Dr. Barry Grossman at
www.texasautism.com
 For more information regarding CAPS, contact Shawn A.
Henry at shawn_henry@ocali.org
 For a copy of the PowerPoint presentation, go to
www.ocali.org/documents
 To purchase the Ziggurat Model visit the Autism Asperger
Publishing Company website at www.asperger.net
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16

Autism Spectrum Disorders: Making Your Student`s

Transcription

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