Children with Autism: Same Needs, Different Approach

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1 Children with Autism: Same Needs, Different Approach Craig Gibson Different, not less. -- Temple Grandin The first few months of the school year have come and gone. By this time you have the routine down pat, and your classroom is running like a well-oiled machine. You know each of your students extremely well. You know their mannerisms and their temperament. Each child is able to consistently follow daily classroom rules and routines, and seldom do you need to address inappropriate classroom behaviors. Then, one day, your program director informs you that a new child will be attending your class in just one week. He informs you that the child possesses deficits in the areas of communication and social-emotional development. He informs you that the child's sensory needs are unique. He informs you that the child has a diagnosis of autism. Through your research, you learn that: According to the Center for Disease Control (CDC), Autism affects 1 in every 88 children in the United States Autism is the fastest growing developmental disability in the United States. Autism is not specific to a particular gender, race, or ethnic group. Autism affects a child's ability to effectively communicate/express his wants, needs, thoughts, and ideas to peers and adults (therefore affecting his social-emotional skills).! Autism affects a child's ability to receive and interpret information appropriately through their senses. The cause of autism is unknown, although some believe that genetics and/or the environment may play a role. There is presently no known cure for autism, although children on the spectrum may improve over time with appropriate supports and interventions.!!!

2 Today's Early Childhood Classroom Early childhood classrooms today look far different than they did 10 or 20 years ago. Today we have children in our care who require us to "think outside the box" in terms of meeting their basic educational needs. Under I.D.E.A. (Individuals with Disabilities Education Act), children of all abilities have the right to be educated alongside their typically developing peers. This is also known as the "Least Restrictive Environment," or L.R.E. Relating to the Autistic Child When developing ideas and strategies for children with developmental delays and disabilities, it is important not to change your overall philosophy: Children of all abilities need to acquire the skills necessary to effectively communicate with peers and adults. Children of all abilities need to acquire the skills necessary to relate to their peers, so that they can develop lasting relationships. Children of all abilities need to acquire self-care skills, in addition to fine motor (e.g., small muscles) and gross motor (e.g., large muscles) skills. Children on the spectrum may learn differently, but they are very much capable. Although you may need to shift your approach in terms of how you work with children on the spectrum, try not to lower your expectations!

3 Breaking it Down by Developmental Domain Communication: This area of development is divided into two parts: Expressive language and receptive language. Expressive language is the ability to convey one's wants, needs, thoughts, and ideas through words and/or gestures. Receptive language is one's ability to comprehend and process what is being said. Strategy to Improve Expressive Language Development If the child is non-verbal, try building his vocabulary by having him request items or activities through pictures. For example, take pictures of the child's favorite food and drink items such as cookies, pretzels, chicken nuggets, apple juice, etc. Place two of the pictures in front of the child and ask him to choose which one he wants (e.g., "What do you want?"). Facilitate verbal communication by prompting the child to say the name of the food item when making that request (e.g., "I want pretzels."). Use the same method for desired classroom activities such as "dramatic play," "blocks," "puzzles," etc. Keep all of the pictures in a book for easy access, and bring out two pictures at a time. Eventually, we want the child to independently look through the communication book for the picture he wants and hand it to you while saying the word (if he's developed the language to do so). You might also want to laminate the pictures for durability. If possible, consult with a speech therapist as she may be well-versed in the process of using picture communication systems like this. Strategies to Improve Receptive Language Development Provide the child with pictures during classroom activities to increase receptive vocabulary (e.g., pictures of circle time, snack time, outdoor play, bathroom, the bus, etc.). You can even create a schedule with these pictures to show him what is to come first, second, third, etc. throughout his day. Provide the child with additional visual cues (e.g., pointing and gestures) to help him understand what you are requesting. Couple the gestures with pictures to increase

4 understanding. Prior to giving the child a verbal direction, prompt him first to give you eye contact. Break multi-step directions down into smaller parts. You do the first step and invite him to complete the next step. As the child becomes more independent, increase the number of demands you make of him. When giving verbal directions, try to limit visual and auditory distractions. For example, clear the child's environment of objects and other items of interest that might distract him from listening to you. Also, try to limit background noise that might be distracting. Cognition: When looking at a child's cognitive skills, we are looking at the way he thinks and learns. Young children develop cognitive skills through their daily experiences. In the context of the classroom, children learn many of these skills through floor play. In many cases, however, children on the autistic spectrum do not participate in play that is functional or purposeful. Their play is often repetitious in nature. For example, instead of rolling a small car back and forth on the floor in an appropriate fashion, they might turn it over to watch the wheels spin. We call this self-stimulatory behavior, and it is commonly associated with autism. The best way to break these types of behaviors is through consistent prompting and redirection. Strategies to Improve Cognitive Development Model for the child how to play with toys appropriately and functionally. Focus on one toy of interest before moving on to the next. Increase the child's interest in toys as he becomes more independent in his play. Provide the child with lots of structured play through floor time activities.

5 Limit visual and auditory distractions when the child is participating in floor time activities. Encourage the child to watch other children during play. Children learn by watching the actions of other children. Provide the child with frequent brief breaks during play, decreasing the number of breaks as the child becomes more independent in his play. When working on activities such as puzzles, provide the child with physical (e.g., handover-hand) prompting. As the child becomes independent with the task, fade out the physical prompts. Social-Emotional: Typically, children engage in parallel play (e.g., playing alongside others) by the time they are around the age of 2 ½. By the age of 3 ½, children learn how to play cooperatively by reciprocating their play with peers. Children with autism often lack the ability to initiate and sustain interactions with other children, and there may appear to be a real disconnect with others and the world around them. Strategies to Improve Social-Emotional Development Encourage the child to initiate play schemes with his peers. Start with non-verbal interactions such as turn-taking and gestures. Provide the child with lots of encouragement in the process (e.g., encouraging words and other motivators). Provide the child with adult models and demonstrations of how to play cooperatively with other children. Also, provide him with peer models (such as a classroom "buddy") who could serve as a social model).

6 Encourage the child to watch other children to help him understand how to interact with other children in ways that are appropriate. Encourage the child to vocalize to gain the attention of others, and to have his needs met when engaging in social play. Most importantly, provide the child with lots of opportunities for social play with his peers throughout the day. Physical: This domain is broken down into two parts: fine motor and gross motor. Fine motor refers to the small muscles in a child's hands which help him build with blocks, complete puzzles, hold a crayon, and cut paper in a coordinated manner. Gross motor refers to the child's large muscles which help him run, jump, and kick, catch, and throw a ball while maintaining his balance and coordination. Strategies to Improve Fine Motor Development Build fine motor, visual motor, and bilateral coordination skills by providing opportunities to play with manipulatives and tasks requiring the use of both hands together. Use arts and crafts activities to practice pre-writing and cutting skills. Provide opportunities for hand-strengthening activities (e.g., play-dough, clay, etc.) Prompt the child to stabilize the paper with his "helper" hand while coloring with his other hand. Prompt the child to use an appropriate grasp on writing utensils, and encourage him to establish a hand preference (e.g., right- vs. left-handed). Typically, we would expect a

7 child to establish a dominant hand by the age of 4. Provide the child with lots of visuals, models, and demonstrations when participating in fine motor activities. For example, if the child is around the age of 4, model for him how to make vertical and horizontal lines and circles, then have him imitate the action. Strategies to Improve Gross Motor Development Set up an obstacle course and have the child complete it, after providing him with a demonstration of what to do. Start off by having the child complete two simple steps, gradually increasing the number of steps as he becomes more independent. Provide the child with lots of pictures and demonstrations of what he is to do first, second, third, etc., fading those prompts to independence (e.g., sequencing skills)! Set up social scenarios where the child participates in gross motor play with other children. For example, include him in a game of kickball where other children can serve as peer models. The child, in this instance, is working on gross motor skills, while at the same time working on his social skills.! Adaptive Behavior: Self-help skills. Many children with autism lack the basic skills to be independent in their self-care. In many cases this is because children with autism lack the sequencing skills to accomplish such tasks. Strategies to Improve Adaptive Behavior Development Provide the child with lots of demonstration and modeling of self-care tasks (e.g., hand- washing, toileting, cleaning up spills, dressing, feeding, etc.).! Provide the child with pictures to help him sequence the steps necessary to complete self-

8 care tasks (e.g., toileting, handwashing, etc.).! Provide the child with opportunities for repeated practice of self-care tasks during the school day. Provide opportunities through play with dolls and stuffed animals and with dress-up clothes. Provide the child with lots of encouragement while completing self-care tasks. Sensory Processing: Sensory processing describes the way our bodies receive and interpret information through our senses (e.g., touch, taste, smell, movement, vision, and sound). When a child has a problem in this area, he may have difficulty regulating his responses to information coming through his senses. Strategies to Help Children Process and Interpret Sensory Information Provide the child with opportunities to engage in sensory input activities to facilitate regulation and attention (e.g., movement such as climbing, running and jumping, messy play, singing and dancing, heavy work such as lifting a heavy box or lunch bin, deep pressure to the joints such as massage, etc.). Implement these strategies prior to the start of structured tasks. Provide the child with lotions prior to the start of structured activities. (Lavender lotion has a calming effect.) Provide the child with a "fidget" toy such as a Koosh ball, a straw, or a rubber ball to help him focus and attend during structured tasks.

9 Have the child sit on a bouncy ball during structured times of the day. This will provide the child with the vestibular input he needs to help him focus and attend. Forming a Partnership Chances are that if the child has a formal diagnosis of autism the family is receiving services of some kind. Perhaps behavioral health is involved. A Behavior Specialist Consultant may be working with the child and family on ways to change undesired behaviors. If the child is enrolled in an early childhood program, the Behavior Specialist Consultant will often consult with caregivers who work directly with the child. A Therapeutic Support Staff (T.S.S.) may also be assigned to work with the child and family. Basically, the T.S.S. follows the behavioral/treatment plan developed by the Behavior Specialist. The T.S.S. works directly with the child, whereas the Behavioral Specialist Consultant acts more like a consultant. The T.S.S. may also work with the child in early childhood settings, if necessary. If the child is receiving early intervention services, a special instructor or therapist might work closely with you monthly, bi-monthly, or even weekly, to help you meet the needs of the child. Regardless of who is assigned to work with you and the child, it is crucial that a true partnership is formed between you and the individual(s). True progress can only be made when strategies are being implemented across all environments!

10 Let's face it, inclusion is here to stay. In today's early childhood classroom, the chances of having a child with developmental delays or disabilities, such as autism, increase every year. Coming up with effective strategies to include children with disabilities is not an easy task. However, once you find the right approach, or series of approaches, that work for that individual child, it will not only make your job that much easier, but it will also increase that child's chances for success! Resources Autism: The International Journal of Research and Practice: Autism Society of America: Autism Speaks: AutismSpot: Empowering the Autism Community: Journal of Autism and Developmental Disorders: Nash, J.M. (2002, April 8). The secrets of autism. TIME Magazine. Retrieved from Pimley, L., Bowen, M., & Morgan, H. (2007). Autistic spectrum disorders in the early years. Thousand Oaks, CA: Sage Publications Snuggs, C. (2009, November 3). Educating preschoolers with autism: Tips for child care providers who care for autistic children. Retrieved from Whiffen, L. (2009). A child's journey out of autism: One family's story of living in hope and finding a cure. Naperville, IL: Sourcebooks.

11 Craig Gibson is a certified teacher in the state of Pennsylvania who has worked in a variety of academic settings, primarily with the special needs population. In addition to working in both public and private schools in Maryland, New Jersey, and Virginia, he worked as an early intervention teacher in Philadelphia, Pennsylvania, and is presently employed as the lead evaluator for a non-profit agency in southeastern Pennsylvania. In addition, Craig advocates for parents of special needs children, and enjoy giving talks to parents and professionals who have children or students with developmental delays. Craig holds bachelor s and master s degrees in Elementary Education and Special Education, respectively. He has published numerous journal articles and is a regular contributor to Exchange. Craig can be reached at craig.gibson6@verizon.net.!