Beruflich Dokumente
Kultur Dokumente
Chicago, IL
27-30 May 2008
Presented by
1
INTRODUCTION
2
W H O A M I?
Introduction — The Past
The Autism Bomb
Loss of
speech
&
tantrums
Selfstims Environmental
withdrawal
3
W H O A M I?
Introduction
4
W H O A M I?
Introduction — Adult
5
AREAS TO CONSIDER FOR SUCCESSFUL ADULTHOOD
Overview
What we are doing now that Interdependent Living
has implications for adult life
Biomedical Residential
Employment
Behavioral/
Relationships (including sexual)
Developmental/
Educational
Continuing Education
Sensory SelfAdvocacy and Disclosure
6
NAVIGATING THE SEA
OF INTERVENTIONS
7
THE SEA OF INTERVENTIONS
Three Areas of Intervention
Educational/Behav Sensory
Educational- • DTT/ABA Occupational Therapy to
Behavioral Treat Imbalances of the
• Daily Life Therapy
Outer and Inner Senses
• TEACCH
• Sight • Touch
• Miller Method
• Taste • Smell
• DIR (Floortime)
Sensory Biomedical • Hearing
• RDI
• Vestibular
• SCERTS
• Proprioception
Stephen Edelson, personal
communication, December, 2004
Biomedical
Treating chemical imbalances caused by internal and external factors
• Digestion • Nutrition • Chelation • GFCF Diet
• Vaccines • Dysbiosis • Immunology • Feingold Diet
• Mercury and other heavy metal toxicities [metallothionein & glutathione]
8
A POSSIBLE INTERVENTION PROFILE
Three Areas of Intervention
Educational-
Behavioral
Biomedical
Sensory
Stephen Edelson, personal communication, December, 2004 9
SOME PROMISING INTERVENTIONS
Lovaas (ABA): Watson, Skinner, Operant conditioning, Shaping
behaviors, Antecedentbehaviorconsequence
TEACCH: Employs approaches based on the needs of a person’s
needs and emerging capabilities (Trehin, 1999).
Daily Life Therapy: Kito Kitihara, Platonic, Order of the physical,
emotional and intellectual.
Miller Method: Miller, Developmental-Cognitive Systems, Elevation,
Piaget, Vygotsky, Luria, Werner, Bertalanffy.
DIR (Floortime): Greenspan, Developmental-Affective, Circles of
communication.
Relational Development Intervention: Gutstein, Experience sharing rather than instrumental
relationships.
SCERTS: Prizant, Social-Communication, Emotional-Regulation,
Transactional Support.
Biomedical: MedicalChemical, Diet (GFCF), Adjusting chemical
imbalances, Persistent measles, Heavy metal toxicities.
Other: Sensory integration, PECS, Inclusion, Social stories,
Power cards, CCT 10
COLLABORATION MODEL FOR SOCIAL INCLUSION IN THE UNITED STATES
Nine Domains of Educational Accommodations
1. Size
2. Time
3. Level of Support
4. Input
5. Difficulty
6. Output
7. Participation
8. Alternate
9. Substitute Curriculum
11
Only hermits
live independently
INTERDEPENDENT LIVING
AND APPROPRIATE HOUSING
Along with
COMMUNITY INVOLVEMENT
12
AREAS TO CONSIDER FOR SUCCESSFUL ADULTHOOD
Residential
We ain’t gonna be
around forever….
Interdependent Living Group Living
• Home/Apt. • Shared Home/
– Roommates? Apartment/Institution
• Degrees of Supervision • Degrees of Supervision
– Minimal to Livein – Part to Fulltime
Least Restrictive Environment Continuum
13
WORK? WHERE? WHAT? HOW?
14
R E A L W O R L D O F W O R K
Defining Work – Adding Meaning to Life
Developing Talents: Careers for Individuals with Asperger Syndrome and
HighFunctioning Autism, Temple Grandin
However…
15
R E A L W O R L D O F W O R K
Reality for People on the Autism Spectrum
16
R E A L W O R L D O F W O R K
Characteristics of Autism – A Reframing
ASA A complex developmental disability that typically
(2005) appears during the first three years of life. Autism
Spectrum Disorder results from a neurological
condition that affects the functioning of the brain.
Reframe
DSM Social interaction • Communication
IVTR Communication (but no significant clinical delay
(2000) for AS) • Socialization
Repetitive motions and restricted interests
• Restricted
Miller Interests
(2000) Anything that interferes with the central nervous
system getting the needed information from the
environment.
OOPS!!!!!
WHAT ABOUT SENSORY INTEGRATION ISSUES?
17
R E A L W O R L D O F W O R K
Characteristics of Autism – Confusion and Chaos
Overly sensitive Difficulty with hair
to loud noises… washing and brushing…
l e
op Proble
pe ms wi
th han
n to e… dwrit
i lin ing…
s
p in
m
Bu
y ea ter… …
Alw
Pick Clumsy ay
s “on
the
go”
Difficult …
y paying a Only likes certain types
ttention
… of clothing…
Adapted from Myles, Cook, Miller, Rinner & Robbins. (2000). Asperger Syndrome and sensory issues :
Practical solutions for making sense of the world. Shawnee Mission, KS: Autism Asperger Publishing. P. 5. 18
R E A L W O R L D O F W O R K
Gearing Work Towards Interests
Interest/strength Implications for Career
Subway maps and computers Design maps for web pages of a
public transit authority
Horses and medicine Equestrian veterinarian
Hypersensitive sense of smell Airplane engine trouble shooter
and engineering
19
R E A L W O R L D O F W O R K
Determining Career Matches – Possible Employment Structures
• Competitive employment
• Full-time employment
• Part-time employment
• Permanent employment
• Short-term jobs
• Seasonal jobs
• Self-employment / Micro-enterprise
20
R E A L W O R L D O F W O R K
Matching Needs to Possible Positions
Adapted from Shore, S. & Rastelli, L. (2006). Understanding autism for dummies. New York: Wiley.
21
R E A L W O R L D O F W O R K
Matching Needs to Possible Positions
Adapted from Shore, S. & Rastelli, L. (2006). Understanding autism for dummies. New York: Wiley.
22
R E A L W O R L D O F W O R K
Matching Needs to Possible Positions
Adapted from Shore, S. & Rastelli, L. (2006). Understanding autism for dummies. New York: Wiley.
23
R E A L W O R L D O F W O R K
The Hidden Curriculum – Peter Gerhardt, 2004
THE HIDDEN
CURRICULUM
Practical Solutions for Understanding
Unstated Rules in Social Situations
Bob Sam
Brenda Myles
http://www.esoterically.net/log/archives/2003_01.html
Melissa Trautman
Ronda Schelvan
Sam arrives after Bob. What two rules did he break?
Autism Asperger Publishing Company 24
THE HIDDEN CURRICULUM INCIDENTAL BOOKS
25
RELATIONSHIPS
26
T H E R A G E C Y C L E
Adapted from Myles, B., & Southwick, J. Asperger Syndrome and Difficult Moments: Practical
Solutions for Tantrums, Rage and Meltdowns. Autism Asperger Publishing Company 27
I M P R O V I N G S E L F – A S S E S S M E N T
Adapted from Myles, B., & Southwick, J. Asperger Syndrome and Difficult Moments: Practical
Solutions for Tantrums, Rage and Meltdowns. Autism Asperger Publishing Company 28
SOCCSS
Situations — Options — Consequences — Choices — Strategies — Simulation
Jan Roosa (1995) in Myles, B., Trautman, M., and Schelvan, R. (2004). The hidden curriculum, Shawnee Mission: AAPC. p. 22
Situation
Who: David and Tom
When: At recess after lunch
What: Tom pushed David when they were both standing in line at the slide. Mrs.
Smith saw them and had both of the sit out for the rest of recess.
Why: David started teasing Tom about the coat he was wearing.
Situation
Who: David and Tom
When: At recess after lunch
What: Tom pushed David when they were both standing in line at the slide. Mrs.
Smith saw them and had both of the sit out for the rest of recess.
Why: David started teasing Tom about the coat he was wearing.
Strategy Plan of Action
The next time that David says something mean to Tom, Tom will tell him to stop
If David doesn’t stop teasing Tom, Tom will tell the teacher.
Simulation Practice
• Visually
• Verbally
• Roleplaying
30
Seek… to understand all aspects of the hidden curriculum
Observe… what people are doing and NOT doing
Listen… to what people are saying and NOT saying
Vocalize… questions and check for understanding
Educate… teach and learn… knowledge is power
31
Stop… what you are doing in order to…
Observe… what people are doing and NOT doing in order to…
Deliberate… to determine the next step of…
Act… based on the information you now have.
32
S O C I A L S T O R I E S – by Carol Gray
Using vignettes to describe how social interactions work employing…
Descriptive Sentences: Background of situation
Directive Sentences: Suggests action and decode meanings
Affirmative Sentences: Suggests commonly shared values or opinions
• When the teacher asks a question, many students would like to
provide an answer. Descriptive
• It’s hard for a teacher to hear when several students try to answer at
once. Descriptive
• Students in a classroom need to take turns talking. Affirmative
• When I want to answer a question that the teacher asks in class, I will
try to sit quietly and raise my hand. Directive
• The teacher may call on me to answer or the teacher may give another
student a turn at answering the question. Descriptive
• If the teacher does not call on me this time maybe next time she will
ask me to answer her question. Descriptive
Adapted from Gray, C. The new social story book. Future Horizons
33
Madeline Teaches Becca How to not Stress Out
Remain Calm
Power Card
Scenario: About 15 minutes into her weekly music lesson, Becca, a 9 year old
girl with AS consistently throws herself into a coach crying that she
“will never be able to do it” and “that is no use.” After 10 minutes,
Becca’s mother calms her down and the lesson continues with a doll
named “Madeline”. This behavior occurs during other activities too.
Motivator: Special
Interest/Hero
The doll Madeline
34
Madeline Teaches Becca How to not Stress Out
Remain Calm
Power Card
Madeline wa
nts you to r
ways to help emember to
calm yourse choose one o
difficulty an lf if you get f the follow
swering a qu f r u strated whe ing
try another. estion. If o n you have
If you need ne of the wa
perhaps nex help to answ ys does not
t time you c er the quest work
an do it all b io n this time,
y yourself.
1. Take 5 d
eep breaths
slowly after exhaling
each breath
.
2. Close you
r eyes and s
count backw lowly
ards from
from 10 to 1
.
3. Get a hu
g fr om Mommy.
4. Take a sh
ort break.
35
THE RAGE CYCLE
Adapted from Myles, B., & Southwick, J. Asperger Syndrome and Difficult Moments: Practical
Solutions for Tantrums, Rage and Meltdowns. Autism Asperger Publishing Company 37
T H E R A G E C Y C L E
Adapted from Myles, B., & Southwick, J. Asperger Syndrome and Difficult Moments: Practical
Solutions for Tantrums, Rage and Meltdowns. Autism Asperger Publishing Company 40
R E L A T I O N S H I P S
Circle of Relationships
Passerby,
Stranger Classmate, Coworker,
Fellow Commuter
Neighbor
Acquaintance Classmate, Coworker
Close Neighbor
Friend Classmate, Coworker
Mom, Dad,
Family >Significant Sibling, Other
other
Boy/Girlfriend,
Fiancé, Spouse
Develop a social
narrative
41
R E L A T I O N S H I P S
Talking About Sex Myths of Sexuality Peter Gerhardt
Common Myths But the Truth is…
• Persons with autism… • Persons with autism are as diverse
sexually as everyone else
have little to no interest in sex
and, sexuality education is
are hypersexual complicated by challenges in
are solely heterosexual language, communication, and
social differences.
While sexual feelings and
interest may be high, a primary
information source is usually not
So… How can we help available – nonspectrum teens
(Volkmar & Wiesner, 2003).
people on the autism
With proper support people with
spectrum deal with this autism can have relationships;
often with a person having a
important part of life? difference.
42
R E L A T I O N S H I P S
Talking About Sex Jerry Newport
How?
Sex is a normal yet a very private act and is clean.
• Discuss in a developmentally appropriate manner
Find the balance between not too much and not too little
• Make sure you understand the question(s) being asked
• Explain in a matter of fact manner
Why?
People find out about sex anyways from classmates, mass media, books, etc.
43
R E L A T I O N S H I P S
Talking About Sex Masturbation Peter Gerhardt
Redirecting Inappropriate Masturbation
• Interrupt the behavior as early in the chain as possible
• Remind the individual as to the parameters of time and place
• Redirect the person to…
A. activities requiring the use of both hands
B. activities requiring preferred levels of attention, focus, or physical
movement
C. the appropriate place for that activity
• Make the alternate activity intrinsically reinforcing
• Consider scheduling “alone time” in their room if appropriate
• Avoid redirection to places other than an individual’s bedroom (e.g.
bathroom)
44
R E L A T I O N S H I P S
Talking About Sex – Resources
Aston, M., The other half of Asperger Syndrome.
Hénault, I., Asperger’s Syndrome and sexuality: From adolescence through
adulthood.
Lawson, W., Sex, sexuality and the autism spectrum.
Mesibov, G., The TEACCH approach to autism spectrum disorders.
Newport, J. & Newport, M., AutismAsperger’s and sexuality: Puberty and
beyond.
Shore, S., & Rastelli, L., Understanding autism for dummies.
SicileKira, C., Autism spectrum disorders: The complete guide to understanding
autism, Asperger’s Syndrome, pervasive developmental disorders, and
others ASDs.
Wrobel, M., Taking care of myself: A hygiene, puberty, and personal curriculum
for young people with autism.
45
SELF-ADVOCACY & DISCLOSURE
46
The road to successful
self- advocacy starts by
accurately assessing your
circumstances.
47
S E L F A D V O C A C Y D E F I N E D
Selfadvocacy involves knowing
when and how to approach others in order to
negotiate desired goals, and in order to
build better mutual understanding, fulfillment,
and productivity.
Successful selfadvocacy often involves an amount of
disclosure about oneself that carries some degree of risk,
in order to reach a subsequent goal of better mutual
understanding.
48
W H E N T O T E L L …
The Twin Challenges of Disclosure and SelfAdvocacy
The issue of
disclosure begins…
…As soon as it is known that a person
has a difference in their way of being
49
W H Y T O T E L L …
The Twin Challenges of Disclosure and SelfAdvocacy
REALITY CHECK
Most people
are busy with living
Most people
are not in the mindset of
accommodating people with differences
50
S U C C E S S F U L T R A N S I T I O N
SelfDetermination —> Disclosure —> SelfAdvocacy
3. Non-judgementally
compare characteristic with
other role models.
51
SelfInitiated Individual Education Plan (Cont.)
Student Who must we get on board?
StudentÕs
(as appropriate)
IEP Team
Special
Regular • Student
Education
Education
Teacher(s)
or Provider
Teacher(s) Student’s Guide to the IEP
Helping Students Develop Their IEP
Student www.nichcy.org
A Person Who StudentÕs
as
Can Interpret School System
IEP
appropriate
Evaluation
Results TEAM
to their
Representative
• Parents
ability
Others with
Knowledge or Transition • Special Education Teacher
Special Services Agency
Represen
• Regular Education Teacher(s)
Expertise
about the tative(s)
Child
Parents
• Administrators
A Guide to the Individualized Education Program.
Office of Special Education Programs. 16 June 2002. • Others
<http://www.ed.gov/offices/OSERS/OSEP/Products/IE
P_Guide/>
52
SelfInitiated Individual Education Plan
To my IEP Team,
Truly yours,
Joey
53
SelfInitiated Individual Education Plan (Cont.)
C C
• Introducing the IEP • What to do before the IEP meeting
• Writing the IEP • Writing the IEP
Y Y
• Getting Ready for the IEP Meeting • Getting ready for the IEP meeting
• During the IEP Meeting • Participating in the IEP meeting
• After the Meeting • After the IEP meeting
www.nichcy.org
54
SelfInitiated Individual Education Plan (Cont.)
Accommodation Menu
Note: This form is not required by IDEA
Student: __Somebody___________ Date: ___10/28/07_____________
Teacher: __Anybody____________ IEP Manger: __Everybody_______
Effectiveness Effectiveness
Used? (15) Accommodation Used? (15) Accommodation
Placement Sensory
Preferential Lighting
√ 4 seating √ 2 Hat with visor
Small group Standing at desk
Assignments Other
Reduced paper/ Outline with
√ 5 pencil tasks √ 5 due dates for
Extended time assignments
Adapted from McGahee et al. (2001). Studentled IEPs: A guide for student involvement. Arlington, VA: Council for
Exceptional Children in Shore (Ed). (2004) Ask and tell: Selfadvocacy and disclosure for people on the autism
spectrum. Shawnee Mission, KS: Autism Asperger Publishing Company. P. 91.
55
Telescoping Forward to the Future
MY ADULT LIFE
Student: _____________________ Date: _______________________
Employment
Goals Goals
Current Accommodations Current Accommodations
Future Accommodations Future Accommodations
Recreation and Leisure
Home/Independent Living
Community Involvement/Volunteer Work
Postsecondary Education/Training
Adapted from Shore (Ed). (2004). Ask and tell: Selfadvocacy and disclosure for people on the autism spectrum.
Shawnee Mission, KS: Autism Asperger Publishing Company. P. 92.
56
CONTINUING EDUCATION
57
SOME STEPS FOR A SUCCESSFUL COLLEGE EXPERIENCE
A.S
Univ
So
O c ia
rg l
an • Friends
iz Parties
at Appropriateness
Li io • Aides
vi n
ng Carbonbased
Co Siliconbased
ur • Dorm? • Home?
se
w Single?
or
k • Part time? • Full time?
• Accommodations?
58
Looking For The Right College (Cont.)
Preparation Questions that need answering
• Documentation… • Where is the office of student
support?
Appropriate A.S.
What is needed to obtain
Recent
Univ
accommodations?
Suggestions for reasonable
Are they friendly?
accommodation
Do they know what AS is?
Issues to consider
Knowledgeable?
• Is assistance needed with…
Willing to learn?
Academic Accommodations
Independent Living Skills
59
M a k i n g C o l l e g e R i g h t (Cont.)
A C C O M M O D A T I O N S W O R K S H E E T
Name: Any Student School: Any State College
Counselor: Unnamed Somebody Date: August 15, 2007
60
AUTISM & SUC C ES S
61
S U C C E S S W I T H A U T I S M
Some Examples…
Zack Kassiane
“a guck goo…” AAU tumbling state
champion; 3rd national
(Special Interest)
62
S U C C E S S W I T H A U T I S M
Some Examples…
Sarah
Teacher of and seller of Laura
beads
A study in synesthesia
(Special Interest)
63
S U C C E S S W I T H A U T I S M
Some Examples…
David Shawn
Finishing a master’s in 1st place ribbon in
meteorology State Science Fair
(Special Interest) (Special Interest)
64
S U C C E S S O N T H E A U T I S M S P E C T R U M
Some Examples…
Valerie Takamimori
Founder of school for Sumo Wrestler
www.youtube.com/watch?v=ajQWQrxn1hc
children with AS
(Personal Experiences) (Special Interest)
65
M A R R I A G E F R O M T H E S P E C T R U M
Definition
If you are productive and fulfilled with your
relationship you are probably successful
e You
i n t h wher are exa
s a ll e you ctly
It ’ n e y right
need
to be
jou r now
66
Thanks for your participation!
Stephen Shore
www.autismasperger.net
67
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