Tag Archives: social

Autism, Direct Instruction and Having Friends

Social understanding and communication are two areas impacted by autism neurology. The way this plays out is different from one autistic individual to the next. Typically, for autistics I have worked with, this means that they do not always pick up social information from the world around them through observation only as most people do. Instead, they sometimes need direct instruction concerning information their autistic neurology doesn’t allow them to automatically pick up and learn.

I think it is important that those around autistics understand that not having typical social understanding of same age peers is part of what autism means. Many times I have seen well meaning adults blame autistics for behavior that is a result of their brain not picking up and synthesizing social aspects of many things in the way people with typical brains do. It is common for adults to think that since the autistic is smart he should know better and that he is choosing to behave rudely. This misattribution has so many negative and far reaching consequences for everyone involved.

In general, it seems that people looking at an autistic really cannot see the autism. This means it is difficult for most people to know what behaviors are reflective of the underlying autism. If a person has a broken arm we can see the cast and understand the person will not be able to use his arm as typically expected. If an autistic person does not have the social understanding of how to act when losing a game we may see him act as a sore loser. We do not see the differently connected neurological pathways that feed information from a variety of brain areas in a split second that are not connected in the usual manner and therefore cannot be used to pull up good loser behavior. That is, we cannot see the autism at play – we can only see the sore loser behavior.

To help in seeing the autism when it comes to areas of unexpected behavior due to atypical social understanding that is part of the basis of an autism diagnosis, here is an example of direct teaching that took place over several months for a 12-year-old boy to learn the skills involved in being a good loser. Learning these skills allowed him to play games with others his age – something he very much wanted to do.

Example of Direct Teaching on How to Be a Good Loser:

Rodney could only play games if he could be assured ahead of time he would win. He would actually say, “I will only play if you let me win.” Rodney very much wanted to play video games and board games with others and even though he had above average intelligence, couldn’t grasp why other 12 year olds didn’t want to play with him.

Social Story: I wrote a social story as a way to give Rodney the social information around winning and losing when playing a game.

Cartooning: Additionally, each time Rodney had played a game he would relay the information and I would draw it out in cartooning style with the talk bubbles. Once the sequence of events were drawn out we would go back over it and fill in thought bubbles. Rodney was often miffed as to the thoughts and feelings of others. He would sometimes take the cartoon home so he could ask his parents if I had the thought bubbles “right.”

Modeling: Additionally, each time I saw Rodney we played UNO and he won. I was very demonstrative in portraying good loser behavior along with identifying it as good loser behavior.

Visual Support: We even started a chart called How to Be a Good Loser and took turns writing down my good loser behavior.

Video Technology: Then, we would watch a You Tube clip that showed kids playing games, particularly watching for good loser behavior. Eventually we watched both good and bad loser behavior of kids playing games and Rodney became quite good at sorting out which behavior was good and which was not good.

Visual Response Prediction Rating Scale: Because Rodney was fond of science and experiments; we made a loser behavior rating scale where we decided, based on the loser behavior whether he would be invited to play another game with his opponent. Here is a snippet from that scale.

Likelihood of Being Invited to Play Again 

Loser Behavior

Invited to Play Again

Maybe Invited to Play Again

Not Invited to Play Again

“Good game”

X

 

 

“I hate you” and throws game pieces

 

 

X

“I hope I win next time” and kicking the board game

 

X

 

Quitting when it looks like you may lose

 

 

X

“Let’s have a rematch!” said with a voice expecting it to be a fun gam

X

 

 

Play Acting Desired Behavior: Next, Rodney practiced the good loser behaviors as if he were an actor in a play. I wrote a script where the characters, Jack and Jane played UNO with Jack winning the first game and Jane winning the second game. Each character exhibited good loser behavior when they lost. Rodney could do this play-acting, but he would always inform me, “This isn’t a real game. It is reading script.”

Video Technology: Then, we made our own video clips on Rodney’s iPad with him playing the character Jack being a good loser. We watched these video clips many times. It allowed Rodney to solidify the picture of himself using good loser behavior.

Predictability: Finally, I told Rodney that I would let him win game 1, 3 and 5 of UNO, but game 2 and 4 I would play my best and this meant that sometimes he might win and sometimes I might win.

Video Technology/Vicarious Behavior Rehearsing/Priming: Right before game 2 and 4 we would take a break to look at our Jack video clips.

Predictability: Whenever it looked like I was close to winning I would announce it so as to prepare Rodney, though he was keeping track pretty accurately.

Non-Verbal Prompting: The first time I was near winning Rodney announced he no longer wanted to play UNO. I pointed to our chart so he could be reminded of where that reaction was likely to lead. I started watching one of his video clips. He didn’t want to watch it, but because I was watching it he heard himself portraying his good loser behavior.

Allowing Extra Time for Processing During Difficult Moment: I told him to let me know when he was ready to finish the game. He took the iPad and watched the video clip and then said he was ready. It was really hard for him that first time he lost, but he was able to pull up the desired behavior.

Repetition and Practice: Eventually, with more practice, Rodney was able to pull up the good loser behaviors. In the beginning he needed to know before starting the game whether I was going to let him win or not. Eventually, we both played our best, neither one knowing who would win until we came to the end of the game.

Desired Outcome Achieved: Ultimately, Rodney was able to play games with others, which is what he so much wanted to do. One day he greeted me with an impish smile on his face and shyly said Darius had invited him to a sleepover on the weekend so they could play video games. He said, “I hope I win, but if I don’t I’ll be a good loser. I have to because mom says if it goes well I can invite Darius for a sleepover at my house next time.”

In retrospect, I could have added in a reinforcement system when Rodney started losing for real. We often reward ourselves when we do hard things well. Setting this up for Rodney likely would have helped him master the skill sooner. It would have also opened the way for us to talk about how he might chose to reward himself in the future when he does something well that was difficult for him to do in the moment. For example, if he loses graciously while playing a game with a friend, he might get 15 minutes extra of screen time (negotiated ahead of time with his parents). This would be similar to me deciding that on work mornings where I start with several hours of email to answer I will have a bagel with my coffee! We all set up self-reinforcement. Some of us do this without thinking much about it and others need to be directly taught to do this. It is simply another one of those  life long skill that can be directly taught!

It is also noteworthy that many autistics need some sensory modifications to the environment, breaks to regulate their sensory system, instruction on how to play the game and other supports particular to the way autism presents in them. I have used Rodney’s example because it required many different support strategies over a long period of time for him to experience his desired outcome of having friends play games with him. Others I have worked with required both less and more in the areas of support strategies and time to learn new skills. While we can all learn from Rodney’s example and find many useful strategies, how support is given to another person needing to learn a similar skill will work best when it is individualized to the needs of that person.

IMG_5606

BOOKS AND DVD BY JUDY ENDOW

Endow, J. (2012). Learning the Hidden Curriculum: The Odyssey of One Autistic Adult. Shawnee Mission, KS: AAPC Publishing.

Endow, J. (2006). Making Lemonade: Hints for Autism’s Helpers. Cambridge, WI: CBR Press.

Endow, J. (2013). Painted Words: Aspects of Autism Translated. Cambridge, WI: CBR Press.

Endow, J. (2009). Paper Words: Discovering and Living With My Autism. Shawnee Mission, KS: AAPC Publishing.

Endow, J. (2009). The Power of Words: How we think about people with autism spectrum disorders matters! Shawnee Mission, KS: AAPC Publishing.

Endow, J. (2009c). Outsmarting Explosive Behavior: A Visual System of Support and Intervention for Individuals With Autism Spectrum Disorders. Shawnee Mission, KS: AAPC Publishing.

Endow, J. (2010). Practical Solutions for Stabilizing Students With Classic Autism to Be Ready to Learn: Getting to Go. Shawnee Mission, KS: AAPC Publishing.

Myles, B. S., Endow, J., & Mayfield, M. (2013). The Hidden Curriculum of Getting and Keeping a Job: Navigating the Social Landscape of Employment. Shawnee Mission, KS: AAPC Publishing.

Teaching Autistic People

Just like people of all ages can learn, so is it that autistic people of all ages can learn. It is an utterly sad state of affairs that this even needs to be said, but unfortunately, it needs to be said. Too often I see autistic children being babysat rather than being taught at school. When I ask about academic curriculum being used, I am told, “Oh, he has autism” as if this is an answer to my question.

In my work as an autism consultant I am called on to go to public schools to see autistic students who are thought to be failing what the system has to offer. Most of the time students I see have behaviors that don’t work well in a school setting. For all students I am called in on, I use the stabilization techniques below, which are also the first steps I use when teaching autistic students if the student is not stabilized. This is why I can say that even when your student has autism, including when behaviors are present, he can learn just like any other student can learn. Autistic people are just as deserving of an education as other human beings. That being said, specific supports must be in place to insure access to that education. After all, nobody can do math (or any subject) when they are literally bouncing off the wall (a sign of extreme sensory disregulation).

Stabilization

  1. Internal Regulation (sensory diet)
    Autistics have a neurology that means many systems (sensory, emotions, movement) in their body do not automatically regulate. This means conscious attention and effort must be brought to regulate whatever systems need regulation. For most autistics I work with, the sensory system is so disregulated that it masks emotional and movement disregulation.

  2. External Regulation (interactive visual schedule)
    It really helps to know what is going to happen when – the schedule of events.

    Most students have a neurology that can pick up this sort of information without being instructed. They can sort out the spoken words of the teacher. Students with autism typically have weak auditory processing abilities. Their neurology may not allow them to take in verbal words, sort out which words are relevant and process those words to understand what will happen next. This means every transition from one activity to another can hit them as a huge surprise, causing further disregulation.

    When typical students are distracted and miss the teacher’s verbal instruction of “get out your math books now” they usually become aware that the other students are getting math books out of their desk so they know they are meant to get out their math books too. Autistic students do not pick up these external cues as readily.

    Even when they see other students getting out math books, autistic students do not necessarily take that to mean they should also get out their math book. This has nothing to do with cognitive ability. It has to do with weak connections between areas of the brain – several areas of the brain working together to synthesize environmental, social, emotional and other kinds of information to inform them “I need to get out my math book.”

    Visual schedules support this issue for most autistic students. It is often helpful for the schedule to be interactive – meaning the student needs to do something with the schedule before each transition.

  3. Relationship
    Most students I have been called on to consult for have experienced much angst along the way. They know they are not like other kids. They may or may not know they have autism. One thing I find is that students who are able to communicate are very aware they are different from other kids and they have made up a narrative to explain their differences to themselves. I have been honored by a number of students sharing these stories about why they are different. I have yet to hear a positive story. They are typically stories about major character flaws, sometimes character traits they have heard others ascribe to them such as lazy, stubborn, willful, violent, refuses to share, refuses to co-operate, etc.

    As I begin working with new students I typically use a simple interactive schedule to show them “work” and “sensory break.” I ensure they are successful at following this schedule even if it means we work for a few seconds and engage in sensory regulating activities for a much longer time. I am visually instructing how schedules work while getting the student’s sensory system regulated and doing that in the context of forming a positive relationship.Most students I see have not experienced a lot of positive relationships. They have learned not to trust others around them. I am giving them an exact visual way our time works. They can count on it, become part of it and will always succeed. Over time strong relationships develop. Once a relationship is solid, we know what sensory activities are needed (along with how long and how often) and the student has mastered his interactive visual schedule I know he is now stabilized. Once stabilized we are ready for more formalized instruction.

Instruction

  1. Identify and Teach Needed Skills
    Besides academic instruction, students with autism often have particular skills for which they need to receive direct instruction. This can be anything from how to open a milk carton to waiting for the teacher to call on you when your hand is raised before contributing. It is helpful to identify a few of the skills that are deal breakers to your student getting along in the classroom. Learning and using these skills can be intertwined with academic content and other parts of the day.

  2. Ensure Success by Decreasing Task Demands
    Differentiated Instruction is one way to reduce educational task demands to match the needs of an individual student while ensuring them opportunity to learn along with their peers even though he may not have the same personal resources to bring to the task. My favorite person when it comes to differentiating instruction is Paula Kluth. Every student can do something. If you need ideas on how to use general education curriculum for students with autism who you think cannot do general education curriculum please look up Paula’s work. (paulakluth.com)

    My favorite people when it comes to a discussion about decreasing task demands are Ruth Aspy and Barry Grossman. (www.texasautism.com) An example of decreasing task demands for a student who struggles with handwriting is to take handwriting off the table in all subjects except Handwriting Instruction. Perhaps a scribe is used to do the actual handwriting task or an app such as Dictation Dragon, which means he can now do creative writing through dictation. If the student is an efficient typist perhaps that is the way to go, which means the student can now do social studies assignment that involves answering questions with a paragraph.

  3. Reinforcement
    There is significant brain research that shows students with autism do not benefit from the same kind of social reinforcement that typical students do. For typical students, in general, the more social opportunities you can add into instruction and use for reinforcement, the more learning that takes place.

    For students with autism, social reinforcement and adding social aspects to learning detract rather than enhance learning. Tangible reinforcement tied to learning has been shown to work better than social reinforcement. In fact, it has been the ticket to learning for many autistic students.

    NOTE: I realize ABA therapy has had a history of using reinforcement in a punitive manner tied to repetitious drilling, often quite disrespectfully. This makes punishment, demeaning drilling and disrespect wrong. It does not make reinforcement wrong. All human beings benefit from positive reinforcement.

2016-06-18 20.07.12

BOOKS AND DVD BY JUDY ENDOW

Endow, J. (2012). Learning the Hidden Curriculum: The Odyssey of One Autistic Adult. Shawnee Mission, KS: AAPC Publishing.

Endow, J. (2006). Making Lemonade: Hints for Autism’s Helpers. Cambridge, WI: CBR Press.

Endow, J. (2013). Painted Words: Aspects of Autism Translated. Cambridge, WI: CBR Press.

Endow, J. (2009). Paper Words: Discovering and Living With My Autism. Shawnee Mission, KS: AAPC Publishing.

Endow, J. (2009). The Power of Words: How we think about people with autism spectrum disorders matters! Shawnee Mission, KS: AAPC Publishing.

Endow, J. (2009c). Outsmarting Explosive Behavior: A Visual System of Support and Intervention for Individuals With Autism Spectrum Disorders. Shawnee Mission, KS: AAPC Publishing.

Endow, J. (2010). Practical Solutions for Stabilizing Students With Classic Autism to Be Ready to Learn: Getting to Go. Shawnee Mission, KS: AAPC Publishing.

Myles, B. S., Endow, J., & Mayfield, M. (2013). The Hidden Curriculum of Getting and Keeping a Job: Navigating the Social Landscape of Employment. Shawnee Mission, KS: AAPC Publishing.

Originally written for and published by Ollibean in June 2016. Add a comment here.

 

Autism and Measuring Normal

Even though people described me as in my own world as I was growing up, I was in the same world as every other human being. I could not help it that other people could not see the details of the world such as the sun sparkles and the misty tails rising up from the ground early in the morning like I could, but that didn’t mean our worlds were different.

Instead our experience of the same world was different. My experience was much more detailed because I had ever so much more to see than most people. I could also hear in a much more robust way than most people. In fact, my sensory experience of the world in general was always to a much higher refinement and greater impact than others report.

If we used my experience as the norm then all the typical people would come up as very lacking. But we do not measure experience from the most to the least sensory quantity or quality perceived. Instead we measure according to what most of the people perceive and label that as normal. Then, any experience that does not fall into this normal range of experience is labeled abnormal and people with this abnormal experience are said to be lacking.

If the truth were told, whenever the neurotypical yardstick of normal is used to measure me I do not measure up to be very many inches. (Endow, J., 2009a, 2009b, 2013) Because there is not a good way to measure the things that make me be me those things go unmeasured. Instead I am measured by the yardstick of what makes you be you and am found to be lacking.

Deficit based language in the field of autism is used for diagnostic purposes. A diagnosis is important in many regards because it can provide access to accommodations and supports, needed services and even a disability income and health insurance in adulthood for those who need it. The problem with deficit-based language comes when we take that deficit language out of the diagnostic arena and start using it to describe the humanity of a person with autism.

It is true that autistics are not like neuro majority folks and that when measured we often land outside of the majority norm. Geniuses land outside of the majority norm, too. Landing outside of the norm does not equate to mean less than as a human being.

Personal Questions for Self-Reflection:

  • Do you confine the use of deficit-based language to the diagnostic arena of Autism Spectrum Disorder?
  • How do you think about what is normal and what lies outside of normal?
  • Do you want or need to change your thinking?

When autistics are treated as equal human beings positive relationships are more likely to develop. This is important because people with autism are generally able to learn new things and to access their highest level skills and abilities in the context of a positive relationship. (Robledo, J. & Donnellan, A., 2008).

And yes, we actually have research to show this – quite sad to need to “prove” autistics respond to positive relationships just like other human beings. Just the idea that this research needed to be done is a reflection of the world’s continuing erroneous presumptions about autistics. Hopefully, research like this will help change the faulty perception of the world about autistics.

Personal Questions for Self-Reflection:

  • In your heart of hearts do you think of autistics as equal fellow human beings? If you are not pleased with your current thinking know you can change it.
  • Do your relationships with autistics have a level of shared high regard for one another? What evidence do you have to support this?

In conclusion, please don’t allow yourself to write off autistics as “in their own world.” This only encourages division – an us-and-them dichotomy – when, in reality, we are all in one shared world. Autistics tend to experience the world with a higher degree of sensory awareness and often interact with or guard against the impact of this experience by employing behaviors that can look different or unusual to those who don’t share the autistic sensory experience.

Saying that someone is in their own world tends to give permission to disregard that person and to invite others to think of him as less than other human beings. When this happens everyone loses, including you. So, if you talk about a child, teen or adult autistic as “being in his own world” will you please stop?

IMG_4542

BOOKS AND DVD BY JUDY ENDOW

Endow, J. (2012). Learning the Hidden Curriculum: The Odyssey of One Autistic Adult. Shawnee Mission, KS: AAPC Publishing.

Endow, J. (2006). Making Lemonade: Hints for Autism’s Helpers. Cambridge, WI: CBR Press.

Endow, J. (2013). Painted Words: Aspects of Autism Translated. Cambridge, WI: CBR Press.

Endow, J. (2009a). Paper Words: Discovering and Living With My Autism. Shawnee Mission, KS: AAPC Publishing.

Endow, J. (2009b). The Power of Words: How we think about people with autism spectrum disorders matters! Shawnee Mission, KS: AAPC Publishing.

Endow, J. (2009c). Outsmarting Explosive Behavior: A Visual System of Support and Intervention for Individuals With Autism Spectrum Disorders. Shawnee Mission, KS: AAPC Publishing.

Endow, J. (2010). Practical Solutions for Stabilizing Students With Classic Autism to Be Ready to Learn: Getting to Go. Shawnee Mission, KS: AAPC Publishing.

Myles, B. S., Endow, J., & Mayfield, M. (2013). The Hidden Curriculum of Getting and Keeping a Job: Navigating the Social Landscape of Employment. Shawnee Mission, KS: AAPC Publishing.

OTHER REFERENCES

Robledo, J. A. & Donnellan, A. M. (2008). Properties of supportive relationships from the perspective of academically successful individuals with autism. Intellectual Developmental Disabilities. 46 (4), 299-310.

Originally written for and published by Ollibean on February 18, 2016.
To leave a comment at the end of this blog at the Ollibean site click here.