Building Educational Success for Students with Autistic Spectrum Disorders
Gina Cosgrove, Psy.D. & Kirsten Eidle-Barkman, Psy.D.
Students diagnosed with one of the Autistic Spectrum Disorders (ASDs), particularly High Functioning Autism, Asperger’s Syndrome, and Pervasive Developmental Disorder, (Not Otherwise Specified) (APA, 2000), are increasingly being included in regular classrooms. Contributing to this, the overall prevalence of ASDs has increased, with the incidence of Autism and Asperger’s together being about 1 per 1000 (Tanguay, 2000). While being included in the regular classroom is of great benefit to these students, it also brings about certain challenges for educators in providing appropriate supports to meet their needs, especially given the varied profiles that these children can display. Further, whereas children with Autistic Spectrum Disorders are a heterogeneous group, there are common challenges faced by each of the disorders. These include weaknesses in social relatedness/social skills, irregularities in language development and usage, and behavioral characteristics such as restricted interests, repetitive behaviors, and perseverative tendencies (Attwood, 1998, Church, Alisanski, & Amanullah, 2000). Although the intensity and severity of the above traits varies depending on the specific diagnosis, it is the presence of these specific characteristics that is common amongst the different ASDs. Given these varied profiles, as well as the increased inclusion of students with an ASD in the regular classroom, regular education and special education teachers are seeking additional information to help them understand the particular needs of these students, as well as to develop specific strategies to build success into the classroom. The present article is provided to assist in this pursuit. The overall social, communication, and management needs of students with an ASD will be reviewed, with specific strategies and interventions following.
Social, Communication, and Management Patterns of Autistic Spectrum Disorders
Social Development
Autistic Spectrum Disorders (ASDs) are often viewed as a “social learning disability” as the critical impairment lies in the child’s ability to process social information in an accurate and spontaneous manner. Often, children with an ASD do not attend to the relevant social cues in their environment and/or misinterpret cues. Additionally, unlike “neurotypical” children, they do not learn efficiently through modeling and/or through incidental teaching within their natural environments. In other words, it is difficult for them to simply build their social understanding through observing others. Instead, these children must receive systematic training across a range of developmental areas. Best practices in working with children with ASD states that their social processing deficits should be addressed across disciplines and multiple settings (Wagner, 1999). Therefore, the following skills are often targeted for treatment in the social area:
· Forming and maintaining friendships
· Processing social information (e.g., relevant social cues)
· Expanding areas of interests
· Building Theory of Mind skills or accurately interpreting the actions and perceptions of others
· Increasing self awareness and regulation of emotions
Communication Skills
Co-existing with the social needs of children with an ASD
are often impairments in communication skills.
As communication skills are necessary to effectively interact with
others in a social manner, treatment of these skills is necessary in helping
with the social development of children with an ASD. Some of the qualitative differences in
communication patterns that one may see in students with an ASD might include:
·
Impaired receptive or expressive language
·
Being less attentive to spoken language (e.g.,
decreased responsiveness to name)
·
Pragmatic deficits (e.g., one sided
conversations, decreased eye contact, off topic responses)
·
Difficulty interpreting abstract language (e.g.,
idioms, jokes, sarcasm)
·
Over reliance on scripted language
Management Needs
Finally, basic management needs are often evident in students on the Autistic Spectrum. These can be behavioral in nature, related to attentional weaknesses or may be brought on by sensory sensitivities. When targeting management needs one may see the following types of developmental patterns:
· Rigidness or inflexibility regarding routines, rules, etc.
· Cognitive inflexibility or a “one track mind”
· Difficulty adapting to new situations or changes in routine
· Difficulty maintaining focus/executive function weaknesses
· Perseveration on particular topics, objects, etc.
· Sensory sensitivities
· Co-morbid psychological diagnoses (e.g., mood or anxiety disorders, ADHD)
The above difficulties that students with ASDs face are well documented, but, with the appropriate supports in place, many of these students can function successfully within the regular education classroom. However, when appropriate levels of support are not provided or when the educational setting does not meet the student’s needs, behavioral challenges are often observed. These can take the form of verbal outbursts, physical aggression, social withdrawal, anxiety, and obsessiveness or perseveration (Smith Myles & Southwick, 1999). The following strategies are provided to help set up an educational environment that will not only prevent the occurrence of these behavioral challenges, but to also teach students with an ASD the necessary skills to help them maneuver successfully throughout the school day.
Interventions for Students with Autistic Spectrum Disorders
Academic Interventions
The language, social, and management weaknesses of students with an ASD intertwine to impact academic development. In the early grades, rote reading, fact knowledge, and calculation skills may be viewed as relative strengths for these students. However, as curriculum demands increase to include more inferential and abstract thinking, these students tend to become more challenged. They have difficulty following more complex directions and processing lengthy verbalizations becomes overwhelming. Further, weaknesses with regards to written expression are often observed, not only as a result of frequent fine motor weaknesses, but also as a result of difficulty integrating information and organizing thoughts without hyperfocusing on details. To address these difficulties and help the student with an ASD meet with further academic success, one may want to incorporate some of the following strategies into the classroom:
· Preteach new concepts so that they have a frame of reference when the concept is taught in the regular education setting.
· When appropriate, incorporate the student’s area of interest. For instance, one of the authors worked with a student who had a particular interest in lights and could cite volumes on the different kinds of lights available. When the class was completing a project on the community which involved researching a local shopping center, she was given the opportunity to research the lighting store located there. This increased her motivation and allowed her to demonstrate her wealth of knowledge in an appropriate way.
· Teach in an explicit manner. Use clear and concrete language and decrease the use of lengthy verbalizations. When one uses sarcasm or idiomatic language, interpret it for the student with an ASD.
· Provide note taking support for the student. This can be in the form of outlines, guided notes, or actual copies of the notes.
· Use graphic organizers to assist with developing and organizing writing assignments. One may refer to Inspirations.com for examples and ideas for developing graphic organizers.
· Use visuals whenever available to accompany verbal information, whether it be directions, lecture material, or a discussion. These can be in the form of charts, checklists, pictures, or lists.
· Modify homework or provide homework support for the student with an ASD.
Classroom Management Interventions
As noted above, basic management needs are evident in students on the Autistic Spectrum which can take the form of inflexibility, difficulty adapting to new situations, difficulty maintaining focus, perseveration, and sensory sensitivities. Below is a list of strategies which can be employed in the classroom to decrease the management needs of the student and increase his/her level of independence in negotiating the classroom environment.
· Use a visual schedule and review the schedule on a daily basis. This can take the form of a Velcro board with picture symbols, a dry erase board, or a laminated schedule inside their organizer. These methods allow for easily noting changes or something different that may occur during the day.
· Use presets for transitions. This provides the student time to process and assists them in changing “sets”.
· Because of difficulties shifting attention, be flexible and allow the student time to complete tasks or bring them to closure. When it is not possible to allow this time prior to a transition (e.g., class transitioning to physical education), one may want to develop a “to be finished” folder and build a set time in the day, which is noted on the schedule, to finish these activities.
· Use a visual timer to help make transitions and elapsed time more concrete.
· Apply rules carefully, as students with an ASD tend to be rigid in following rules. It is ok to be flexible with children who have an ASD (“fair does not always mean equal”).
· To assist with emotional regulation, provide a safe place, created in advance, where the student can go to process and calm down.
· Prior to giving directions, give presets and review directions after they are given. Provide visuals to support directions or provide a written form of multiple step directions (write on board, use dry erase board, etc.).
· To address attentional issues, provide preferential seating, develop a cueing system, use aide support to help cue the student to important information, and preset the student to listen and on what to listen for.
Social Interventions
Given the academic demands of
school settings, it is often the social programming of students with ASD that
takes less of a priority. Those who work
daily with these students, however, have grown to recognize that systematically
working on social-communication needs results in these students creating more
meaningful relationships with their peers, as well as building their sense of
independence (one of the most valued goals for these students). There is agreement in the literature that
students on the Autism Spectrum are at high-risk for social rejection. For instance, studies have indicated that
students with Asperger’s Syndrome are at high-risk for depression and even
suicide due to the social isolation that occurs during adolescence and young
adulthood (Attwood & Gray, 2004). It
is becoming increasingly more evident that assisting these students in linking
with their peers is one of our most important goals. Building social connectedness enhances a
student’s independence within the classroom, as well as building cooperative
skills that are critical within the educational environment (Prior, 2003). Given the importance of strengthening these
skills, a higher level of focus is being directed to the strategies in this
area.
Team Collaboration
Within the schools, a collaborative team with expertise in treating children with ASD will often work across therapeutic settings to address the range of needs. Often, speech and language therapists are building the student’s pragmatic (social language) skills within small groups as well as within the natural environment. This may include teaching conversational skills in a systematic manner, then generalizing the skill by facilitating interactions between the students and their peers. Actively integrating cue cards (i.e. depicting the steps of the targeted skill), as well as building the student’s understanding of the importance of the skill is needed. At times, video taping the student as he/she demonstrates the specific skills (e.g., working with a team) can be very effective in provind the student with important feedback in order to generalize the skill in a natural setting. These interventions are often coordinated with the support of a special education teacher who can further reinforce a student’s generalization of skills (recess, lunch, specials). Sharing of information across the team is critical (general education teacher, aides, other related service providers) to insure that “teachable moments” are supported throughout the day.
Social Skills Programming
Selecting
social skills curriculums and therapy tools is an important part of the
treatment process. Traditional skills
programs may outline common social deficits, but often fail to assist the
students in building their social reasoning skills. In other words, the student may learn the
“how” of performing the skill, but never develop the understanding of “why” the
skills are important, as well as “when” they should be performed. In fact, building social understanding in
children with ASD is truly the challenge of programming. (Attwood, 1998).
Carol
Gray has emerged as a leading innovator in treating social reasoning deficits
inherent in individuals with ASD. Social
Stories, developed by Gray,
meaningfully share social information with students in order to
improve their understanding of what is happening within a specific social
setting (Gray, 2000). The stories are
written individually for the student and often accurately describe a specific
event/situation. In order to write an
effective Social Story, Gray (2000) has identified a specific methodology for
writing the stories including descriptive statements (details outlining the
event or situation), perspective statements (how others in the environment are
thinking/feeling), as well as directive statements (specific behavioral
responses for the student). The stories
are written based on the child’s developmental level (i.e. their
language/reading capacity). The stories
are often written by therapists and/or parents and are read to the child prior
to the situation and/or event with the goal of providing the student with
accurate social information. Often,
these stories assist the child in organizing a more adaptive behavioral
response to the situation and can prove significantly more effective than
simply relying on rewards and consequences for addressing social-behavioral
deficits (Gray, 2000).
Social
Stories are written for children across the developmental continuum (Gray, 2000).
Younger children often have pictures to enhance the story, while older students
may assist in writing and illustrating the text. The stories have been written for a range of
problematic areas including the following topics: “Raising my hand when I have
a question”, “Saying hello to friends”, “When I make a mistake”. When the story accurately follows the
defined criteria set forth by Gray (2000), the Social Story often has the
impact of creating change in the child’s social adaptation. More recently, Carol Gray has emphasized the
importance of writing these Stories to highlight a child’s strengths and social
accomplishments (Attwood & Gray, 2004).
A range of programmatic models have emerged within the schools to meet this goal of building social connections. When deciding upon a program model, educators should attempt to select the less restrictive intervention. Making use of the natural environmental supports should be a rule of thumb when developing interventions. In other words, what are the social supports that exist within the classroom setting that could be accessed to build the child’s sense of connectedness. For instance, perhaps actively highlighting an ASD student’s strengths within the classroom could increase the child’s access and status with peers (Wagner, 1999). Another level of intervention may include a selected peer buddy or even a small group of students (peer network) who are selected in order to provide active support to the student throughout the day. One of the authors of this paper has had the opportunity to work in developing a peer network for a student on the autism spectrum within a suburban middle school. The students were solicited as volunteers and met with the building school psychologist regularly to discuss active ways of socially supporting the identified student (i.e. seeking him out during lunch for conversation, prompting him to organize his belongings as he switches class, etc.). This support has served to increase the student’s contact with his peer group (improved status), as well as to increase his level of independence (less reliant on aide support). This experience has revealed the importance of accessing peers as agents of social change and growth.
Peer
education models have also emerged as an effective social intervention for
students with ASD. Again, Carol Gray has creatively designed a curriculum known
as “The Sixth Sense” in which students are trained to better understand the
needs of their fellow student(s) with ASD (Gray, 2002). The training highlights the “theory of mind”
deficits of students on the autism spectrum.
Theory of mind refers to our ability to intuit social information based
on social cues in the environment. Our instinctive processing of social
information guides our social responsiveness. For instance, linking a specific
event (e.g., a child falling on the playground) to a specific emotional state
(e.g., child feeling embarrassed) may not be as easy for a student with
ASD. Thus, their social response of
laughing or just walking by the child when he/she falls may be viewed as rude
and/or insensitive. Without explicit
teaching to assist the child in making these connections more reliably, the
student is often at a significant social disadvantage.
Improving
peers’ knowledge of the autism spectrum and how they can support their fellow
student(s) can result in meaningful change for the identified student. Again, one of the authors of this article had
the opportunity to implement this training within an elementary classroom. Amazingly,
the students have provided incredible insights regarding how they could support
their fellow student with Autism. It is
unclear if the implementation of this program has been the sole reason for the
sudden growth in the identified student’s level of independence within his
classroom (less reliant on aide support, more driven to being like his
peers). What is known is that the
students feel more comfortable and equipped to relate to this student with
Autism.
A final
point related to the social programming of students with ASD is the importance
of bullying prevention within the schools.
Students with ASD are unfortunate targets of bullies within the schools
due to their social naiveness and reduced capacity to
detect teasing behaviors and defend themselves.
Additionally, it is a well-known fact that students who are alone
(isolated from their peers) are more likely to be targeted by bullies (Olweus, 1993).
Therefore, school-wide bullying prevention programs are critical to
reducing the victimization of students with ASD, along with other students who
are prone to being targeted. Specific
training for responding to bullies is essential for students with ASD. One of the most important pieces of the
intervention is to ensure that the student is either surrounded with peers
during at-risk times (when adult supervision is decreased), or is aware of the
importance of being with friends or around other children. Bullying prevention programs often assert
that students must be able to say something in defense of themselves to the
bully and then be able to access a team member for support. Ignoring bullies is not often effective, reacting emotionally or physically may result in
injury to the victim. Again, training
students with ASD on how to respond assertively while accessing support (“say
one thing and say it well, then talk to a support person”) is critical (Attwood
& Gray, 2004; Gray, 2000).
Thanks to the incredible
commitment of parents and professionals, there is a wealth of information for
school personnel to access when developing treatment intervention for students
with ASD. The above information helps to
identify a variety of needs for the student with an ASD, but also provides
practical and effective interventions for the educators working with these
students to optimize their development.
References
American
Psychiatric Association. (2000). Diagnostic and
statistical manual of mental disorders (4th ed.), text revision.
Atwood, T.
(1998). Asperger’s syndrome: A guide for parents and professionals.
Attwood, T &
Gray, C. (2004). Understanding asperger’s
syndrome: Social skills and social stories. Paper presented at
Church, C., Alisanski, S., & Amanullah, S. (2000). The social, behavioral, and academic experiences of children with asperger syndrome. Focus on Autism and Other Developmental Disabilities, 15, 12-20.
Gray, C. (2000). Gray’s guide to bullying, part 1: The basics. The Morning News, 12 (4).
Gray, C. (2000). The new social
stories book: Illustrated edition.
Gray, C. (2002). The sixth sense
II.
Olweus,
D. (1993). Bullying at school.
Prior, M. (2003). Learning and behavior
problems in asperger syndrome.
Tanguay,
Peter (2000). Pervasive developmental disorders: a ten year review. Journal
of the
Wagner, S. (1999). Inclusive programming for elementary students with autism.