Saturday, October 22, 2011

Dealing With Autism Spectrum Disorder (ASD) - Oct. 11, 2011 Georgetown SEPAC Meeting Notes

Georgetown Special Education Parent Advisory Council (SEPAC) Meeting
Meeting Minutes, May 17, 2011 – 7:00pm, Penn Brook Library

Meeting Topic: October 11, 2011 – Dealing With Autism Spectrum Disorder (ASD), Georgetown SEPAC Meeting, Tuesday, Oct. 11, 2011 at the Penn Brook School Library, 68 Elm St. in Georgetown, 7-9PM. Refreshments will be served. Everyone, parents, school staff, the public, is invited!

Dr. Ali Pedego, Ph.D., BCBA-D, Behavior Analyst, of The Melmark School, will speak with the Georgetown SEPAC about what Autism Spectrum Disorder is, how it is identified and diagnosed. What are the best ways to help and understand our children with related special needs? What strategies in school and at home are useful? Applied Behavior Analysis (ABA) – What is ABA and how does it work? What can school special education programs include and feature to help children with ASD? What outside resources and/or support are available? All parents, school staff, and the public are welcome. Refreshments will be served. Questions? Call Pam Lundquist, 978-352-5407. A Behavior Analyst is a practitioner who specializes in analysis of behavior problems and development of appropriate intervention and treatment plans. Find more info at

Dr. Ali Pedego has been working with the Georgetown School District for 3 years to develop special education programs for students with Autism Spectrum Disorders in all schools, beginning with the Middle School.

Handouts included: powerpoint presentation: An Overview of Pervasive Developmental Disabilities

Objective For Participants
- Introduction to Pervasive Developmental Disabilities
- Areas of impairment
- Behaviors you may observe
- General learning characteristics of persons on the Autism Spectrum

What is Autism Spectrum Disorder?
Autism is one of five developmental disorders classified in the DSM IV-TR under Pervasive Developmental Disorders (PDD). These include:
- Autistic Disorder
- Asperger’s Disorder
- Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS)
- Childhood Disintegrative Disorder
- Rett’s
• The diagnosis of these disorders is based on a defined group of behaviors which combine to result in a disrupted pattern of development.
• All of these disorders are characterized by varying degrees of impairment in:
- Communication skills
- Social Interactions
- Restricted, repetitive and stereotyped patterns of behavior

Recent reports indicate that as many as 1 in 110 children are diagnosed with Autism Spectrum Disorder.
- 10/10,000 people with “classic” autism
- 20/10,000 people with ASD, including PDD
- 50/10,000 people with ASD, including PDD and Asperger syndrome
Higher risk in siblings
4 times more common in boys than in girls
Occurs across all racial, ethnic, and social groups

Involves a comprehensive evaluation by a psychologist, a neurologist, or a psychiatrist with experience with children with Pervasive Developmental Disorders

The evaluation should involve input from family and possibly, educational staff

Improved diagnoses and environmental influences are two often considered explanations for increases in incidence.

Qualitative Impairment in Social Interactions
Marked impairment in the use of multiple nonverbal behaviors (eye contact, facial expressions, body posture, gestures to regulate social interaction)

Failure to develop peer relationships appropriate to developmental level

Lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (eg, showing, bringing, or pointing out objects of interest).

Lack of social or emotional reciprocity

Qualitative Impairment in Communication
Delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime).

For those with adequate speech, marked impairment in the ability to initiate of sustain a conversation with others
Stereotyped and repetitive use of language or idiosyncratic language

Lack of varied spontaneous make believe play or social imitative play appropriate to developmental level

Restricted, Repetitive, And Stereotyped Pattern of Behavior
Preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus

Apparently inflexible adherence to specific, nonfunctional routines or rituals

Stereotyped and repetitive motor mannerisms (eg, hand or finger flapping or twisting, or complex whole body movements)
Persistent preoccupation with parts of objects

Rett’s Disorder
All of the following:
- apparently normal prenatal and perinatal development
- apparently normal psychomotor development through the first five months after birth
- normal head circumference at birth

Onset of all of the following after the period of normal development:
- deceleration of head growth between ages 5 and 48 months
- loss of previously acquired purposeful hand skills between ages 5 and 30 months with the subsequent development of stereotyped hand movements (eg, handwringing handwashing)
- loss of social engagement early in the course (although often social interaction develops later)
- appearance of poorly coordinated gait or trunk movements
- severely impaired expressive and receptive language development with severe psychomotor retardation.

Childhood Disintegrative Disorder
Apparently normal development for at least the first two years after birth as manifested by the presence of age-appropriate verbal and nonverbal communication, social relationships, play, and adaptive behavior.

Clinically significant loss of previously acquired skills (before age 10 years) in at least two of the following areas:
- expressive or receptive language
- social skills or adaptive behavior
- bowl or bladder control
- play
- motor skills

Abnormalities of functioning in at least two of the following areas:
- qualitative impairment in social interaction (eg, impairment in nonverbal behaviors, failure to develop peer relationships, lack of social or emotional reciprocity)
- qualitative impairments in communication (EF, delay or lack of spoken language, inability to initiate or sustain a conversation, stereotyped and repetitive use of language, lack of varied make-believe play)
- restricted, repetitive, and stereotyped patterns of behavior, interests and activities, including motor stereotypes and mannerisms)

The disturbance is not better accounted for by another specific pervasive developmental disorder or by schizophrenia.

Asperger’s Syndrome
Qualitative impairment in social interaction, as manifested by at least two of the following:
- marked impairment in the use of multiple nonverbal behaviors such as eye-to-ety gaze, facial expression, body postures, and gestures to regulate social interaction
- failure to develop peer relationships appropriate to developmental level
- lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (EG, by a lack of showing, bringing, or pointing out objects of interest)
- lack of social or emotional reciprocity

Restricted, repetitive, and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:
- preoccupations with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
- apparently inflexible adherence to specific, nonfunctional routines or rituals
- stereotyped and repetitive motor mannerisms (eg, hand or finger flapping or twisting, or complex whole body movements)
- persistent preoccupation with parts of objects

Significant impairment in social, occupational, or other important areas of functioning

No significant delay in language (EG, single words used by age 2 years, communicative phrases used by age 3 years)

No significant delay in language (eg, single words used by age 2 years, communicative phrases used by age 3 years)

No significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment

Currently, there are no effective means to prevent autism, no fully effective treatments, and no cure.

Research supports the concept that autism is a biologically based developmental disorder but there is no definitive cause at this time.

Research indicated that early intervention in an appropriate educational setting for at least two years during the preschool years, can result in significant improvements for many. Effective programs focus on developing social , cognitive and communication skills.

Putting it All Together
- Poor Social Skills
- Atypical Behaviors and Interests
- Diminished Communication Skills
All three work together to create Challenging Behaviors

The Person with Autism Spectrum Disorder
- not understand what is expected
- not respond to commands
- avoid eye contact, say “look at my eyes”/”look at me”
- not be able to communication with words
- be echoic (repeat back what you say)
- say “no” or “yes” to all questions
- say “no” for “yes” and “yes” for “no”
- not judge personal space too well (too close or not enough)
- be hypersensitive to sensory input (touch/head/cold/wet/sirens/crowds)
- give misleading statements
- not acknowledge physical pain or be hypersensitive to pain
- not be able to communicate the extent of trauma due to lack of understanding, or inability to communicate verbally
- not use correct volume
- sound rude/blunt

Other Behaviors You May Observe….
- Hyperactivity, short attention span, self-injurious behavior, aggressive behavior
- Abnormal cognitive development
- Odd responses to sensory input
- Abnormal eating, sleeping patterns
- Abnormal mood/affect
- May have other co-occurring disorders or medical conditions
- Seizure disorders (1 in 4)
- Unusual reactions to sensory input: auditory, tactile, visual
- May demonstrate inappropriate vocals

General Learning Characteristics
- difficulty attending
- rote learning/memorizing
- resistance to physical prompting
- focus on less important components of lessons and reading materials, missing key information/themes
- variability in performance
- mistakes interfere with learning
- avoids social interactions
- difficulty establishing independent responding
- difficulty generalizing skills

What is Applied Behavior Analysis?
Applied Behavior Analysis (ABA) is a special kind of teaching. It is the only approach with large amounts of data supporting its effectiveness as an intervention for Autism Spectrum Disorders. Positive support strategies are aimed at teaching skills, how to….develop a friendship, start/continue/end a conversation,

ABA is…..
- Applied – Used to address real-world problems
- Behavioral – We identify and count behavior
- Analytic – We demonstrate, convincingly, that our changes are helping.
- Based on scientific principles of behavior
- Based on the work of many researchers and practitioners for over 30 years.

ABA is not…..
- new, a fad, a therapy, just discrete trial instruction, just for addressing challenging behavior, against inclusion, about turning students into “robots”

What is Applied Behavior Analysis?
- Procedures are experimentally derived from principles of behavior/learning
- Treatment procedures are well-defined and systemically applied
- Focus on teaching skills and making socially valid changes in behavior that lead to meaningful improvements in people’s lives
- Ongoing assessment to ensure that teaching or treatment procedures are responsible for changes in skills and/or behavior

Quality ABA Programs…..
- Are comprehensive, in that they address all skill areas
- Measure skills by direct observation
- Break skills down into components
- Include teaching that is broken into components: instructions, prompt, student’s behavior, and consequence
- Target skills that are meaningful and socially valid for the individual student

Characteristics of ABA Programs
- Start simple, build to more complex skills
- Students are provided with many learning opportunities, in a variety of learning contexts: 1 on 1, group, inclusion settings, reverse inclusion (bring in same-age peers)
- Focus on teaching new skills, not just decreasing “bad” behavior
- Requires formal training and experience to oversee

ABA Really is…
- Fun for the student…emphasis is placed on determining how the student learns and what they prefer
- Individualized to the student’s skill level, attention level, and learning style
- All about success…ABA used correctly results in a highly successful student!

There are a variety of ways to support children with Pervasive Developmental Disabilities at school, at home, and within the community….

Systematic Preference Assessment….determines what (activity, person, place, thing) motivates a child the best, and then that preference is offered as a reward for accomplishment/good behavior. However, preferences are ever changing, so the assessment process is fluid and ongoing.

Environmental Supports
- Make things predictable
- Consistent routines
- Avoid surprises
- Reduce distractions

Behavioral Supports
- Function-based interventions
- Visual supports (schedules, rules, checklists, social stories, colorful labels, graphic organizers)
- Teach self-management
- Behavioral contracts
- Reinforcement (praise, reward with preferences)
- Teach to request “escape” (taking a break) when needed, before “it’s too late”

Academic Supports
- Visuals (highlighting, manipulatives, graphic organizers, checklists and outlines)
- Direct instruction (often for reading comprehension)
- Dealing with Special Interests
- Controlled access
- Encourage other activities
- Preferred interest/activity contingent on participation
- Earn access to special interest

Social Skills Training
- Individualized social skills curriculum
- Support at recess
- Lunch Bunch
- Pre-teach before social situations
- Teach how to enter play/conversation
- Teach to accept mistakes and say “I don’t know”
- Teach how to observe and respond to nonverbal cues from others

- Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) (2000) American Psychiatric Association, Arlington, VA
- Gray, C. (2000) The New Social Story Book: Illustrative Edition. Arlington, TX Future Horizons, Inc.
- Henry, K.A. (2005) How Do I Teach This Kid? Visual Work Tasks for Beginning Learners on the Autism Spectrum. Arlington, TX, Future Horizons
- Hodgdon., L.A. (1995) Visual Strategies for Improving Communication: Practical Supports for School and Home. Troy, MI: Quirk Roberts Publishing
- Hodgon, L.A. (19999) Solving Behavior Problems in Autism: Improving Communication With Visual Strategies. Troy, MI: Quirk Roberts Publishing.
- McClannahan, L.E., Krantz, PJ (1999) Activity Schedules for Children with Autism – Teaching Independent Behavior. Bethesda, MD; Woodbine House
- McClannahan, L.E., Krantz, PJ (2005) Teaching Conversation to Children with Autism – Scripts and Script fading. Bethesda, MD; Woodbine House
- Rouse, C., Katera (1997) Quick and Easy Ideas and Materials to Help the Nonverbal Child “Talk” at Home. Solana Beach, CA: Mayer-Johnson Co.
- Savner, J.L., Smith Myles, B (2000) Making Visual Supports – Work in the Home and Community: Strategies for Individuals with Autism and Asperger Syndrome; Shawnee Mission, KS; Autism Asperger Publishing Company
- Wrobel, M. (2003) Taking Care of Myself: A Healthy Hygiene, Puberty and Personal Curriculum for Young People with Autism. Arlington, TX, Future Horizons, Inc.

Useful Web Sites
- adapted

Additional Resources
- clip art
- boardmaker
- (read information under treatment)

Thank you very much, Dr. Pedego, for doing such great work with the Georgetown School District and for sharing your wealth of knowledge with us this evening!

Respectfully submitted, Pam Lundquist, Georgetown SEPAC, Chairperson, 10/14/11

* Please do not reproduce any of this material in any unauthorized way. Thank you.

Other Useful Websites:
Behavior Analyst Certification Board -

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