“Autism Spectrum Disorder, Intellectual Disability : Coping in the classroom” Assoc Prof Robyn Young School of Psychology Flinders University November 9, 2012 Areas of Impairment Rigidity of thought Social Interaction Restricted interests Social and emotional understanding Resistance to change Sensory Processing Verbal Non verbal Communication ASDs • Autism Spectrum Disorders (ASD) affect one in 160 Australians • male to female ratio of 4:1.1 • A devastating, life-long and often debilitating condition with no known cause or cure. • Although it manifests in the first three years of life the condition is life long • Estimated lifetime cost for an individual with an ASD is $3.5-$5 million Autism Spectrum Disorder More Severe Childhood Disintegrative Disorder Less Severe Classic Asperger Autism Syndrome PDDNOS Communication • • • • • Understanding and using words Understanding and using gestures and body language Interpreting facial expressions Understanding idioms and sarcasm Voice presentation may be unusual in monotone, accent and volume © Autism SA 2010 What do you mean? Don’t put all your eggs in one basket Hit the books © Autism SA 2010 Social Interaction • • • • • Understanding personal space Initiating and maintaining conversation Strong sense of social justice Developing and maintaining relationships Working in and joining groups © Autism Social Interaction • • • • Difficulty understanding the unwritten social rules Difficulty with sharing, taking turns, waiting, asking for help, listening and making mistakes May like to spend some time on their own May be vulnerable to teasing and bullying © Autism Theory of mind It was an accident. Why did you push me? That was done on purpose!! Kathy Hoopman –All cats have asperger syndrome What does this mean?? • I Didn’t Say She Stole My Money • I didn’t say she stole my money ( but someone said it). • I DIDN’T say she stole my money ( I definitely did not). • I didn’t SAY she stole my money ( but I inferred it). • I didn’t say SHE stole my money ( but someone stole it). Rigidity of Thought • Difficulty with change e.g., change in timetable, excursions, staff changes • They like routine, structure and predictability • May have different priorities and interest areas to you © Autism SA Sensory Processing • Oversensitive or under sensitive to touch, taste, smell, sight or sound (e.g. hands over ears). • May have difficulty with coordination • May have difficulty concentrating and may need movement or a quiet place during the day © Autism SA 2010 Students with ASD often display a high level of anxiety due to sensory, communication, social and emotional difficulties. This may result in: • Low self esteem • Depression • Meltdowns © Autism SA 2010 Students with ASD may need things to help them learn • • • • • • • Break cards Reward systems Movement breaks Visual supports Timers Fidgets Chill out spots © Autism SA 2010 Possible Phenotypes (Wing et al) • Aloof • Passive • Active but odd. Intervention Strategies • Teach alternative perspectives and solutions. • Facilitate appropriate conflict resolution. Encourage Friendship Skills • Behavioral strategies of observation and recording, task analysis, cues, prompting, shaping and rewards. • Cognitive strategies to learn the theory and script using Social Stories. Philosophy and Attitude • Discovery not correction (advice perceived as criticism) • Appeal to reason and intelligence. • Teach understanding not compliance. • Share information. Team Work Skills Other strategies • Teach them to watch other children as a model of what to do. • ‘Rent a friend.’ • Inclusion with neurotypical children as they can modify their social play to accommodate the child Friendship Characteristics Associated With Asperger’s Syndrome • Intensity of the friendship(Possessive). • Not ageist, sexist or cultural bias. • Exhaustion. “It takes all my brain power to be a friend” Affective Education • A project on a specific emotion. • Start with happiness or pleasure. • Create a scrap book that illustrates the emotion. • Diary with new experiences. • Compare and contrast other children’s scrap books. Affective Education • A thermometer, volume control, ruler, gauge, rope on the floor or speedometer to measure the degree of intensity. • Place photographs and words at the appropriate point on the ‘thermometer. • Increase precision and accuracy in verbal expression. Examples of activitiesHappiness • What are the feelings and sensations when you are happy? • Compliments can make someone feel happy. Choosing, giving and receiving compliments. • Rope activity. Stand at the point that represents the level of feeling. Examples: You find and can keep $20, Your mother says that she loves you. Relaxation Tools. Decrease Heart Rate • • • • • • Sleep. Stress ball. Pleasures book. Deep pressure. Jigsaw Art Simple operant conditioning • A B C • Discriminative Stimulus / Antecedent (A) • Operant Response / Behaviour (B) • Reinforcement / Punishment / Consequence (C) Things to avoid • Avoid giving eye-contact for disruptive behaviour – (this can be reinforcing). • Avoid repeating instructions – (every request must be responded to). • Avoid overuse of the child’s name – (this in itself is a request for eye-contact and a separate drill) • Avoid over-prompting – We are trying to make the child as independent as possible Criminals in waiting? • ASD assumed to be a key causal factor underpinning offending behaviour in many high profile (Howlin, 2004). • Sexual and violent offences have typically dominated • recent cases include the fulfillment of obsessions such as computer hacking and arson (e.g., the cases of Ryan Cleary, Gary McKinnon, William Cottrell). • In some of these cases Asperger Syndrome (AS) has been used as a defense against criminal conviction. • Judge described ASD as an “affliction” which made him incapable of “intent in aiding and abetting the destruction” (Mikulan, 2009, September 10). • Damaging claims in the press: Teenage 'hacker' has Asperger's syndrome • Ryan Cleary, the teenager accused of a hacking attack against the website of the UK's Serious Organised Crime Agency has been diagnosed with Asperger's syndrome since his arrest. Does having ASD increase risk of criminal involvement? • claims individuals with ASD are up to 7 times more likely to experience contact with the criminal justice system (Curry, Posluszny, & Kraska, 1993) • no convincing empirically based estimates relating to prevalence rates of persons with ASD in the criminal judicial system • recent research suggesting NO increased likelihood of criminal activity (e.g., Dein & Woodbury-Smith, 2010; Långström, Grann, Ruchkin, Sjöstedt, & Fazel, 2009; Mouridsen, Rich, Isager, & Nedergaard, 2008; Myers, 2004; Woodbury-Smith, Clare, Holland, & Kearns, 2006). • The reality is that the majority of persons with ASD do not engage in criminal behavior and are lawabiding citizens, often pedantic in their adherence to the law (Murrie, Warren, Kristiansson, & Dietz, 2002; Wing, 1997). • prevalence may be inflated by the likelihood of getting caught and convicted • some characteristics of the disorder however, may lead some individuals to an increased likelihood of criminal activity So why then do some individuals with ASD get into trouble? • unique from the perspective of criminal involvement • may fail to appreciate the nature and impact of their behavior. • diagnostic features can render them more vulnerable to involvement in antisocial behaviour • becoming naïve targets, accomplices or victims of crime. • core-features of the disorder: (i) poor social understanding or ToM, reflected by an inability to appreciate the social implications of one’s behavior, and (ii) rigidity of thought and obsessiveness. Questions