Autism and ADHD Handout ©Jared Stewart, M.Ed. jareds@svacademy.org ADHD Strengths 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. Adventurous Animated Artistic Creative Curious Exciting Presenters Flexible Forgiving Fun-loving Great imagination Hyperactivity (Productive) Idealistic Impulsivity (Decisive) Incentive driven Intuitive Leadership Abilities Musical Passionate Persuasive Risk taker Sense of Humor Sensitive Spontaneous Trusting Visionary Autism Spectrum Strengths 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. Other Strengths by Lara Honos-Webb, PhD; excerpted from The Gift of ADHD. Studies suggest that many ADHD traits can be expressions of deeper gifts: powerful imagination, searching insight and unusual intuition. Seeing the Big Picture Those with ADHD are excellent at getting the big picture, in and out of the classroom. Students with ADHD may miss the little details, but they are masters at understanding the importance and meaning of material. The Energy of Impulse To think daringly original thoughts and to create new ideas or perspectives requires impulsiveness. It is a necessary ingredient for forging new ground in any area of study or thought. Naturally Creative ADHDers have been given the natural ability to engage in reverie or imaginative thought, to be bold and daring in wanting to bring his imagination into the world, and to be sensitive to inspiration from his thoughts, emotions, or the outside world. On the Importance of Being Confused Confusion is essential to creativity. In pretending to know it all, “normal” students and teachers gloss over the complexity and mystery of the world. Admitting or experiencing “not knowing” can be a liberating experience. In fact, the struggle to always have the right answer actually prevents a person from learning. If we think we have the answers, we are not open to a deeper understanding or exploring other ways of seeing the world. Thus, the slower, less-certain ADHD approach is often a strength. Approximately 1-3% have ASD Approximately 3-10% have ADHD Roughly 1/3 of those have both! Ability to put ideas together in a unique manner—highly creative Ability to thrive on routines and clear expectations Deep concern, caring, and love for “safe” beings Deep curiosity and desire to learn (usually prefer independent learning) Exceptional ability to systematize Exceptional ability with puzzles, mazes, and word games Exceptional auditory abilities (hyperconnected auditory brain centers) Exceptional rote memory (often vast stores of facts and figures) Exceptional visual abilities (static spatial, illusions, patterns, colors, etc) Five times more likely than “neurotypicals” to have perfect pitch Great honesty and respect for rules Highly deductive/analytic/logical—able to make more rational decisions than NT’s Idealism and a strong sense of right and wrong/social justice Laser-like focus of energies/attention on topic of interest Often natural leaders (albeit with some communication issues) Perfectionism (this can be both a strength and a challenge depending…) Powerful learning style strengths (implicit; vis/spat.; log/math; naturalistic; etc) Superior ability to process/locate information Ten times more likely to have savant skills (music, art, calculation, etc) Valuable employment characteristics: persistent, accurate, logical, reliable Notes on Giving Praise: Effective teachers praise their students consistently (frequently and predictably) and proactively (before a child gets off task). Successful teachers focus their behavioral intervention strategies on praise rather than on punishment. The following strategies provide some tips for giving effective praise: 1. Define the appropriate behavior while giving praise. Praise should be specific for the positive behavior displayed by the student. The comments should focus on what the student did right and should include exactly what part of the student's behavior was desirable. Rather than praising a student for not disturbing the class, for example, try praising for quietly completing a math lesson on time. 2. Give praise immediately and sincerely. The sooner that approval is given regarding appropriate behavior, the more likely the student will repeat it. The more sincere and emotionally positive the praise is, the more reinforcing it becomes. Similarly, students will notice when teachers give insincere praise, and this insincerity will make praise less effective. 3. Vary the statements given as praise. Don’t use the same phrase over and over. Eventually it loses all meaning and influence. Mix things up! Notes on External Reinforcement: Many students with ADHD and/or ASD do not deal well with abstract rewards, and will respond much better to concrete, external rewards. These rewards will need to be delivered as immediately, frequently, and powerfully as possible. Here are some strategies to consider: 1. Establish positive consequences before negative ones. Get as many positive consequences in place as possible. Set your students up to win! When negative consequences are administered, they should be given in a fashion that does not embarrass or put down students. 2. Token economy systems can work, but... These systems typically involved giving students tokens (e.g., poker chips) when they display appropriate behavior. These tokens are in turn ex-changed for tangible rewards or privileges at specified times. The tokens need to be appropriate to the students’ developmental level, age, and interests. Rewards must be changed or rotated frequently. 3. Consider Response-cost programs. A specific response-cost program found to be effective with ADHD students involves giving a given number of points at the start of each day. When a rule is broken (a problem behavior is displayed), points are taken away. Thus, to maintain their points students must avoid breaking the rule. At the end of the period or day, students are typically allowed to exchange the points they have earned for a tangible reward or privilege. DEALing with Inappropriate Behaviors: (Jared Stewart, M.Ed.) 1. Determine Context ABC’s (antecedent, behavior, consequences)? Sensory/Biological factors? Purpose of behavior? (what were they intending to do?) 2. Explore Causes Comprehension or communication deficits (verbal/nonverbal) Physical/Biological Factors (health, pain, comorbid, etc) Sensory Factors (hyper/hypo stimulation, boredom, etc) 3. ALleviate Behavior (using intervention strategies) • Facilitate Communication! (student, family, & educational team) • Teach social/emotional coping skills as well as academic skills • Therapy as necessary (CBT, ABA, Group, etc) Instructional Interventions 1. Antecedent intervention strategies Priming Academic Modifications Visual Supports/Schedules Planners/Organizers Environmental Modifications o Arrangement and seating o Color o Lighting o Temperature o Distractions o Stimulation Level o Space Use 2. Scaffolding/Task Analysis 3. Explicit instruction 4. Literacy strategies 5. Active learning strategies 6. Graphic organizers 7. Video Modeling 8. Self-Management Effective Classroom Interventions Behavioral Interventions 1. ABA 2. “Home Base” 3. Token Economies 4. Social Skills Training 5. Planned Distractions 6. Relaxation Techniques 7. Problem Solving Systems 8. Procrastination/Delay Systems Developed by Dr. Ruth Aspy and Dr. Barry Grossman, 2008 9. Know when/how to disengage! 10. Occupational Therapy and/or Sensory Integration Therapies Home-coordinated Interventions 1. Homework supports – Build in rewards (that the child helps choose) – Build in breaks (5 minutes every 20) – Set times/places (low distraction, natural lighting or no windows, clean, etc) – Get an extra of each textbook/workbook to keep at home if possible 2. Planner supports (reinforce the system that the school uses) 3. Sleep supports (use sleep hygiene, consider Melatonin) 4. Teacher supports (invite teacher to home!) 5. Medication supports (make sure it’s addressed) Other Tips 1. Use the “Rule of 2” 2. Get your MBA— “Master of Being About” 3. Find ways to say YES [but] (avoid “No”, “Stop”, and “Don’t”) –focus on what it is you WANT them to do! 4. Always give PURPOSE for desired actions 5. Teach SYSTEMS that break down tasks for specific results, and help them to run these independently 6. Social Stories (often in the form of videos) 7. PRAISE – PRAISE - PRAISE! (make things feel GOOD!) 8. Consider exercise and diet 9. Pick your battles! Some Hints for Helping with Differential Diagnosis: Behavior Issue More Like ASD Could be Either or Both More like ADHD Friendships Often not terribly interested in making friends (or very selective); tends to be socially anxious or see peers as objects Bullied (or a bully); Lonely— avoided by peers; Perceived as overbearing; Often interested in performing for others Makes friends easily, but loses them quickly; Likes to “show off” Video Games Likes to focus on the rules, setting, and mechanics of the game; often shows repetitive or asocial quality to their play Plays games for hours; Difficulty regulating interest; Seems obsessed or addicted Likes the instantaneous feedback, high stimulation, and fast pace of the game; often sees it as a way to socialize Reciprocity/ Sharing Creates for self first; often neglects basic social reciprocity Perceived as rude or antisocial; Interrupts; Grabs objects Trouble waiting for turn or for instructions; blurts out answers Poor planning and Organization Gets stuck in the details; lacks “big picture” or ability to see main ideas; loses track of time pursuing special interest Difficulty with deadlines; difficulty “caring” about the expectations of others Difficulty keeping track of assignments/materials; difficulty seeing the steps; forgets about commitments/appointments Movement/ Motor issues Repetitive, rhythmic, selfstimulating movements; poor at sports; stiff or uncoordinated; doodles constantly; anxious Difficulty staying seated; Constantly moving or fidgeting; Poor handwriting; “sloppy” work; hits others; trouble relaxing/slowing Movement more coordinated and energetic; movement aids concentration and executive function; good at sports Poor eye contact; rigid posture; inexpressive face (flat affect); needs lots of personal space; delayed/no reactions Monotonous or odd prosody; uses words that are “wrong”; Very quiet; talks endlessly about the same subject(s); echolalia Fascinated with inherent systems; stereotypical fixation on movement, objects, rules, maps, schedules; difficulty with change Doesn’t understand the physical or social consequences/context; Is hyperfocused or hyperstimulated Mismatched or unstylish clothes; poor hygiene and grooming; fails to read others’ body language Often touches or invades others’ personal space; misses facial or body cues because of inattention Excessive talking; interrupts or injects self into conversations that may or may not involve them; quotes movies/TV a lot Switches topics frequently; Makes constant ongoing comments/noises/narration; Asks people to repeat information/instructions Capable of focusing for hours on areas of interest; extremely hyperfocused Often “burns through” an interest and moves on to a new object of hyperfocus Seems oblivious to danger; tendency to be accused of stalking and/or harassment Makes decisions impulsively, without taking the time to think through the consequences Learning disabilities; Dislikes school; Dislikes group work; Lots of incomplete or missing assignments Loses assignments and materials, starts a project but doesn’t finish, unable to spend the time needed Nonverbal difficulties Verbal difficulties Perseverative Interests Dangerous/ Risky Behaviors Poor grades School and schoolwork is high stress; gets caught up in the minute details and perfectionism ©Jared Stewart, M.Ed.