St Christopher’s School and Children’s Home (Bristol) Policy on Flexibility of Thought Ratified by Trustees November 2014 Review date December 2015 Introduction The purpose of this policy is to describe our understanding of one of the major difficulties encountered by pupils with Autistic Spectrum Disorders (ASD), and how it affects their ability to learn and to cope with day to day life. It is also within the remit of this policy to detail how we support those pupils and promote their learning and development. A diagnosis of autism or ASD means that the pupil has problems in three areas of development: communication, social interactions and imagination (restricted flexibility of thought), also known as the ‘triad of impairments’ (Lorna Wing, 1996). In 2013, a new Diagnostic-Statistical Manual (DSM) description of ASD replaced the Triad with a Dyad of impairments which includes Social Communication and Repetitive and Stereotypical Behaviour. Experiencing such deficits in these fundamental areas of development, often results in high levels of anxiety, and at times this can be expressed inappropriately through aggressive or self injurious behaviour. Our task is two-fold, on the one hand to create a safe and secure learning and living environment that helps reduce levels of anxiety, whilst on the other, it is to enable pupils to develop more flexibility and better coping strategies to improve their independence, their capacity to learn and their enjoyment of life. What is Flexibility of Thought? The typically developing young child initially learns through pretend play, imitation of actions they experience and perceive in their immediate environment. Later on, this is transformed in to a more abstract form of thinking and learning. This natural ability is impaired in the development of the pupil with ASD. Children with ASD have difficulties in using imagination to solve problems and in predicting outcomes in day to day life. These difficulties link to a limited ability to OM 7. Flexibility of Thought Policy File 2 Page 1 generalise from one experience to another, perhaps similar one, as well as an inability to anticipate new experiences, not already encountered. Learning activities that require imaginative or abstract thinking can be difficult for them to make sense of and engage in. Impaired flexibility of thought can be seen in the following behaviours: Restricted interests, e.g. Disney videos. Repetitive activities, e.g. ordering objects in their environment. Dependency on established routines and rituals in order to secure familiar outcomes. Difficulty with transitions between environments or activities. Difficulty with changes in the familiar environment, people or routines. Poor levels of imitation and incidental learning skills. Creating a safe environment Problems with flexibility of thought can arise from overload: difficulty in processing information from more than one sensory channel; inadequate filtering; selecting of stimuli. We can help the pupil with autism by providing them with familiar activities, routines, rhythms, and structure, as well as opportunities for repetition of newly taught experiences. It is also helpful, if when communicating with the pupil or presenting activities, we ensure that we do not engage more than one sense e.g. do not demand that the pupil look as well as listen at the same time. Of course this will vary for each pupil and therefore it is important to be aware of which senses are preferred by the pupil you work with, and how well they are able to process these stimuli. Developing flexibility of thought There are a number of very helpful strategies that we use to enable pupils to develop flexibility of thought and increasingly cope with change. Three of the most common at St. Christopher’s are: Visual Support, Structured Teaching, and Intensive Interaction. These approaches will be discussed below in more detail. In addition to these teaching strategies we must also ensure that we plan plenty of opportunities in the pupils’ daily life where they can engage in making choices and decisions, manage change and solve problems. One of the advantages of the residential school provision is the Waking Day Curriculum. Pupils are taught in one setting, and encouraged to practice them in a variety of settings. For example, in planning joint IEP targets in language and communication the pupil can learn to make choices of a snack using PECS, in the House and in the classroom. Another example is teaching a skill such as sorting, e.g. cutlery in Numeracy, then practicing this in ‘real life’ when setting the table in the House dining room. It is essential for school and care staff to enable the transfer of learning by liaising regularly with each other – this forms the basis of our Waking Day Curriculum. OM 7. Flexibility of Thought Policy File 2 Page 2 Visual Support and Structured Teaching These are two very important aspects of TEACCH (Treatment and Education of Autistic and related Communication handicapped Children). Visual Supports we use are mainly visual schedules, and also visual work systems. Visual schedules help pupils make sense of time sequence and the beginning and end of activities. Using visual schedules in the classroom and House helps pupils cope better with transition from one activity to another as well as from one setting into the next. Having a ‘change’ or ‘surprise’ card as part of a visual schedule can also help to explain when an expected activity is cancelled unexpectedly. Structured Teaching is the main element underlying the TEACCH programme. Its main purpose is to improve the pupil’s adaptation. This can be achieved on one level by developing the pupil’s skills, often using his or her special interests, whilst on the other by modifying or structuring the environment to accommodate autism deficits. (Schopler, Mesibov & Hearsey, 1995). There are four major components to structured teaching: Physical organisation Schedules Work systems Task organisation Physical organisation has to do with creating visually clear areas and specific boundaries in the classroom or House that pupils can identify with specific activities. Making associations between activity and physical space will help the pupil know what’s expected of them. E.g. when going to their work station they know they have a learning task to complete. It can be useful to have in the classroom or House a ‘transition area’ where the pupil’s visual schedule is kept. Going to the transition area in between activities as well as checking the visual schedule can help with making transitions. Schedules (visual timetables) provide a visual aid that gives pupils a concept of when and what activities will occur and in what sequence. Visually clear schedules help pupils anticipate and predict activities. They help reduce problems with memory or attention, time and organisation. They compensate for problems with receptive communication, and encourage the pupil’s independence. Schedules can also increase the pupil’s motivation, by readily available visual reminders e.g. “first work, then play”. Schedule (visual timetable) cards can also be used as ‘transition cues’, when the pupil can take an activity card off the schedule and match it to a card outside the area where the activity takes placed e.g. Groves Hall. This practice also helps pupils become more independent and confident with transitions. OM 7. Flexibility of Thought Policy File 2 Page 3 Work systems are another important element in Structured Teaching. They give a visual sequence of a distinct learning or work task, e.g. getting dressed in the morning using a sequence of prompt cards to show the correct order of clothing items to put on. Work systems also help develop flexibility of thought, by enabling the pupil to complete daily tasks independently. Task organisation is the fourth element of structured teaching, and is mainly used in the classroom, when pupils are completing tasks in their individual work stations. This involves setting up the actual task to be completed in a left to right sequence (or sometimes top to bottom) that the pupil can independently follow and when completed, put in a ‘finished’ box e.g. completing a jigsaw puzzle. Intensive Interaction We can help pupils develop flexibility of thought, through our understanding and engaging them with what has meaning for them. We use Intensive Interaction to engage with and interact with autistic youngsters. Here the focus is on developing early communication and social interaction. Pupil and carer need a shared language. A first step in Intensive Interaction is for the pupil to recognise something of their own thoughts and activities in the other person. Carers need to be flexible to make themselves available in this way. We look out for and respond to any interaction the pupil initiates themselves. We build up a repertoire, practice through repetition and work toward general interactivity, where dedicated one to one sessions start to lead to a more general style of engagement with the pupil. Flexibility of thought can then be developed through generalisation of activities: introducing new games, new settings and new people. Generalisation of Skills It is important to create plenty of opportunities for the pupils to generalise newly-acquired skills. This could be done by practising a new skill in more than one environment e.g. learning to tie shoe-laces in class and in the House. It should also be done by introducing slight variations to familiar activities and tasks, e.g. when teaching a new concept, such as ‘a cup is for drinking’, show a variety of cups. Pupil-Centred Approach St Christopher’s follows a holistic ethos, based on Rudolf Steiner’s therapeutic educational approach. This approach is based on the collaboration of a multidisciplinary team of care, education and therapy staff, in developing a holistic picture of the individual pupil, and their unique abilities and needs. The understanding of each pupil is based on observation, empathy and assessment of needs with the aim of creating a sense of security, a balanced routine and identifying key areas of learning and therapy intervention. OM 7. Flexibility of Thought Policy File 2 Page 4 Developing a healthy sense of rhythm through significant routines forms an important part of our philosophy. The rhythms of day, week, the seasons and celebrations help to create a sense of security as well as introduce elements of imagination and fun to the pupils’ life at school. Staff training All new staff attend an induction course within the first two months of their appointment. This includes an introduction to Autism and to Play and Interaction. All care and teaching staff attend visual communication workshops 1 & 2 as part of their induction. All care and teaching staff receive a three day PBM training course on dealing with challenging behaviour. Please refer to: Policy on Transitions (file 2) Policy on ASD Needs (file 2) OM 7. Flexibility of Thought Policy File 2 Page 5