CADS – Module du Trouble
du Spectre de l’Autisme
CADS - Autism Spectrum
Disorder Module
By: CADS Technical Committee
2015-2016
1)
2)
3)
4)
5)
Definition
Category
Strength
Weaknesses
Interventions
1) Communication
2) Security
Training plan
Be able to assess communication and
intervention strategies,
 Be able to prepare for a ski lesson using
multiple strategy and plans,
 Be able to organize multiple choices
within each ski lesson.

…. with and without the uses of pictograms.
Aim of the Training Plan
Autism Spectrum Disorder (ASD), also
referred as autism, is:

A Neurological Disorder that causes
developmental disability...and
affects the way brain functions
resulting in:
◦ Communication difficulties
◦ Social interaction difficulties
◦ May also include unusual behaviour patterns,
activities and interests.
1- ASD: definition
The term “spectrum” refers to a continuum
of severity or developmental impairment.
1. ASD : Definition
The conditions cover a wide range in:
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Number and kinds of symptoms,
Severity: mild (1) to severe (3),
Age of onset,
Levels of functioning,
Challenges with social interactions,
1. ASD : Definition
Includes:
A.
Persistent deficits in social communication
and social interaction across contexts;
B.
Restricted, repetitive patterns of behaviour,
interests, or activities;
C.
Symptoms must be present in early
childhood;
D.
Symptoms together limit and impair
everyday functioning;
1. ASD : Dx
The severity code is in line with amount of
support needed:
1.
Need for support;
2.
Important need for support;
3.
Very important need for support;
2- Severity Code
DSM-V
Parts of the brain affected by ASD
Amygdala
 Emotion
 Aggressive
behaviours
Prefrontal
cortex
 Attention
 Planning
 Abstract
thinking
 Social
behaviour
Temporal Lobe
 Language
 Social
perception
Cerebellum
 Attention
 Motor:
Causes / origins…



Coordination
Balance
Speaking

Non verbal reasoning skills,
◦ Chess.

Reading Skills,

Perceptual Motor skills,
◦ Baseball.

Computer interest and skills with
computers,
Strengths exhibited 1/2

Exceptional memory,

Visual and Spatial abilities,

Music Skill,

Drawing skills,
Strengths exhibited 2/2
Stephen Wiltshire, incredibly drawing the entire London skyline from memory
Exceptional memory & Drawing
skills

Impaired Communication:
◦
◦
◦
◦
◦
◦
Idiosyncratic words or phrases, (“Yes Sir” )
Choppy language,
Repetitive language,
Difficulty staying on-topic,
Poor conversation skills,
Abnormalities in pitch, stress, rate, rhythm and
intonation of speech.
Weaknesses Exhibited

Impaired Social Skills:
◦ Lack of Awareness:
◦
◦
◦
◦
◦
 Awkward social initiation,
 Little to no social initiation,
 One sided conversation,
 Struggling with perspective taking,
 Takes you literally,
 Little to no eye contact,
Abnormal Seeking of Comfort when Stressed,
Impaired Imitation Skills,
Abnormal Toy Play,
Difficulties forming relationships,
Perseveration.
Weaknesses Exhibited

Dependence on routine,
◦ But not all individual.

Abnormal responses to Sensory
Stimulation,
◦ Hyper-hyporeactivity.
◦ Hyper-hyposensitivity.

Behaviour problems
◦ Tantrum
◦ Self injuries
◦ Property destruction, etc.
Weaknesses Exhibited

Difficulties in Sleeping,

Eating challenges / diet,

Gastrointestinal problems,

Motor skills problems,
◦
◦
◦
◦
Balance,
Agility,
Limb speed,
Coordination (Eye-Foot).
Weaknesses Exhibited

Talk less – listen & observe,

Use show and tell strategy,

Avoid the Yes/No question type,

Brake the task into achievable pieces,
Interacting with an individual with
ASD

Give time to process,

Utilise repetition:
◦ Re-teach, repeat and practice.

Ensure your communication style matches
your student’s ability.
Interacting with an individual with
ASD
Support Strategies (AOT)
Like / dislike?
Anything I should avoid?
Is there one strategy I should be using?
Checklist?
Interacting with an individual with
ASD
Communication & behaviour tips:

First – then;
◦ Motivation

Countdown Strips;
◦ Shows how many
more are needed
◦ Help stretch the First-then
Interacting with an individual with
ASD
Communication & behaviour tips:

Token Boards;
◦ Motivation
◦ Positive feedback
Interacting with an individual with
ASD
Communication & behaviour tips:
Timers;
Good in transition between
activities

Interacting with an individual with
ASD
Communication & behaviour tips:
CHOICE
Play with snow
ball
Built a Snowman
Go Snowboarding
Choice can be : verbal, written or pictures in a choice board
Interacting with an individual with
ASD
Communication & behaviour tips:

Visual Scheduler…
◦ Decrease anticipation
-stress -anxiety
◦ Help the individual
understand what is
going to happen today.
Interacting with an individual with
ASD
Behaviour Support Tools:

Wait Cards;
◦ Make waiting more concrete
◦ Hold the card
Interacting with an individual with
ASD
Behaviour Support Tools:

Visual support for teaching safety;
◦ How to wear equipment safely… example
Interacting with an individual with
ASD
Cognitive and
Intellectual Disability
By: CADS Technical Committee
2015-2016
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Definition
Down Syndrome
Fragile X Syndrome
ASD
Severity Codes
Brain Injury
Common difficulties
Presentation for CI

Defining cognitive disability/impairment
(CI) is not easy, and definitions of
cognitive disability are usually very broad.

Individuals with CI also present:
◦ difficulties in various types of mental tasks.
◦ diminished cognitive and adaptive
development.
◦ may require assistance in daily activities.
Definition
Known and called Trisomy 21
◦ Extra chromosome on the 21st pair (t21)
Refers to a type of cognitive delay in
general intellectual functioning that may
include deficits in :
◦
◦
◦
◦
adaptive behaviour,
motor coordination,
muscle tone,
cardiac, digestive, vision and hearing
impairments.
Down Syndrome
Individual with Down Syndrome shows:

Loose joints
◦ Hyperlaxia

Low muscle tone
◦ Muscular hypotonic

Atlanto-axial/occipital instability
◦ Two first cervical bone

Effect on learning style
Down Syndrome
Fragile X is the second leading genetic
cause of intellectual disabilities:
◦ Most common cause in men,
◦ Generally large in stature but with poor muscle
tone,
Fragile X Syndrome
Behaviour features:
◦ Reluctance to make eye contact,
◦ Engage in odd stereotyped movements,
◦ Hyperactivities,
◦ Tremors,
◦ Poor motor coordination,
◦ Social and communication skills are not well
developed.
Fragile X Syndrome
Similar behavioural symptoms are
characteristic of ASD.
Three Subtypes of Fragile X
(only two will be
presented here)
◦ 1- Cognitive deficits more severe and share
with ASD.
 Social avoidance
 Repetitive movement
 Severe delays in developing speech and language
◦ 2- affect motor skills (balance), present tremor
and memory deficits.
Fragile X Syndrome
*1-Conceptual,
Category
2-Social,
3-Daily activities
Efficacy in
3 domain*
Description
85
 Can achieve academic success
 Mostly self-sufficient
 Need assistance with life decisions, finances,
nutrition, shopping and transportation
Moderate
10
 Adequate communication but complexity is
limited
 Social cues and social judgment regularly
need support.
 Self care can be achieve (support may be
required)
 Can be employed with some support.
Severe
3-4
 Communication skills are basics
 Self-care require daily assistance
1-2
 Usually 24-h care and support is needed
 Presence of co-occuring limitations (sensory or
physical
Mild
Profound
Severity Code
Genetic/neurobiological factors/injury that
alters the brain functioning process relate
to learning.
Its refer to a number of disorder that may
affect:
◦
◦
◦
◦
Acquisition,
Organisation,
Retention,
Understanding or use of verbal or nonverbal
information.
Learning Disabilities
Damage to the brain, which occurs after
birth and is not related to a congenital or a
degenerative disease.
Could be from but not restricted to:
◦
◦
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Stroke,
Illness,
Traumatic Brain Injury (TBI),
Brain tumors, and
Meningitis.
Brain Injury
Impacts of Brain Injury could be observed
in:
◦ Motor capacity (66%)
 Agility, coordination, limp speed, reaction time
 Focal paralysis of on or few muscles
◦ Sensory capacity (28%)
 Balance, and vision (61%)
◦ Cognitive (93%)
 Learning, memory(79%)
◦ Psychological (79%)
 Anxiety (61%), frustration-control of (68%)
Brain Injury
Lesions to the main line of the motor system
may result in an enhancement of some
features (positive features or exaggerated
response) or a reduction (negative features).
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Positive features or exaggerated
response can include:
◦ Hyperreflexia and hyper-tonus (abnormal resistance
to passive movement).

Negative features can include:
◦ Loss of strength, Loss of dexterity, Fatigability.
Brain Injury

Brain Stem System may lead to:

Motor Areas of the Cerebral Cortex may
cause:
◦ Dyscontrol of automatic behaviours, such as
posture, balance, locomotion and breathing.
◦ Weakness - hyperreflexia - spasticity.
◦ Organising, shaping and refining movement
difficulties.

Cerebellum lesions may lead to:
◦ Poor planning of movement,
◦ Poor regulation and timing of movement,
◦ Reduced smoothness and co-ordination of
movement.
Brain Injury
Common difficulties:
Reduce Frustration tolerance,
 Self-Esteem,
 Social Skills,
 Hyperactive ,

◦ Difficulties blocking out signals
◦ Prone to motor sickness

Hypoactive,
◦ Difficulties attending to signals
Brain Injury
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Create positive relationship
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Clear, simple and concise instructions
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Give student time to process
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Use the «Doer & Feeler» approach
Tips to create a successful
learning environment
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Maintain a positive attitude,
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Give positive feedback,
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Look for achievements, and be able to
highlight it,
Tips to create a successful
learning environment
For exercise #1a, #1b, #2a and #2b:
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Use participant characteristic #1 for ASD
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Use participant characteristic #2 and #3
for CI
Exercises
Create an activity using Pictograms to
perform any of the steps 1 to 4 (CADS
Level 1) or steps 1 to 6 (CADS Level 2).

Be creative,
 Use suggested pictogram or Create your own,
 Time 15 min,
 AOT must include Checklist,
 Must include safety,
 Team up to 4.
Use the Marking grid to help candidate
instructor building a successful ski lesson
ASD/CI Exercice #1a
Create an activity without Pictograms to
perform any of the steps 1 to 4 (CADS
Level 1) or steps 1 to 6 (CADS Level 2).

Be creative,
 Use other communication tools,
 Time 15 min,
 AOT must include Checklist,
 Must include safety,
 Team up to 4.
Use the Marking grid to help candidate
instructor building a successful ski lesson
ASD/CI Exercice #1b
Create an activity using Pictograms to
perform lift procedure

Be creative,
 Use suggested pictogram or Create your own,
 Time 15 min,
 AOT must include Checklist,
 Must include safety,
 Team up to 4.
Use the Marking grid to help candidate
instructor building a successful ski lesson
ASD/CI Exercice -2a
Create an activity without Pictograms to
perform lift procedure

Be creative,
 Use other communication tools,
 Time 15 min,
 AOT must include Checklist,
 Must include safety,
 Team up to 4.
Use the Marking grid to help candidate
instructor building a successful ski lesson
ASD/CI Exercice #2b
13, Fille, 37kg
Dx= Trouble du spectre de l’autisme (TSA) / TDAH, Scoliose
Rx= Dexedrine
Sx= difficulté motrice et faible résistance/endurance
(fatigue), Problème de posture, intolérance face à certaines
textures d’aliment, mutisme sélectif (mais parle aux
personnes connues)
___________________
13, Girl, 37kg
Dx= Autism Spectrum Disorder (ASD) / ADHD, Scoliosis
Rx = Dexedrine
Sx= Motor difficulties et little resistance/endurance (fatigue),
Stance problem, dislike some food texture, do not speak to
stranger (but do with known individual)
ASD/CI Exercise - participant #1
46, Femme, 85Kg,
Dx= T21, glande tyroïde
Rx= Syntroïde, (hypo)
Sx= Sous-réactive (hyporéactive), difficultés motrices,
problème de prononciation (dysarthrie), anxiété sociale.
__________________
46, woman, 85Kg,
Dx= T21,down syndrome, Thyroid
Rx= Syntroid (hypo)
Sx= hyporeactive, motor difficulties, language difficulties
(dysarthria), social anxiety.
ASD/CI Exercise - participant #2
18, homme, déficience intellectuelle léger, 65Kg
Dx= Déficit d’attention, TDAH; déficit d’apprentissage
Rx= Pms methylphenidate, (4 fois par jour)
Sx= Basse vision, dyspraxie, opération scoliose en mars
2008… mise en place d’une tige de métal.
Problème de positionnement des pieds (ouverts) lors des
déplacements
_______________________
18, men, CI mild, 65Kg
Dx= ADHD; learning disability
Rx= Pms methylphenidate, (4 times a day)
Sx= low vision, dyspraxia, scoliosis surgery in march 2008…
rods and screws.
Foot (open) position when walking
ASD/CI Exercise - participant #3