Evidence based assessment tools include: Ages and Stages Questionnaire Autism Diagnostic Observation Scale (ADOS) Modified Checklist for Autism in Toddlers (MCHAT); MCHAT follow-up
“ Autism interferes with the normal development of the brain in the areas of reasoning, social interaction, and communication skills. Autism is often referred to as a spectrum disorder, meaning that symptoms and characteristics of autism can present themselves in a wide variety of combinations, from mild to severe. Although Autism is defined by a certain set of behaviors, children can exhibit any combination of these behaviors with varying degrees of severity.”
These children are attending Maryland’s schools in a number of settings, ranging from inclusion in public general education settings to placement in non-public residential school programs. Parents, family members, caregivers, educators and health care professionals who serve children with Autism are in constant pursuit of information about how to best meet the unique needs of these children and youth. Determined areas of need: Early Screening/Identification and Services Professional Development/Training Recommended number of hours
Major deficits in executive functioning, specifically with reference to: planning, flexibility, organization Each of these is instrumental in handling stressful stimuli
2010 data- there are now 8,827 children coded Autistic This is consistent with national trend data.
Biomedical therapies for people with ASD are focused on altering the individual with Autism’s physiology in such a way that the severity of his maladaptive symptoms and behavioral characteristics is diminished, thus improving his quality of life. CAM treatments can include, but are not limited to: dietary regimens (Gluten Free, Casein Free diets), psychopharmacological treatments, (antidepressants, stimulants, antipsychotics, atypical antipsychotics), neurological interventions (hyperbaric oxygen therapy, electroconvulsive therapy) vitamin/nutritional supplementation (Vitamins B12, C and D; Probiotics, Melatonin); detoxification therapy (Chelation), and physical therapy techniques (craniosacral therapy, acupuncture) as well as emerging experimental treatments (Secretin therapy, Stem Cell therapy, etc.).
Environmental factors- what would this student’s least restrictive environment look like? How do we facilitate his growth to get him there? Adaptations- what does your classroom look like? Sound like? Smell like? How is the lighting? The temperature? Any combination of these factors could cause a child with autism to become overloaded with sensory input, decreasing his ability to concentrate and to learn. Communication- how does the child communicate his or her wants? needs? Every child needs to be able to clearly communicate his or her needs, whether with PECS, sign language, or an output device. How about schedules? Does the child have a visual reminder of all of the day’s activities? Does he know what is coming next?
Couple those challenges to learning with these behavioral challenges.. Based on the aforementioned difficulties related to Self Regulation and Executive Functioning, Each of these feelings can trigger a strong emotional or behavioral response from a student with ASD.
Individualized Family Service Plan (IFSP) By recognizing each family's concerns and priorities and focusing on each child's strengths and needs, the Maryland Infants and Toddlers Program assists families of children with special needs during the first three years of the child's developmental journey. Support, information, and coordinated services in community settings are what families tell us enhance their ability to manage the challenges and celebrate the gifts that each child has to offer. As families and children leave the early intervention system, the focus on the child's strengths and inclusion in community activities continues. Preschool special education services and other community supports and services for young children and their families assist preschoolers with special needs to develop the skills that will be the foundation for school success. Discuss the evidence supporting community-based early intervention and the importance of providing family or child supports and services in natural environments Explain the variety of ways that formal and informal family or child supports and services can be offered Explain how the identification of a family’s priorities, concerns, and resources provides the foundation for decision-making during the development of an IFSP Explain the purpose for developing a flexible IFSP with families that reflects their desired outcomes Identify the information which must be included on an IFSP, and how to facilitate discussion with families to ensure all IFSP components are addressed Identify at least four concerns families may voice during the development of an IFSP for their child Describe how to assist families to identify their desired outcomes Identify the components of a functional outcome, measurable criteria, and effective strategies and illustrate with three examples Describe the factors to consider in determining the frequency and intensity of family or child supports and services Describe at least four decisions to make with family members while developing a flexible IFSP
Ours is one of 11 Autism Waivers currently in implementation in the US The Autism Waiver registry has more than 3,700 children and families awaiting consideration for slots on the waiver as they become available. There are currently no children under the age of seven receiving Autism Waiver services. For that reason, we make continued efforts to leverage funding for additional slots on the waiver. During the 1998 legislative session, DHMH, in collaboration with MSDE, was charged with applying to the Center for Medicare and Medicaid Services for a Home and Community Based Service Waiver that would allow children with Autism, certified as needing services from an Intermediate Care Facility for the Mentally Retarded (ICFMR) to receive waiver services to safely support and maintain them in their homes and communities Services available to youth on the Autism Waiver include intensive individual support services, respite care, family training, therapeutic integration, service coordination, environmental accessibility adaptations, residential habilitation, and adult life planning During the first year of Autism Waiver Service provision, 250 children were served. Now in its ninth year, the Autism Waiver accommodates 900 children with ASD across the State The Autism Waiver is currently at capacity. To track the growing number of families interested in accessing this resource, an Autism Waiver Registry is maintained, allowing eligible families to be referred to MSDE in chronological order when there are waiver vacancies
This is the foundation for All early intervention services
The Autism Speaks 100 Day Kit and the Asperger Syndrome and High Functioning Autism Tool Kit were created specifically for newly diagnosed families to make the best possible use of the 100 days following their child's diagnosis of autism or AS/HFA. Through a generous partnership with FedEx, after calling an Autism Response Team Coordinator and providing them with your information, you can pick up a complimentary printed copy of the 100 Day Kit or AS/HFA Kit at a FedEx Office location near you! 100 Day Kit Sections Autism Diagnosis, Causes and Symptoms Family Tips: Sharing, Caring and the Future Early Intervention and Education Rights Information on Therapies and Treatments Assembling and Managing Your Team 10 Things Your Child Wishes You Knew Resources by Topic Action Plan for the Next 100 Days Safety Tips Useful Forms Glossary
Karla Saval, M.Ed.Maryland State Department of EducationDivision of Special Education/Early Intervention Services
What is Autism Spectrum Disorder? Your child has been diagnosed with Autism: Now What? Early intervention Autism Waiver registry Elements of Effective Service Delivery to children with Autism Resources
“Autism is a complex developmentaldisability that typically appears during thefirst 3 years of life and is the result of aneurological disorder that affects thenormal functioning of the brain, impactingdevelopment .” -Autism Society of America
Video from the Centers for Disease Control ( (3:38) http://www.cdc.gov/NCBDDD/autism/videos/wha
Three main criteria: Qualitative impairment in social interaction Qualitative impairment in communication Restricted, repetitive, stereotypic patterns of behavior/ circumscribed interests, activities Three main categories: Autism Asperger’s Disorder Pervasive Developmental Disorder, Not Otherwise Specified (PDD-NOS)
Interferes with development of reasoning, social interaction, and communication skills Is a “spectrum disorder” has implications for an array of social, language, educational, sensory, behavioral, and medical issues
1 in 88 boys will be diagnosed with ASD The number of children in Maryland identified as having an ASD has dramatically increased from 260 in 1993 to 8,827 in 2010 There are 900 slots for Maryland’s Autism Waiver, and 3,700+ children on the Registry (CDC, MSDE, 2012)
Self Regulation Executive Functioning Socialization/Communication Biomedical Complications/ Comorbid DisordersLet’s explore each of these…
Produced by the Maryland State Department of Education 4/20/10 9
As a result of biomedical issues, individuals with Autism may have difficulty with regulating their: Attention Wakefulness Stress Frustration Response to sensory stimuli
Children with Autism exhibit deficits in executive functioning, specifically with reference to these domains: Planning Organization Flexibility Self-monitoring
Youth with Autism have may have difficulty: Communicating wants and needs Establishing shared attention with peers Monitoring social signals Reading social cues Responding to others’ stress Reading others’ expression of emotion Making social inferences Understanding others’ perspectives
…that the average child with Autism Spectrum Disorder is engaged in a minimum of 5 complimentary and alternative medical interventions to remediate his biomedical symptoms? Dietary regimens Psychopharmacological treatment Neurological interventions Vitamin/Nutritional Supplementation Detoxification therapy Physical Therapy Experimental Therapies (IAN, 2008)
Biomedical Complications Environmental factors Communication Choices Social/Emotional Competence Methodological approach to instruction Setting in which IEP is being implemented
Environmental factors that make youth withAutism “NUTS” Novelty Unpredictability Threatening Sense of control is limited(Sonia Lupien)
Now What? Contact the Infants & Toddlers Program in your jurisdiction. Your child could meet the criteria for early intervention services under the Individuals with Disabilities Education Act (IDEA). http://marylandpublicschools.org/MSDE/divisions/earlyinterv/in 1-800-535-0182 Put your child’s name on Autism Waiver Registry immediately! Call 866-417-3480 Seek supports and resources for your family!
The State of Maryland, as required by the IDEA, affirmatively attempts to locate, identify, and evaluate all children with disabilities at no cost to families. Mission and focus: To ensure that every child has a place in the community and the best possible chance to succeed.
The Medicaid Home and Community-Based Services Waiver for Children with Autism Spectrum Disorders Administered in collaboration with the Department of Health and Mental Hygiene (DHMH) Serves 900 children with ASDs Provides free services to maintain children with ASDs in their home and community: Intensive Individual Support Services Respite Care Family Training Environmental Adaptations Therapeutic Integration Adult Life Planning
Comprehensive assessment of skills, needs, and challenges Clearly defined goals/objectives Effective teaching strategies Progress monitoring Comprehensive team approach
“…Educational services should include a minimum of 25 hours per week, 12 months per year, in which the child is engaged in systematically planned, developmentally appropriate educational activity aimed toward identified objectives…” (National Research Center, 2001)
Autism Society of America Education, advocacy, services, research and support http://www.autism-society.org/ 1-800-328-8476
Autism Speaks 100 Day Kit Action planning for the first 100 days after a diagnosis of autism http://www.autismspeaks.org/family- services/tool-kits/100-day-kit
Pathfinders for Autism We’re newly diagnosed. Where do we begin? http://www.pathfindersforautism.org/articles/category/n This site provides a comprehensive listing of the variety of supports, services, and resources available in Maryland
Maryland State Department of Education AutismConnect This site contains recommendations made in the Autism Task Force Report, released in 2004, as well as MSDE research, education, and advocacy initiatives and partnerships focused on autism. www.autismconnectmd.org
Maryland State Department of Education The Early Childhood Gateway A resource for providers and families with young children with disabilities, birth through five http://www.mdecgateway.org/home
Maryland has Family Support Services Coordinators in each jurisdiction that assist families of children with disabilities ages birth to 21. A directory of Family Support Services is on the web at www.mdecgateway.org. For additional information, call: 1-800-535-0182
Contact:Karla M. Saval, M.Ed.Interagency Staff Specialist- Autism, Children’s Mental HealthMaryland State Department of EducationDivision of Special Education/ Early Intervention Services200 West Baltimore StreetBaltimore, MD firstname.lastname@example.org(410)767-0827