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  • 1. Through the Eyes of a Child Conference November 12, 2009 Brian Johnson, Education Consultant - Autism Marge Resan, School Administration Consultant Special Education Team Wisconsin Department of Public Instruction Nuts and Bolts: Autism Spectrum Disorders
  • 2. Meet Will November 12, 2009
  • 3. Meet Will
    • Will is currently 7 years old, the middle child in a family living in an mid-sized community in Wisconsin.
    • Will was a content, quiet infant. Some described him as withdrawn.
    • Will’s speech development was delayed; however, once he began to speak he exhibited advanced vocabulary.
    November 12, 2009
  • 4. Meet Will
    • When he was 3 years old, Will began expressing extreme interest in carrots. He did not like to eat carrots; rather he liked to talk about carrots, hold carrots, draw carrots, make Play-Doh carrots, etc.
    • Will REALLY enjoyed talking about carrots – all the time -to the exclusion of other topics.
    November 12, 2009
  • 5. Meet Will
    • Will’s parents became concerned about his extreme love of carrots.
    • Will also became easily frustrated, and would occasionally become so upset he hurt himself by banging his head or scratching his tummy until it bled.
    • Will’s parents took him to see his pediatrician, who referred them to a pediatric neurologist.
    November 12, 2009
  • 6. Meet Will
    • The pediatric neurologist took a health history, ruled out seizure activity, and administered some screening tests.
    • Will was diagnosed with Asperger’s Syndrome, an autism spectrum disorder.
    November 12, 2009
  • 7. Meet Will
    • Will’s parents were told he might benefit from occupational therapy, speech therapy and other interventions.
    • However, Will’s parents found out their insurance did not cover these kinds of interventions.
    • Will’s pediatrician told his parents the county would help them obtain services.
    November 12, 2009
  • 8. Meet Will
    • The county early intervention program assessed Will, and determined he was too high functioning to qualify for any kind of services.
    • The county assured Will’s parents their school district would help Will.
    November 12, 2009
  • 9. Meet Will
    • Will’s parents took him to a screening program through the school district.
    • The schools learned Will was a very smart little boy, but agreed he had some confusing behaviors. They placed him in a Title I preschool program.
    November 12, 2009
  • 10. Meet Will
    • Eventually Will’s parents referred him for a special education evaluation by an Individualized Education Program (IEP) team at his school.
    • Will’s parents provided the IEP team information from his pediatrician, the neurologist, and the county evaluators.
    • The school staff conducted observations and did lots of testing.
    November 12, 2009
  • 11. Meet Will
    • Will’s parents hoped he would finally get some of the therapies that could help him.
    • However, the IEP team determined Will did not qualify for special education and did not need services.
    November 12, 2009
  • 12. What’s the moral of Will’s story?
    • Support systems (medical, social, educational) operate for different purposes and often don’t speak the same language.
    • Parents and families must learn “on-the-fly” to navigate complex systems, often without much help.
    • This can lead to great confusion and stress for families and systems alike.
    November 12, 2009
  • 13. Autism Spectrum Disorders
    • Continuum
      • Wide variability
    • Neurological Disorder
      • Physical differences in the brain
      • Wide Continuum
      • Range of Severity
    • Facts:
      • Prevalence rate is dependent on study:
        • National Children's Health Survey Report Finds Autism Prevalence Now 1 in 91
        • 1 in 150 children (1 in 94 boys)
    November 12, 2009
  • 14. November 12, 2009
  • 15. Video
    • http://vids.myspace.com/index.cfm?fuseaction=vids.individual&videoid=10239671
    November 12, 2009
  • 16. Medical versus Educational Eligibility
    • Medical Determination
      • Not required to determine whether a student meets eligibility criteria for the educational impairment area of autism.
      • If medical information is available, it should be considered as part of a districts evaluation but must not be the sole component.
      • Not mutually exclusive
        • Do not have to have a medical determination to have an educational determination nor do you have to have an educational determination to have a medical determination.
    November 12, 2009
  • 17. Educational Determination
    • IEP teams make the eligibility determinations for an educational impairment of autism.
    • IEP teams do not make medical diagnosis.
    November 12, 2009
  • 18. Characteristics
    • Autism affects socialization.
    • Autism impairs one’s ability to Communicate; affecting Receptive Language, Expressive Language and Pragmatic or Social Language abilities.
    • Autism may affect motor development.
    • Autism may affect the “thinking process.”
    • Autism may affect the entire sensory system.
    • Autism may affect behavioral repertoire.
    November 12, 2009
  • 19. Characteristics
    • Social Participation
    • The child displays difficulties or differences or both in interacting with people and events. The child may be unable to establish and maintain reciprocal relationships with people. The child may seek consistency in environmental events to the point of exhibiting rigidity in routines.
    November 12, 2009
  • 20. Examples
    • This is NOT because the child doesn’t want social interaction
    • JER: all I wanted was a girlfriend
    • Rigidity in routine, following a schedule
    • Communication difficulties
      • Initiation or maintaining interactions
    • http://www.youtube.com/watch?v=1zIY6DQSlbY
    November 12, 2009
  • 21. Characteristics
    • Communication
    • The child displays problems which extend beyond speech and language to other aspects of social communication, both receptively and expressively. The child’s verbal language may be absent or, if present, lacks the usual communicative form which may involve deviance or delay or both. The child may have a speech or language disorder or both in addition to communication difficulties associated with autism.
    November 12, 2009
  • 22. Examples
    • Communication is everything!
    • Non-verbal
    • Echolalia
    • Expressed through behavior
    • Highly verbal with excellent vocabulary
    • Problems may arise in both receptive and expressive language or individually
    November 12, 2009
  • 23. Characteristics
    • Developmental Rates and Sequences
    • The child exhibits delays, arrests, or regressions in motor, sensory, social, or learning skills. The child may exhibit precocious or advanced skill development, while other skills may develop at normal or extremely depressed rates. The child may not follow normal developmental patterns in the acquisit ion of skills.
    November 12, 2009
  • 24. Examples
    • Usually involves splintering skills
      • Clear strengths and weaknesses
    • Usually do not follow a normal developmental pattern or progression
    • Early signs
      • No looking at faces and smiling back by four months
      • No big smiles and joyful expressions with gaze by six months.
      • No back and forth sharing of sounds, smiles, and other facial expressions by nine months of age
      • No reciprocal gestures such as pointing, showing, reaching, or waving by twelve months of age.
      • No babbling by twelve months of age.
      • Any loss of language or social skills at any age.
    November 12, 2009
  • 25. Characteristics
    • Cognition
    • The child exhibits abnormalities in the thinking process and in generalizing. The child exhibits strengths in concrete thinking while difficulties are demonstrated in abstract thinking, awareness, and judgment. Perseverant thinking and impaired ability to process symbolic information may be present.
    November 12, 2009
  • 26. Examples
    • Concrete and literal understanding
    • Difficulty with executive functioning skills, i.e. attending, problem solving, organizing, prioritizing, and generalizing.
    • Academic difficulties (despite intellectual ability)
    • Critical thinking (comparing and contrasting, discerning main ideas, sequencing, organizing, etc.)
    November 12, 2009
  • 27. Characteristics
    • Sensory Processing
    • The child exhibits unusual, inconsistent, repetitive or unconventional responses to sounds, sights, smells, tastes, touch, or movement. The child may have a visual or hearing impairment or both in addition to sensory processing difficulties associated with autism.
    November 12, 2009
  • 28. Examples
    • May exhibit hypersensitivity (over sensitivity or sensory aversion)
    • May exhibit hyposensitivity (under sensitivity or sensory seeking)
    • OT skills are critical!
    • Inability to be able to function
    • Can manifest through behavior
    • Should be incorporated as part of day
    November 12, 2009
  • 29. Characteristics
    • Behavioral Repertoire
    • The child displays marked distress over changes, insistence on following routines, and a persistent preoccupation with or attachment to objects. The child’s capacity to use objects in an age-appropriate or functional manner may be absent, arrested or delayed. The child may have difficulty displaying a range of interests or imaginative activities or both. The child may exhibit stereotyped body movements.
    November 12, 2009
  • 30. Strategies for School and Home
    • Communication Systems
    • Social Stories
    • Power Cards
    • Predictability/Routine
      • Use concrete and visual cues as much as possible
    • Evidence Based Practices
      • www.autisminternetmodules.org
    November 12, 2009
  • 31. Professional Development
    • Building the Local Capacity for Students with Autism Spectrum Disorders within Wisconsin Schools
      • Webinars and Face-to-Face Trainings
      • www.dpi.wi.gov/sped/autism.html
  • 32. Contact Information
    • Brian Johnson
    • Education Consultant, Autism
    • [email_address]
    • 608-266-3648
    November 12, 2009