 Most common: Word Level
Reading LD (“dyslexia”)
 Others: reading comprehension,
reading fluency, math, written
expressi...
 Common: 5-10% of total population, largest
single group of students in special education
 Almost 2/5 of all children id...
Reading requires awareness:
1. Words break down into sounds
2. Represented by letters
Phonological awareness =
The ability...
“Ha, ha, Biff. Guess What? After we go
to the drugstore and the post office,
I’m going to the vet’s to get tutored.”
 LD traditionally not diagnosed until early
elementary age, but deficits in
phonological awareness are present
much earli...
3 yrs
4 yrs
5 yrs
6 yrs
+
Spontaneous rhymes
Identifies rhymes
Segments syllables
Blends syllables
Generate rhymes, blend ...
 Phonological awareness allows for
accurate reading decoding
 Later steps:
- Fluent, automatic reading
- Reading compreh...
“Sophia”
- Pattern in late elementary school
* decodes familiar words accurately
* guesses at unfamiliar words
* slow read...
 Biological Factors
› LD is genetic - Runs in families
 50-80% of variance explained by genetic
factors
› LD in brain-ba...
 Risk characteristics present in
Kindergarten and G1 (and earlier)
 Letter sound knowledge, phonological
awareness, oral...
Examples:
 Orton-Gillingham
 Wilson
 Lindamood-Bell
 Phonographix
Look to the Florida Center for Reading Research:
htt...
What matters most?
- Direct instruction in decoding using
phonological rules
- Intensity, duration, frequency
- Teacher tr...
 Over 90% of children reading below the
15th percentile at the beginning of first
grade read at or above grade level by
t...
 Fifteen minutes of instruction in the
alphabetic code as part of a standard
kindergarten curriculum led to significant
g...
 Phonological activities:
› Rhyming (nursery rhymes, rhyming stories)
› Segmentation (breaking sentences into
words, inve...
Students Need to Know Teachers Need to Teach
Phonological Awareness rhyme, alliteration;
deletion; segmentation
Alphabetic...
 Inclusion by default – very young
children not yet identified but at risk
 Older students:
› Usually have history of li...
 Mixed results
 Inclusion
› Best for mild LD
› Associated with better social/emotional?
 Some studies show better outco...
 Vision training/ eye exercises
 Tinted lenses or filters
 Special visual-motor exercises to
“develop the cerebellum”
...
 Impulsive, acts without thinking, gets hurt
a lot, always “into things,” risky behaviors
 Described as “busy” his whole...
Attention Deficit/ Hyperactivity Disorder:
1. Inattention
2. Overactivity
3. Impulsivity
 ADHD, Predominantly Hyperactive/
Impulsive Subtype
 ADHD, Predominantly Inattentive
Subtype
 ADHD, Combined Subtype
 Fidgets, squirms
 Leaves seat
 Runs about or climbs
excessively
 Difficulty playing
quietly
 “On the go" or
"driven ...
 Fails to give close
attention to details,
makes careless
mistakes
 Difficulty sustaining
attention
 Does not seem to
l...
 Six hyperactive/ impulsive and six
inattentive symptoms
 7% of children have ADHD
› 4% of children 4-8 yrs old
 Increase from 1997-2006
 Boys more likely to be diagnosed than
...
Beyond the traditional triad of
“not paying attention”, “not
thinking before he acts” and
“running all over the house
cons...
… We see…
› Disorganization
› Can’t remember 3-step instructions
› Can’t track time
› Poor planning
› Not checking his/ he...
Also known as…
Executive Dysfunction
 The "conductor of the
orchestra"
 The “CEO of the corporation”
 The “general of the army”
3 year olds – normally impulsive, limited
attention
* only 10% might have ADHD
4 year olds – problems more likely to be
pe...
 ADHD Preschoolers:
› Challenging to parent and to teach
› Impulsivity or Weaknesses in Behavioral
Inhibition often most ...
Result…
* More temper
tantrums
* Higher parental
stress
* Disruptive in groups
* More likely to be
expelled from
preschool...
 More likely to repeat Kindergarten
 At major risk for academic failure;
inconsistent performance
 Disorganization and ...
 Problems with getting started on tasks,
organization, planning, self-monitoring,
and holding information in mind emerge
Neurobiological disorder
› Prefrontal cortex/ frontal networks
 Genes / Heredity- runs in families
› Dopamine-related gen...
 Prefrontal/ frontal areas important in
attention and self-regulation
 Evidence for under-activity in frontal
networks i...
 ADHD clearly has a strong genetic
component
› Heritability .65-.90
 Converging evidence related to genes
that affect do...
Multimodal Treatment
 Medication (stimulant or non-)
 Psychosocial
 Parent training
 Social skills training
 Coaching...
 Special diets – limiting or eliminating
sugar, preservatives, artificial flavors/
colors, etc
› Sugar does not cause hyp...
Not yet enough evidence for or against:
 Omega fatty acid, glyconutritional
supplementation, regular multivitamins
(withi...
Myth #1: ADHD is not a “real” disorder
Myth #2: ADHD only affects kids
Myth #3: ADHD is overdiagnosed
Myth #4: Children are being over-
medicated
Myth #5: Poor parenting causes ADHD
Myth #6: Minority children are over-
diagn...
 Estimate 50% qualify under IDEA
› LD, OHI or other categories
 Majority of identified students in OHI and
ED group have...
 Most commonly used:
› Strategic seating
› Behavior modification techniques
› Extended time
› Modified assignments
› Test...
 Has best research support of any
classroom intervention
› List target behaviors (e.g., raise hand before
speaking)
› Spe...
 Research evidence for preschool / K
curriculum that directly teaches
executive function skills (Tools of the
Mind)
› Imp...
 Consistent routine every day
 Roadmaps for daily activities
› Visual schedules
 Preparation and support for transition...
 Highly structured approach to teaching
 Teachers who are interpersonally flexible
 Collaborative with parents to meet
...
 Generic social skills training for whole
classroom
› Cooperation skills
› Helping skills
 Social Initiation
› Asking qu...
 Cooperative learning groups with high
level of teacher attention
› Increased academic engagement
› Better academic perfo...
 Promote peer interaction
 Create opportunities for cooperation
and negotiation
› Supported group work
› Sharing of reso...
 Normalize unusual behaviors
 Reduce stigma for children with special
needs
 Research suggests early education
promotes...
 In early education
› Phonological awareness training works to
prevent LD
› Interactive reading builds literacy and
compr...
 Accommodate LD in the inclusion
classroom
› Multimodal presentations
› Prompting and cuing to elicit correct
responses
›...
 Planned physical movement
 Structure the unstructured
 Proximity control
 Strategic seating
 Break tasks and directi...
 Behavior modification
› Whole class
› Contingency contracts
› Daily Behavior Report Card
 Catch them being good
 Plann...
•School level support
•Access to specialists
•Address attitudes toward inclusion
•Components of an inclusion classroom
 Administrative support
› Mentoring
› Training
› Ongoing support and encouragement
 Identify at-risk situations outside ...
 Educational Specialists
 Developmental Specialists
 Autism Experts
 Speech-Language Pathologists
 Occupational Thera...
 Positive, open mindedness is important
 Teachers with positive, optimistic
attitudes disseminate that to students
› Beh...
 Numerous population based study have
found no link between autism and any
vaccine
 http://www.cdc.gov/ncbddd/autism/do
...
Evaluating Autism Spectrum Disorders with the ADOS
Evaluating Autism Spectrum Disorders with the ADOS
Evaluating Autism Spectrum Disorders with the ADOS
Evaluating Autism Spectrum Disorders with the ADOS
Evaluating Autism Spectrum Disorders with the ADOS
Evaluating Autism Spectrum Disorders with the ADOS
Evaluating Autism Spectrum Disorders with the ADOS
Evaluating Autism Spectrum Disorders with the ADOS
Evaluating Autism Spectrum Disorders with the ADOS
Evaluating Autism Spectrum Disorders with the ADOS
Evaluating Autism Spectrum Disorders with the ADOS
Upcoming SlideShare
Loading in …5
×

Evaluating Autism Spectrum Disorders with the ADOS

908 views

Published on

0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
908
On SlideShare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
6
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide

Evaluating Autism Spectrum Disorders with the ADOS

  1. 1.  Most common: Word Level Reading LD (“dyslexia”)  Others: reading comprehension, reading fluency, math, written expression  Some would include: language problems, “slow learners,” mild intellectual disability
  2. 2.  Common: 5-10% of total population, largest single group of students in special education  Almost 2/5 of all children identified for special education in the US  Problem with decoding words  Underlying deficit: Phonological Awareness
  3. 3. Reading requires awareness: 1. Words break down into sounds 2. Represented by letters Phonological awareness = The ability to recognize, hear the difference between, and manipulate the sounds of your
  4. 4. “Ha, ha, Biff. Guess What? After we go to the drugstore and the post office, I’m going to the vet’s to get tutored.”
  5. 5.  LD traditionally not diagnosed until early elementary age, but deficits in phonological awareness are present much earlier
  6. 6. 3 yrs 4 yrs 5 yrs 6 yrs + Spontaneous rhymes Identifies rhymes Segments syllables Blends syllables Generate rhymes, blend and segment phonemes Delete phonemes, manipulate phonemes and syllables
  7. 7.  Phonological awareness allows for accurate reading decoding  Later steps: - Fluent, automatic reading - Reading comprehension - Spelling
  8. 8. “Sophia” - Pattern in late elementary school * decodes familiar words accurately * guesses at unfamiliar words * slow reading fluency * weak comprehension * poor speller
  9. 9.  Biological Factors › LD is genetic - Runs in families  50-80% of variance explained by genetic factors › LD in brain-based – differences in neural activation  Environmental Factors › Exposure to print materials, rich language › Instructional factors
  10. 10.  Risk characteristics present in Kindergarten and G1 (and earlier)  Letter sound knowledge, phonological awareness, oral language development  Assess all children and INTERVENE- first in the classroom and then through supplemental instruction
  11. 11. Examples:  Orton-Gillingham  Wilson  Lindamood-Bell  Phonographix Look to the Florida Center for Reading Research: http://www.fcrr.org/ Reading Programs Must Include: •Phonemic Awareness •Phonics •Fluency •Vocabulary •Comprehension
  12. 12. What matters most? - Direct instruction in decoding using phonological rules - Intensity, duration, frequency - Teacher training
  13. 13.  Over 90% of children reading below the 15th percentile at the beginning of first grade read at or above grade level by the end of the first grade with appropriate intervention.
  14. 14.  Fifteen minutes of instruction in the alphabetic code as part of a standard kindergarten curriculum led to significant gains in phonological analysis skills
  15. 15.  Phonological activities: › Rhyming (nursery rhymes, rhyming stories) › Segmentation (breaking sentences into words, investigating word length) › Syllables (clapping and dancing to syllabic rhythms) › Phonemes in words (initial sound vs. rime)  Interactive reading: Pause, ask questions, expand and elaborate
  16. 16. Students Need to Know Teachers Need to Teach Phonological Awareness rhyme, alliteration; deletion; segmentation Alphabetic Principle letter-sound patterns (phonics) with correlated text Orthographic Awareness spelling; writing conventions Comprehension Strategies main idea; inferencing; study skills
  17. 17.  Inclusion by default – very young children not yet identified but at risk  Older students: › Usually have history of limited success in general education › Does it make sense to continue to educate them in general settings?
  18. 18.  Mixed results  Inclusion › Best for mild LD › Associated with better social/emotional?  Some studies show better outcomes for combination general ed/ resource pull- out
  19. 19.  Vision training/ eye exercises  Tinted lenses or filters  Special visual-motor exercises to “develop the cerebellum”  Vitamins or herbal remedies  Chiropractic manipulations  Biofeedback
  20. 20.  Impulsive, acts without thinking, gets hurt a lot, always “into things,” risky behaviors  Described as “busy” his whole life; “even in the womb!” – “on the go”  Curious, often off-task, quickly bored
  21. 21. Attention Deficit/ Hyperactivity Disorder: 1. Inattention 2. Overactivity 3. Impulsivity
  22. 22.  ADHD, Predominantly Hyperactive/ Impulsive Subtype  ADHD, Predominantly Inattentive Subtype  ADHD, Combined Subtype
  23. 23.  Fidgets, squirms  Leaves seat  Runs about or climbs excessively  Difficulty playing quietly  “On the go" or "driven by a motor;"  Talks excessively.  Blurts out  Difficulty awaiting turn  Interrupts or intrudes on others
  24. 24.  Fails to give close attention to details, makes careless mistakes  Difficulty sustaining attention  Does not seem to listen  Does not follow through/ fails to finish  Difficulty organizing tasks and activities  Trouble with sustained mental effort (schoolwork, homework)  Loses things  Easily distracted  Forgetful
  25. 25.  Six hyperactive/ impulsive and six inattentive symptoms
  26. 26.  7% of children have ADHD › 4% of children 4-8 yrs old  Increase from 1997-2006  Boys more likely to be diagnosed than girls  Rates vary from place to place  Similar rates in Caucasian (7.6%) and African-American kids (7.4%); but Hispanic (5.1%)
  27. 27. Beyond the traditional triad of “not paying attention”, “not thinking before he acts” and “running all over the house constantly”...
  28. 28. … We see… › Disorganization › Can’t remember 3-step instructions › Can’t track time › Poor planning › Not checking his/ her work › Difficulty accepting other strategies, getting stuck › Overemotional › Desk/ bookbag/ room a disaster
  29. 29. Also known as… Executive Dysfunction
  30. 30.  The "conductor of the orchestra"  The “CEO of the corporation”  The “general of the army”
  31. 31. 3 year olds – normally impulsive, limited attention * only 10% might have ADHD 4 year olds – problems more likely to be persistent
  32. 32.  ADHD Preschoolers: › Challenging to parent and to teach › Impulsivity or Weaknesses in Behavioral Inhibition often most striking  Acts without thinking  “Leaps before she looks”  Can’t stop  Can’t self-regulate (including emotions)
  33. 33. Result… * More temper tantrums * Higher parental stress * Disruptive in groups * More likely to be expelled from preschools * More likely to be behind in academic readiness
  34. 34.  More likely to repeat Kindergarten  At major risk for academic failure; inconsistent performance  Disorganization and poor planning  Poor working memory  Social rejection
  35. 35.  Problems with getting started on tasks, organization, planning, self-monitoring, and holding information in mind emerge
  36. 36. Neurobiological disorder › Prefrontal cortex/ frontal networks  Genes / Heredity- runs in families › Dopamine-related genes  Other risk factors?
  37. 37.  Prefrontal/ frontal areas important in attention and self-regulation  Evidence for under-activity in frontal networks in ADHD
  38. 38.  ADHD clearly has a strong genetic component › Heritability .65-.90  Converging evidence related to genes that affect dopamine communication in the brain
  39. 39. Multimodal Treatment  Medication (stimulant or non-)  Psychosocial  Parent training  Social skills training  Coaching/ EF tutoring  School-based
  40. 40.  Special diets – limiting or eliminating sugar, preservatives, artificial flavors/ colors, etc › Sugar does not cause hyperactivity  Mega doses of vitamins (can be dangerous)  Treatments targeting “inner ear system”  Chiropractic manipulation  Vision therapy
  41. 41. Not yet enough evidence for or against:  Omega fatty acid, glyconutritional supplementation, regular multivitamins (within RDA), and herbals  Neurofeedback  Computer-based training of attention/ working memory
  42. 42. Myth #1: ADHD is not a “real” disorder Myth #2: ADHD only affects kids Myth #3: ADHD is overdiagnosed
  43. 43. Myth #4: Children are being over- medicated Myth #5: Poor parenting causes ADHD Myth #6: Minority children are over- diagnosed with ADHD
  44. 44.  Estimate 50% qualify under IDEA › LD, OHI or other categories  Majority of identified students in OHI and ED group have ADHD  Of special education students with ADHD, majority (63%) are in general education settings most of the time
  45. 45.  Most commonly used: › Strategic seating › Behavior modification techniques › Extended time › Modified assignments › Testing accommodations
  46. 46.  Has best research support of any classroom intervention › List target behaviors (e.g., raise hand before speaking) › Specific criteria for meeting target (< 3 violations) › Teacher records progress on DRC, gives feedback/ praise › DRC goes home – link to rewards
  47. 47.  Research evidence for preschool / K curriculum that directly teaches executive function skills (Tools of the Mind) › Improves self-regulation, also classroom management and academic readiness gains › Used successfully with range of special needs learners in inclusion model
  48. 48.  Consistent routine every day  Roadmaps for daily activities › Visual schedules  Preparation and support for transitions › Advance warning › Develop transition rituals › Provide additional support for transitions
  49. 49.  Highly structured approach to teaching  Teachers who are interpersonally flexible  Collaborative with parents to meet children’s needs  Positive, non-punitive behavior management system
  50. 50.  Generic social skills training for whole classroom › Cooperation skills › Helping skills  Social Initiation › Asking questions › Verbal negotiation  Teacher modeling and reinforcement of social initiation
  51. 51.  Cooperative learning groups with high level of teacher attention › Increased academic engagement › Better academic performance  Social activities that appeal to all children  Physically structure classroom to promote interaction – place child with ASD near a high status who is likely to initiate
  52. 52.  Promote peer interaction  Create opportunities for cooperation and negotiation › Supported group work › Sharing of resources
  53. 53.  Normalize unusual behaviors  Reduce stigma for children with special needs  Research suggests early education promotes more acceptance as children age  Provide opportunities for children with special needs to show their strengths
  54. 54.  In early education › Phonological awareness training works to prevent LD › Interactive reading builds literacy and comprehension skills  More intense intervention › Look to the research: Florida Center on Reading Research www.fcrr.org › Increase teacher training
  55. 55.  Accommodate LD in the inclusion classroom › Multimodal presentations › Prompting and cuing to elicit correct responses › Make the abstract concrete › Allow alternative response modes › Increase access to written word
  56. 56.  Planned physical movement  Structure the unstructured  Proximity control  Strategic seating  Break tasks and directions into smaller steps  Provide choices
  57. 57.  Behavior modification › Whole class › Contingency contracts › Daily Behavior Report Card  Catch them being good  Planned ignoring
  58. 58. •School level support •Access to specialists •Address attitudes toward inclusion •Components of an inclusion classroom
  59. 59.  Administrative support › Mentoring › Training › Ongoing support and encouragement  Identify at-risk situations outside of class › Lunch › Recess › Transition › Before-after school
  60. 60.  Educational Specialists  Developmental Specialists  Autism Experts  Speech-Language Pathologists  Occupational Therapists
  61. 61.  Positive, open mindedness is important  Teachers with positive, optimistic attitudes disseminate that to students › Behavior management problems predict attitudes  Parents are quite variable about inclusion Ferraioli and Harris, 2010, Journal of Contemporary Psychotherapy
  62. 62.  Numerous population based study have found no link between autism and any vaccine  http://www.cdc.gov/ncbddd/autism/do cuments/vaccine_studies.pdf

×