Autismo y educación -Rita Jordan

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Autismo y educación

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Autismo y educación -Rita Jordan

  1. 1. Autism & Education Prof Rita Jordan PhD OBE Emeritus Professor in Autism Studies University of Birmingham, UK Conference for the 35th Anniversary of APNABI: December 11, 2014 Bilbao
  2. 2. What’s Special about ASD? • need to learn explicitly what others acquire intuitively or through social tutoring – identity of self/ other – saliency of social signals – agency and intention – relevance and priority – social/cultural meaning – nature of communication – emotional consciousness
  3. 3. Co-Morbidities Wing: “Nature never draws a line without smudging it” • ASD rarely occurs as sole disorder • additional developmental disorders & later anxiety disorders • diagnostic heirarchy rules deny reality: – language disorder & autism – ADHD &ASD – SpLD & ASD – SLD (LD) & ASD • expression of disorders affected by comorbid conditions
  4. 4. The ‘ASD’ lens • diagnosis not a good basis for services – should be needs led • individual needs determine learning and should determine teaching • individuality is even more the case in ASD • yet a lack of mutual empathy means – teachers have to use non-intuitive routes in teaching those with ASD – just as those with ASD have to use non intuitive routes in their learning
  5. 5. SEN of ASD Jordan (2005) • children with ASD have needs that are: – common (as children) – individual (as individuals - assessed needs) but also – group (related to ASD) • and it is only through awareness of group needs that individual needs can be recognised and met
  6. 6. Role of Education • as entitlement to broad & relevant curriculum – human right – adult success – need to consider reality of access • as therapy addressing the problems presented by ASD both aspects are needed but vary in priority with individual needs
  7. 7. Intervention & Education • educational entitlement – adaptation and access – range of provision – parent support for informed choice • education as therapy – eclectic tradition – no evidence of single approach – fit with local services – based on principles and best practice
  8. 8. Learning Style • visual rather than verbal • memory – cued – rote • ‘social’ is a dimension of difficulty • emotions and cognition – use interests for engagement • at sensory stage of meaning – presentation -> reference • repetition & consolidation • need explicit strategies for problem solving
  9. 9. Difficulties & Differences • executive functions – ‘monotropic’ attention – impulse control (difficult to limit) – idiosyncratic perception • imagination & reality testing • empathy & emotional/ conscious understanding • concept development – problems abstracting (not to do with ‘abstract’ concepts) – rigidity of concept & schema boundaries (teach to include exceptions)
  10. 10. Sensory Issues • evidence that at extremes • both over- and under-responsive to different senses • ‘over-responsive’: sensory avoiding; ‘under-responsive’: sensory seeking • most sensory avoiding • shield from sensitivities and/or desensitise • attach meaning to perception - reduce ‘bombardment’ of meaningless stimulation • aware of variability - use proximal blocks • give environmental control to individual if possible • reduce overall stress • teach to monitor and manage levels of arousal
  11. 11. Perceptual Challenges • cannot easily understand social meaning so: – teach for meaning (emphasise goals not parts of tasks - or get prompt dependence) – give explicit rules & instructions • visual ‘rules’ & ‘matching’ – allow time for processing – check on child’s perspective (squirrel story)
  12. 12. Memory Challenges • excellent rote memory but poor functional memory: • processes for teaching or generalisation of skills in functional environments • methods to enable memory cues across home/ school environments e.g. in homework • teaching a range of memorisation strategies (stories of cake making)
  13. 13. Communication • language and communication separate • often associated language problems • prognosis • all aspects: – gesture – posture – facial expression – emotion – pragmatics • use of IT - reversal of learning process - ‘reading’ 1st?
  14. 14. Social & Emotional Development – skills difficult without understanding – need some rules with a wide currency e.g. need communicative partner – value of Legotherapy / SHEDs for adults - social skills in context – other 'rules' may be socially disabling e.g. look when being addressed • will not know purpose • not able to time gaze appropriately • danger of giving wrong signals
  15. 15. Teaching for Purpose • different approach needed to suit – individual characteristics • sociability • language • cognitive level • sensory issues • age – goal – practitioner comfort/ ability/ knowledge – Gunilla Gerland (2013) (Secrets to Success for professionals in the Autism Field: JKP}
  16. 16. Individual factors: Sociability • Sociability NOT the same as social skills or understanding • Wing’s classification – withdrawn/ solitary -> passive/ responds -> ‘active but odd’ -> eccentric & sensitive • varies with conditions & with teaching • level suggests optimum form of approach – withdrawn - 1:1 directive & desensitisation – passive - interest & structured play experience – active but odd - social rules & experience (context) – eccentric - social skills in context e.g. buddy
  17. 17. Behaviour & ASD • behaviour itself not the basis of ASD – only a guide to underlying brain functioning/ psychology (Frith, 1989; Peeters, 1997) – no behaviours unique to ASD – poor basis for diagnosis - should be clinical judgment based on developmental history – DSM-V likely to exacerbate problems with ‘social & communication’ category for PDD-NOS not meeting ASD criteria
  18. 18. Is ‘Normal’ a Sensible Goal? • ‘acting’ typically may still be at a cost – more stress – breakdowns in unfamiliar/ unsupported situations • ‘recovery’ is liable to mean withdrawal of support or even understanding • cases of successful individuals with ASD at school failing to cope with ‘ordinary’ life – even suicide
  19. 19. Goals of Education • to become as good as one can be • not necessarily ‘less autistic’ in terms of behaviour alone • But: – free from the fear & stress of not understanding – with skills and support to lead a full & worthwhile life – with capacity for enjoyment – with resilience to cope when life is difficult or disappointing
  20. 20. Role of the Teacher/ Supporter • not to create artificial ‘autism friendly’ environments, at least, not long-term • to teach explicitly all the knowledge, skills and understanding that the rest of us just ‘pick up’ in ways that are both meaningful and accessible to the individual • most of this will not be ‘set’ lessons but a sensitivity to what needs to be taught in daily contexts • focusing on deficit, we get it wrong
  21. 21. Understanding is key • there is no intuitive or instinctual responses across the autism/ non-autism divide • both parties have to use cognitive routes to understand the other • such routes are difficult and inefficient • but they are essential if we are to live happily together
  22. 22. Principles that should underlie effective educational practice: • need for education to adapt to the learning style of individuals with autism • need to help individuals to adapt their learning style - better able to understand and operate independently in the non-adapted environment
  23. 23. Problems with Educational Language • model of conversation – contributions, topic maintenance • assumption of joint attention – holding up, eye/finger pointing • sarcasm & metaphor • literal understanding – jokes, idioms, pragmatic context, • model of questions – display, probe
  24. 24. Teaching to Cope • pre-empt: – stress - prosthetics & exercise – anger - alternative – frustration - communication – panic - posture / drill • train for ‘escape’ • teach relaxation • teach social understanding – Social Stories/ video life/ soaps
  25. 25. Research Evidence on Interventions • no single approach • evidence for: – structure – broad modern behavioural methods – training in social interaction & communication techniques • in all studies some do well and some do not • in all studies children tend to learn only what they are explicitly taught
  26. 26. Important Distinction (Mesibov 2009) • Evidence Supported Treatment (EST) – most common use – starts with treatment & asks if it works for a particular (narrow) group • Evidence Based Practice (EBP) – what we should do – starts with person and asks how we can achieve the best outcome
  27. 27. Importance of Process • sensitivity & flexibility of implementation at least as important as particular intervention • rigid interpretation of manuals leads to poor outcomes • lack of understanding of ASD de-skills staff and prevents effective individualisation
  28. 28. Curriculum for ASD • entitlement to culturally valued skills, knowledge & understanding • therapeutic needs from ASD difficulties • additional explicit content for otherwise ‘intuitive’ knowledge • long-term need for a ‘curriculum for life’
  29. 29. Goal is Q of Life not getting through the lesson • try not to give definite answers or models when there are exceptions • be authentic & praise effort, not success • don’t introduce unnecessary levels of learning e.g. fake materials when the real is available • appreciate the value of contact time – don’t use it for work that could be done independently – always think what is the student learning rather than what am I teaching – use structure to make choices (and non-choices) clear
  30. 30. Build on Strengths • relationships - use them – getting consistency across staff – motivating the children to learn – work with CAL • detailed planning – plan to pre-empt difficulties rather than ‘mopping up’ • opportunities to apply learning - plan for some ‘out of the box’ lessons that use the environmental facilities available – make lessons fit into life rather than be apart from it
  31. 31. Understanding behaviour: Functional Analysis • Settings – ‘last straw’ not always ‘trigger’ – whole child (inc. skills) & whole school approach – parent collaboration • Behaviour – accurate – frequency – duration – intensity • Results
  32. 32. Teaching Consequences • less able - single track • more able - – railway - no turns – 2 clear termini with no connections – choice point emphasised Moment of choice Problem Taught alternative
  33. 33. Basic Guide to Anxiety Reduction • relaxation – general - sensory/ meditation/ yoga/ deep pressure – specific - fold arms, close eyes, chant or hum • exercise – aerobic/ contingent & non-contingent • diet – GI index low / low stimulants/ sugar & additives • talking with others – drawing? music
  34. 34. Examples of Good Practice • CBT e.g.Attwood (anxiety/ anger/ toolbox); Greig & McKay (homunculi programme) • CBT for adults (Hare) • Moran - PCP - ‘ideal self’ • structured support for families (Preece & Almond) • self-help support groups
  35. 35. Tensions in Education for ASD • entitlement vs. specialism – access or meeting SEN? • optimum for learning vs. optimum for social integration – specialised or peer engagement • ‘readiness’ for inclusion vs. learning without experience – how to achieve ‘readiness’ without experience?
  36. 36. Processes for Inclusion • support – trained - ASD – enabling - Observe/ Wait/ Listen • staged – special -> reverse ->integrated • resource base – better than ‘unit’ or ‘class’ • ‘free time’ – use of buddies / circles of friends
  37. 37. ‘Unprepared’ Integration • evidence that it is not successful – from research – from autobiographies of those with ASD – from parents seeking tribunals – Council of Europe study • results in – increased segregation – even institutionalisation
  38. 38. Later: Ecological Curriculum • assess individual • assess current and future environments & occupations • gaps in skills, appreciation, knowledge and experience form curriculum goals • teach in functional ways • practise in functional contexts
  39. 39. Train for sensory ‘panic’ • need for trained response for ‘panic’ situations & buddy or visual cue to remind. • note use of prime numbers!
  40. 40. Use of LSA • care from a distance • checking not creating ‘learned helplessness’ • available to others
  41. 41. Teaching adaptations • visual instructions • lists for meaning • allow time for interests • work then play
  42. 42. Managing Democracy • no tact or sensitivity • no intentional rudeness • give alternative • mark for future teaching
  43. 43. Fostering ‘Realistic Optimism’ • use ‘ecological curriculum’ approach to life and social skills – accurate appraisal of self – see plan for future coping • help them notice good things that happen • teach ‘mindfulness’ & avoid – too much worry over future – too much anger & distress over past
  44. 44. Teaching is hard • teaching students with ASD is hard – intellectually hard to try to ‘work out’ what would otherwise be intuitive – pragmatically hard to ‘act against the grain’ and do things not to suit ourselves but someone else - and keep it up – practically hard to monitor the students and oneself continuously - exhausting, in fact
  45. 45. 'Normalist' assumptions • exclude the particular needs of individuals • deny the right to be different Treating people equally means treating them differently, according to need

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