2. Learning Goals & Objectives
The purpose of Module 2 is to help familiarize you to the
definition of autism spectrum disorder (ASD). The
expectation is not to have you diagnose, but to help you
recognize symptoms of ASD and how they impact your
student’s interactions in the classroom.
NOTE: These modules will use the term “autism” or “ASD” interchangeably. These both refer to students
with autism spectrum disorder.
3. Question 1 from focus group
● Link to Qualtrics
● Embed word cloud in to the next page of Qualtrics
5. Introduction
According to the Center for Disease Control (Baio et al., 2018), about 1 in
59 children will be identified as having ASD. It occurs at similar rates
across all ethnic and racial groups, and is 4 times more common among
boys than in girls. The symptoms of ASD are organized into two
categories:
(1) social communication challenges
(2) restricted, repetitive behaviors
The symptoms that fall within these two domains can manifest in a lot of
different ways in terms of intensity and frequency.
6. Introduction
According to the Center for Disease Control (Baio et al., 2018), about 1 in
59 children will be identified as having ASD. It occurs at similar rates
across all ethnic and racial groups, and is 4 times more common among
boys than in girls. The symptoms of ASD are organized into two
categories:
(1) social communication challenges
(2) restricted, repetitive behaviors
The symptoms that fall within these two domains can manifest in a lot of
different ways in terms of intensity and frequency.
Click here for more information on
"Autism's sex ratio, explained"
7. What is Autism Spectrum Disorder?
NOTE: Symptoms are generally present before age 3 and occur across multiple contexts
Source: Dr. Brian Willoughby
17. Real-Life Examples of Social Communication
Challenges in the Classroom
● During Circle Time when asked what plants need to grow,
typically developing children may say “sun, air, and water”
but the child with autism may behave like a little professor
and say, “No, it’s not air, it’s carbon dioxide.”
● While talking to a peer, the child may frequently talk about
their preferences with little regard to the peer, “Do you like
dinosaurs? I love dinosaurs. I know all the names of
different dinosaurs. Dinosaurs are extinct, they lived a long
time ago…”
18. Real-Life Examples of Social Communication
Challenges in the Classroom
● During a group activity, a child is trying to tell
his peer about the activity. The child gets very
close to the peer, without any regard for an
appropriate distance between him and peer.
The child then loudly says “We should use my
idea for the activity. MY idea is…”
● During free play, a child makes an attempt to
interact with peers by snatching a toy.
19.
20. Real-Life Examples of Restricted, Repetitive
Behavior
● Peering at objects with peripheral
vision, staring at lights, mirrors or
windows
● Flapping hands
● Spinning
● Moving fingers and/or hands in
front of face
● Always sitting in the same seat (not
assigned seats)
“When I did stims such as
dribbling sand through my
fingers, it calmed me down.
When I stimmed, sounds
that hurt my ears stopped.
Most kids with autism do
these repetitive behaviors
because it feels good in
some way…”
- Temple Grandin
(Person with ASD)
21. Restricted, repetitive behaviors can be manifested as
sensory sensitivity
● Hypo-sensitive: less sensitive to sensory stimuli than typical population
● Hyper-sensitive: more sensitive to sensory stimuli than typical population
● These sensory needs often change as children grow, and they ebb and flow
over time
● Using parent input can help with understanding the student’s specific sensory
needs
● Potential classroom solutions/recommendations for sensory needs include:
○ Noise-cancelling headphones, dimming lights, allowing activity breaks
NOTE: Symptom severity -- or the combinations of all of these symptoms or characteristics --
differs for each child. One child can appear almost “typical” and another can be spotted right
away as having autism.
22. Examples of Sensory Sensitivity
● Bright lights
● Loud sounds
● Smells
● Touch (e.g., tags on their shirt, deep pressure, weighted vests)
Some children like sensory stimuli, while others do not. For example, some children will stare
at bright lights, and others will avoid them. Some children like weighted vests, while others
dislike being touched.
Specific School Examples:
● covering ears during assembly
● touching items to their lips
● smelling items
● fluttering fingers around their eyes
● strong food preferences or aversions
25. How might you recognize a student with ASD in your classroom? Some children
with ASD have a medical dx, some may have a educational classification. Others
might have neither.
Click here [link] - redirect them to optional resources to 2 slides on medical vs
educational definition
26. Asperger’s syndrome is a disorder separate from autism.
That’s a myth! A diagnosis of ASD now encompasses several diagnoses that were
once considered separate disorders, including autistic disorder, pervasive
developmental disorder not otherwise specified (PDD-NOS), and Asperger’s
syndrome. Asperger’s syndrome is often referred to as “high-functioning” ASD.
High functioning typically refers to individuals who have average to above average
IQs, do not have language deficits, and have less severe ASD symptoms.
On the next slide, more common myths about autism are discussed!
27. Myth Fact Evidence
Vaccines cause ASD.
Multiple high-quality research studies
have rejected any causal links
between vaccines and ASD
→Click here for research on thimerosal and ASD!
All Children with ASD have an
Intellectual Disability (ID).
ASD and ID are distinct disabilities.
Although many children with ASD also
have ID, they are not always linked.
Many children with ASD do struggle
with academic tasks, but also have
high intelligence in other areas.
→Click here for the 2018 Centers for Disease Control and
Prevention (CDC) Report!
“Refrigerator Mothers,” or
mothers who are cold and
distant, cause ASD.
The idea that autism is caused by poor
parenting has no scientific basis.
Instead, this notion has promoted
feelings of parental blame and stigma
from the public.
→There is no scientifically established single cause of
autism (Boyd et al., 2010). Click here for the direct link to
this research!
→Many agree that family interactions combined with
biological makeup affect the development of ASD (Hertz-
Picciotto, Schmidt, & Krakowiak, 2018). Click here for the
direct link to this research!
28. Summary Points: What You Learned
● Autism is characterized by deficits in
social interaction and communication,
as well as the presence of restricted,
repetitive behaviors.
● Sensory sensitivity is a manifestation
of restricted, repetitive behaviors
specific to the diagnosis of autism, and
commonly occurs with autism.
● A medical diagnosis of ASD is different
than special education eligibility of
autism.
“[Autism] is about
developing
differently, in a
different pace and
with different leaps.”
- Trisha Van Berkel
(ASD advocate)
30. How might you recognize a student with ASD in
your classroom?
● Some children have either a medical diagnosis of ASD or an educational
classification of autism, but not both. This situation can occur when, for example, a
student has a medical diagnosis of ASD but their impairments do not adversely
affect his/her educational performance, and thus, they do not meet criteria for
school-based services and supports.
● Conversely, if a child has qualified for special education services at school under an
autism classification, they may not automatically have a medical diagnosis of
autism.
● In order to receive a medical diagnosis, a child needs to meet autism criteria based
on the Diagnostic and Statistical Manual (DSM-V, also referred to as “the DSM”)
through a comprehensive evaluation conducted by a clinician.
***Perhaps replace “so you know what strategies and supports you can use in an inclusive way. Such strategies will be discussed in more detail in subsequent modules.” with “and how they impact your student’s interactions in the classroom.” This would keep the overall slide even briefer. -Abbey
Done. YB
Assuming we will cover some of the ASD/autism terminology in Module 1?
Yes! YB
***Can we build into Module 2 (or maybe Module 1 if we decide it fits better there) a self-reflection exercise where we ask them the same Question 1 we asked our focus group participants? We’d ask them to record (and ideally submit in some way through Blackboard) their responses. Then once they do so, they be taken to the next slide, which would show a word cloud of how other teachers responded to the same question (all the focus group responses). Jacob is preparing this word cloud to show us by Thursday. -Abbey
Mention in the first in-person meeting that some of the online modules include content/quotes from the focus group
Add the source: Produced by Atlantic Public Media (www.atlantic.org) for Massachusetts General Hospital's Aspire program. Animation by Hannah Jacobs. Music by Stellwagen Symphonette and Podington Bear
Downloaded link for video:
***THis is great. What about adding bullet points, as in (I also changes the wording of the racial and ethnic groups point slightly below). -Abbey
“According to the Center for Disease Control (Baio et al., 2018), about 1 in 59 children will be identified as having ASD.
ASD occurs at similar rates across all ethnic and racial groups
ASD is 4 times more common among boys than in girls.
The symptoms of ASD are organized into two categories:
(1) social communication challenges
(2) restricted, repetitive behaviors
The symptoms that fall within these two domains can manifest in a lot of different ways in terms of intensity and frequency.”
***Also, if we go with audio narration, can the purple-highlighted part be saved for the next slide, since it is describing the information presented on the next slide? -Abbey
We need to decide if we’re including audio because if not it doesn’t make sense to make edits based on audio narration. Also, we’re not sure if the slides look as presentable in all bullet points. YB
***(can we add a small-font crediting Brian Willoughby, Ph.D. for the graphic?)-Abbey
Done. YB
***THis slide has no text, which is okay, but if we can manage to have audio narration of our slides, then the following text (originally on slide 4) can be presented on this slide (and presented only through audio narration):
“The symptoms of ASD are organized into two categories:
(1) social communication challenges
(2) restricted, repetitive behaviors
The symptoms that fall within these two domains can manifest in a lot of different ways in terms of intensity and frequency.”-Abbey
This slide was originally meant as an intro/overview slide to the subsequent “meatier” slides on ASD symptoms. Narration would work here, but again I think we want to be cautious about having a slide where if audio wasn’t simultaneously playing, teachers would still get the content. Options under consideration: (1) keep this text in slide 4 (2) have the pulled text above go in a slide after this overview slide or (3) only have audio narration of the text above. YB
***I have added this slide as a suggestion: if we decide to keep the 6-minute video on Slide 2, but want to break it up and show the 5 questions separately, here could be a good place to embed Question 2 “What’s hard about living with autism”-Abbey
-We might even add an audio introduction to this by asking teachers to reflect on what they think would be hard for their students with autism first, as they go into this clip.
Laura clipped the original video to answer the question (What’s hard about living with autism?). - YB.
***I like the clip! I would still suggest adding an interactive element here, such as asking teachers to reflect on what they think would be hard for their students with autism first, and record their thoughts (ideally submit their thoughts via Blackboard, as they go into this clip. It does not HAVE to be here, but in general, we do want to make the modules interactive and allow places for teachers to reflect, to engage in thinking, and to relate the material to their students. So this is a global suggestion as well.
Real look autism - website with 14 videos, mostly home based.
YB: Wish we could find school based videos
I found one video that seems like it’s for preschool but there are parent/home scenes interspersed here. There is also narration throughout the video so i’m not sure if we want to include it. You can have a look here: https://www.youtube.com/watch?v=3mXFJ8S-boU - Looknoo
This video may be good as an optional video in the end! Or what parts do you like? Maybe we can clip them to fit with this material. YB
Real look autism - website with 14 videos, mostly home based.
YB: Wish we could find school based videos
I found one video that seems like it’s for preschool but there are parent/home scenes interspersed here. There is also narration throughout the video so i’m not sure if we want to include it. You can have a look here: https://www.youtube.com/watch?v=3mXFJ8S-boU - Looknoo
This video may be good as an optional video in the end! Or what parts do you like? Maybe we can clip them to fit with this material. YB
Should we add 2-3 more examples also to emphasize the different possible symptoms hese can also supplement the points in the previous slide to provide more context (it doesn’t have to be mandatory but maybe teachers can “click here for more examples”... I had the following ideas based on real stories I’ve had:
Unusual social interactions -- During a group activity, a child is trying to tell his peer about the activity. The child gets very close to the peer, without any regard for an appropriate distance between him and peer. The child then loudly says “We should use my idea for the activity. My idea is…”
Difficulty adjusting behaviors to social contexts -- During the school day, the teacher brings in a guest to speak about a topic for the children. The child blurts out to the entire class and in front of the stranger “My mom told me not to speak to strangers!”
Difficulty with social initiations: While trying to initiate an interaction during play time, a young child snatches a toy from his peer to play with him. An older child walks around the playground, observing his peers play a game he likes, without joining them.
Is it worth giving an example of children who use communication devices. While it is rare in general education classrooms, I think it is possible that some children may need to use tablets or communication devices to help them in the classroom - Lana
***Lana, I like this idea. It would be great if these additional examples could be “real-life examples compiled from teachers,” which could mean we put the ones you’ve given into anecdotes or case examples, or we share quote(s) from teachers. I am torn about the best way to present these examples - maybe this is something we can get teacher consultants’ help with. -Abbey
Should we add 2-3 more examples also to emphasize the different possible symptoms hese can also supplement the points in the previous slide to provide more context (it doesn’t have to be mandatory but maybe teachers can “click here for more examples”... I had the following ideas based on real stories I’ve had:
Unusual social interactions -- During a group activity, a child is trying to tell his peer about the activity. The child gets very close to the peer, without any regard for an appropriate distance between him and peer. The child then loudly says “We should use my idea for the activity. My idea is…”
Difficulty adjusting behaviors to social contexts -- During the school day, the teacher brings in a guest to speak about a topic for the children. The child blurts out to the entire class and in front of the stranger “My mom told me not to speak to strangers!”
Difficulty with social initiations: While trying to initiate an interaction during play time, a young child snatches a toy from his peer to play with him. An older child walks around the playground, observing his peers play a game he likes, without joining them.
Is it worth giving an example of children who use communication devices. While it is rare in general education classrooms, I think it is possible that some children may need to use tablets or communication devices to help them in the classroom - Lana
***Lana, I like this idea. It would be great if these additional examples could be “real-life examples compiled from teachers,” which could mean we put the ones you’ve given into anecdotes or case examples, or we share quote(s) from teachers. I am torn about the best way to present these examples - maybe this is something we can get teacher consultants’ help with. -Abbey
We like the idea of changing this to “real-life” examples. We changed the slide heading to reflect this. And stretched this into 2 slides. - YB
I love these two examples! (andthe image.) :) COuld we make it clear for the teacher how these examples reflect social communication challenges? (i.e. how do these reflect symptoms of autism, and what symptom(s) are evident here, as opposed to it reflecting defiant or uncooperative behavior, for instance).
Can we give examples of what these look like in the classroom? Either descriptions, or even video clips.
I wonder if there are some quotes we can pull to supplement this from the FG. - Looknoo There might be something around routine and transition
***I agree, it would be great to pull out a couple of these that might show up in the classroom and give examples of how these might show up. We also might want to acknowledge that these behaviors aren’t necessarily always problematic, and don’t necessarily need to be reduced. Rather, they may be helpful coping tools for the student, and may only be an issue if they interfere with the child’s ability to engage in other activities. Because in general, I think it’s ok for us to editorialize in our modules, to help them make sense of the info we’re presenting. :) -Abbey
***one idea is using a word cloud of all the responses teachers gave to Focus Group Question 1 that fell into the RRB category (since they classified their responses into categories at the end of the focus group exercise). THis word cloud would capture the ways in which RRBs showed up for teachers in the classroom.
Need a quick video here?
YB: How does this OAR video look?
***I think “Peering at objects with peripheral vision, staring at lights, mirrors or windows” might be better included on the next slide, since that is where the other sensory behaviors are.
We added a quote here because we have many videos in this module. We can always replace this with a quote from a teacher in our FG! YB
***YAY ! I love this quote and I agree that it works better than the previous video. AND it also implicitly makes the argument that RRBs are functional and soothing for kids, not something to discourage.-Abbey
***We might even want to explicitly raise the idea of whether teachers can allow/enable opportunities for kids to engage in their RRBs in the classroom, and whether teachers can find ways to help the child, and others, see these as a viable coping strategy rather than something to be discouraged, assuming they can support the child to engage in them safely and to redirect them to other tasks when needed. Maybe add a line saying something like: “Consider: how can you make it more possible for your student(s) with ASD to engage in RRBs that they find soothing or useful? What gets in the way of you currently allowing opportunities for these behaviors? How could you address some of these barriers?” -Abbey
***Maybe add a subheading, right before “hyposensitive,” that says something like: “What are the 3 types of sensory sensitivity in ASD?” -Abbey
***I might also add, in addition to hypo and hyper sensitive, “sensory seeking” and define this as well. While it overlaps with the other two, it is often described as a third thing. (The DSM-V includes all three in its symptoms:: “Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment”, referring to it as unusual sensory interest.) And since it’s often the most visible, observable manifestation of sensory sensitivity, it seems useful to highight it as a third type here. -Abbey
**I like this rainbow of symptoms idea: maybe the idea of diversity of symptoms can be an ongoing theme in each of the “social communication challenges”, “RRB” and “RRB sensory sensitivity” example slides (slide 8, 10, and 11) - such that when we talk about examples, using an illustration we show that there is a range of symptoms. - Lana
Can we indicate in the top part that some children like this, while others do not, eg, some children with stare at bright lights and others will avoid them.
YB: Done.
Add words to this and a note that this image may appear elsewhere. - YB
Produced by Atlantic Public Media (www.atlantic.org) for Massachusetts General Hospital's Aspire program. Animation by Hannah Jacobs. Music by Stellwagen Symphonette and Podington Bear
**How about changing “Asperger’s syndrome is often referred to as “high-functioning” ASD.”
To
“Asperger’s syndrome is often referred to as “high-functioning” ASD, but it is still a part of ASD.” -Abbey
****Either here or in a clip closer to the end, can we add an audio or written introduction to this clip, by first asking teachers to answer some reflection question here, as they go into this clip? They can record their own thoughts. I’m not sure what the question would be, but here or closer to the end, it would be good to have a wrap-up, post-test self-reflection exercise. -Abbey
I like this myth-fact table! When I see the Myth statements in bold, it makes these statements stand out more than the facts - so maybe next to each myth we can have an X graphic to also emphasize its incorrectness (like the image I put next to the slide). It’s pretty obvious but just in case any teachers skim through the slide :) LA
***I also really like this. I love the refrigerator mother point, great that we are refuting this right up front.
I think the second “fact” (about aggression) could be rephrased - I am not sure what the key take home point is here, but if it’s to directly refute the myth “Children with ASD are aggressive” then we would probably want something that explains that not all children with ASD have difficulties with aggressive behavior. (Or maybe omit this myth altogether since it’s hard to deny entirely and truthfully. -Abbey
Love the idea of the X! I added a green check too! Is this how you meant? Agree, we removed the aggression row. YB
ID: https://theautismblog.seattlechildrens.org/autism-intellectual-disability/: an easier to read source for ASD and ID myth (interview with Dr. Gerdts), the interview was completed in 2016 MH-- if we want to include one research resource and one easier to read link.
***Great idea to add this link. -Abbey
***can we make this animated as they read down through each myth in the table, so that each myth appears one by one, and next a red X appears next to it, then the fact next to it appears, followed by a green check + the evidence, etc. that would encourage them to read through the myths one at a time. -Abbey
I think the last point is not as important. Why not: While there are commonalities among children with the diagnosis of autism or ASD, their level of symptom severity can vary greatly. It is important not to have a set “image” of autism.
YB: I think that’s an even better point to stress. But if we make that one of our summary/takeaway points, we need to add 1-2 slides on this topic. Anyone have something we can include?
I think if we have the diversity of symptoms as an ongoing theme when we provide examples for each of the ASD characteristics, then it can make a strong takeaway point without dedicating specific slides for it. - Lana
Let’s discuss the “rainbow of diversity” at our next meeting as our last point. Maybe come up with a cool graphic! YB
Let’s check: Is it “medical diagnosis” and not full psychodiagnostic work-up? This is odd since I’m betting few kids are diagnosed by any medical (ie doctors know little about this.) Thus, this can be confusing.
***There are certainly lots of cases of the former (where a child has a psychological diagnosis of ASD, but not a school classification. But I wonder about the reverse situation. In practice, is it consistent with others’ experiences that it’s very rare for a child to have a school classification of ASD but NOT have a non-school diagnosis of ASD? In my experience it is almost unheard of for a school to classify a child as having ASD unless it’s because the family is coming in with an outside diagnosis. It might just help streamline this if we made this clear. In other words, our point is that not all kids with an outside diagnosis of ASD will qualify for special ed services. -Abbey
***Maybe we can discuss as a team on Thursday 3/21 what are the most important points we want teachers to get out of this medical dx vs. school designation conversation. So that we can make sure we are distilling it to the most central message. -Abbey
Should education be added to “authority,” as in school psychologist or educational psychologist or other?
I’m a little confused as to what we want the take-away point to be from this. In terms of an action point - can we make this more explicit in terms of what they can do with this information and why it’s relevant? Are we trying to say teachers and parents can advocate for the student to have an IEP if you feel that he needs it (even without a medical diagnosis)? - LA
***I agree - let’s discuss on Thursday 3/21 so we can figure out what are the most central messages we want teachers to walk away with here.- Abbey
I really like this, although parts of it are a little s-l-o-w so I hope teachers stick with it.
I love this video! If we think it’s slow maybe we can give them the suggestion to increase the speed of the video. We can say something like “Some of the transitions between segments in this video are slow. You can adjust the speed of the video by pressing settings and choosing the speed that works for you”. However, I don’t know how encouraging it would be to say speed it up, as if we’re de-valuing it. - LA
***Can we edit the video ourselves into clips, to skip the short parts, so the teachers don’t have to do this themselves? Specifically, the first 25 seconds of it can be cut, as can the 10-15 seconds between each of the 5 questions. -Abbey
Yes, I think we can download the video and edit it. Alternatively, we could split this main video into five videoes according to the questions. Then we can title each one based on the question and have the teachers explore the clips. Cons of this approach: teachers might not watch every clip, Pro: splitting it up might give teachers some agency over this material (which is long but insightful), then may be they will end up watching every clip that way? -Looknoo
***Looknoo, I like this idea. We could think about how/where each of the 5 questions best fits into this module. That way we can cut out the slow transitions between questions, and also the clips would be shorter and more digestible. We could also make the length of the videoclip visible on the slide so they’ll know how short each one is and not avoid it altogether. -Abbey
Overall, it sounds like we like this video but want to cut it into short clips to answer our specific reflection questions. Lara is working on cutting video clips - YB
