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Process schemes presentation

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This presentation was used for 1st Short Term Joint Staff Training in Poland as a part of Erasmus+ project My Work is My Future.

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Process schemes presentation

  1. 1. Process Schemes Visually Cued Instructions
  2. 2. Visual support with a scenario created to compensate missing inner scenario of a child with autism.
  3. 3. Process Schemes We can use process schemes to support:  Self care  Hygiene  House work  Food preparation  Work skills
  4. 4. Self care Recommended comentary: 1. I take the end of the right sleeve with my left hand. 2. I pull out my hand from the sleeve 3. I take the end of the left sleeve with my right hand. 4. I pull out my hand from the sleeve. 5. I pull the jumper over my head. Taking off the jumper
  5. 5. Hygiene Putting on the lotion Recommended commentary: 1. I take the lotion. 2. I open the lotion. 3. I take a bit of lotion with my finger 4. I put the lotion on my face. 5. I spread out the lotion over my face 6. I put the lid back on the lotion.
  6. 6. House workWatering flowers Recommended commentary: 1. I take an empty bottle. 2. I pour water up to the line. 3. I turn off the tap. 4. I water a plant. 5. I put the bottle back.
  7. 7. Food preparation Baking biscuits Recommended commentary: 1. I spread the pastry 2. I cut out biscuits. 3. I put the cut outs on the bakery dish 4. I put the dish into the oven for 10 minutes 5. I take the dish out of the oven 6. I stick two busciuts with jam. 7. I put the buiscuits on the plate.
  8. 8. Hot drink preparation Recommended commentary: 1. I pour water into the kettle up to the line. 2. I put the kettle on. 3. I take the cup from the cupboard 4. I put a tea bag into a cup. 5. I pour boiling water into a cup. 6. I wait for 5 minutes and take the tea bag out. 7. I put two tea spoons of sugar into a cup 8. I stir the tea.
  9. 9. Work skills 1. Paper with scissors 2. Start cutting from right bottom of the paper. 3. Cut along the line. 4. Cut along the next line. 5. Continue cutting till all strips of paper are cut out.
  10. 10. Process Schemes The level of abstraction of the process scheme depends on the person, the process scheme is made for. It can use:  Words  Photographs  Pictures  Objects
  11. 11. SHOES
  12. 12. Process Schemes Main aim: independence from support of other people (including also independence from verbal prompts) Main reasons of dependency on others:  One of the reasons is deficit in socialization - children with ASD are not motivated by social acceptance by their social environment and during their development the period of “I do it myself” is missing. Learning by imitation is also affected.  Often there are deficits in motor skills needed to learn some self care activities.  Problems with sensory processing can play role in their behaviour.
  13. 13. Using Process Schemes  Reinforcement of independence is the only way to help a person with autism to function without help of adults.  For the future, training in daily living skills from early age is the best way to prepare for independent life.  Before we begin to teach these skills, we need to make an analysis of specific ability of a child with autism in order to know what steps to include into a process scheme.  By observation we identify which steps a child knows and which steps he/she yet needs to learn. After that we can introduce visual support.
  14. 14. Using Process Schemes  We visualize the steps, the child does not yet know! (eg. washing hands consists of … steps. We visualize only 5)  The visual aids are not meant to be used permanently. If a child is able to do the task without visual support, we gradually stop using them.  Also when we see that a child is able to do a certain step in the process without visual support, we take this step away from the process scheme.
  15. 15. What is the purpose of Process Scheme?  The aim of process schemes is achieving independence so the person does not rely on help of others (including independence from verbal instructions)  The aim of the process scheme is not detailed visualization of the process, but process scheme which maximize his/her independence in accomplishing the entire process.  Process schemes help compensate deficits in ability to process audio inputs. “Visual is real.” (Mesibov, 1996)
  16. 16. What should process scheme look like? The form of the process scheme is very individual and depends of the level of abstract thinking and generalization of the person. We can use  objects  photographs  pictures  pictures with supporting text  text
  17. 17. I take a coat from the hanger. I turn it facing the buttons. I put right hand into right sleeve. I put my left hand into the sleeve. I do the buttons. Photographs
  18. 18. Recommended commentary: 1. I take my clothes off 2. I stand under the shower 3. I put shower on . 4. I put soap on my body. 5. I wash the soap off. 6. I turn the shower off. 7. I dry myself with a towel 8. I put my clothes on. Colored Pictures
  19. 19. Black & White Pictures
  20. 20. Planning of development of self care and work skills  When we want to attempt to improve the development of some of the areas of self care using process schemes, first we need to consider the actual level of independence of the person in this area.  We can find out (measure) this level using various developmental scales, which can help us identify the actual age level of this area for the child we work with.
  21. 21. Self care observation sheet putting a cap on Looking at the cap Touching the cap Recognizing front and back side of the cap Holding the cap with both hands on the sides. Putting a cap on the head. Pulling the cap over ears. Adjust the sides of the cup. Assessing scale: 0 – can not do it at all 1 – can do it with a physical and verbal prompt at the same 2 – can do it either with verbal or with physical prompt 3 – can do it with occasional prompt 4 – can do it without any prompts – independently
  22. 22. Observation We focus on the area of self care, which we intend to improve: Our observations has to be based on these key points:  Which of the daily self care activities is the person doing independently and which of them is not and help is necessary?  When identifying deficits it is important to clarify, if these deficits emerge from insufficient skill or from the lack of motivation to do the task.  Is the level of fine motor skills sufficient in order to carry out the self care activities without support (independently)?
  23. 23. Observation  Can the person with autism carry out activities in sequence?  What is the level of imitation of the person with autism?  How does the person with autism communicate? (Verbally, using gestures or signs, pictures, photographs or written text)?  What are the best motivation situations to use in training and teaching independence?  What are the most effective incentives for particular person with autism we want to work with?
  24. 24. Observation and planning It is important to know a daily routine of the person:  Can he/she wash/bath independently?  Can he/she brush teeth, put on/take off clothes, open lids without help?  Can he/she eat, pour liquids into a cup, use cutlery without help?  Can he/she help with house work?  Is he/she able to walk to school, go shopping, organize his/her free time independently? When answering these questions we have to take into account age and developmental stage of the person as well as preferences of the parents.
  25. 25. Observation and planning It is important to focus if the observed person has certain abilities to accomplish the task:  Has the person correct gripping movements? Or do we have to first focus on improving this area? Other key issue is a motivation:  Is it necessary to train independence in daily self care situations?  Is it possible to motivate a person with attractive incentives?  Who with and in which situations a person can carry out certain task?
  26. 26. Training methods When teaching more complex tasks with support of process schemes, we can use following methods:  Teaching in steps from the beginning / chaining from 1st step to last step  Teaching back-stepping / chaining from last step back to the 1st step  Demonstration/Modeling and following imitation  Physical guidance (physical prompt),  Visualization (use of process schemes) and reinforcing.
  27. 27. Which training method to choose? When considering appropriate training method we need to reflect the main deficits characteristic for people with autism:  Problems with imitation – we use physical guidance (physical prompts)  Problems with social modeling – we use social demonstration together with a physical prompt in modelled situation,  Problem with sequence memory – we break a task into a sequence of simple steps  Problem with orientation and organization/ focusing on unimportant detail – we stress out (visualize) the important, eg: side of clothes  Problem with understanding of concept of the task – we use so called BACKWARDS CHAINING – meaning: we do as many last steps of the process, as the person is able to follow, in order to make the steps of the process clear.
  28. 28. Which training method to choose?  Problem with time perception – seasons, weather – people with ASD often can not judge correctly what clothes to put on – visual rule is necessary  Problem with perception of social rules and consequences – they are unaware of how their appearance affect other people – they are often unkempt  Problem with understanding of hygiene and health and safety – why it is necessary to wash hands after toilet, etc.
  29. 29. Basic principles when using process schemes Naturally we want the person with autism be flexible. Our aim is not to teach a person with ASD the sequence of an action mechanically but, if possible, introduce (incorporate) changes into the work scheme, just as it happens in everyday life. (Of course, it is not possible nor appropriate in every situation as it strongly depends on the level of autism of the person.) In such cases it is very helpful to combine a visual timetable with daily routine, so after each step can person with ASD check what comes next.
  30. 30. Basic principles when using process schemes It has to be visually clear for the person working with the process scheme  Which steps are finished  Which step is he/she working at now  Which step is next There are various ways to do visualize this, according to developmental level of the person and his/her fine motor skills and ability to sustain attention, etc.:  Flipping the picture with the step that was accomplished  Stamping marked space on the card/picture depicting the accomplish step  Marking the accomplished step with a sticker or a peg  Crossing out accomplished step  Turning the card/picture depicting the accomplished step facing down.  Taking away the picture and placing it into a designated container  etc…
  31. 31. Basic principles when using process schemes  If the person is able to perform the task without help, then we start removing visual support. However, we need to proceed with caution. If we remove the visual aid too fast, a person with ASD do not have to accept or tolerate it (unintentionally).  We need to learn to see people with autism exactly as they are and not as what we would want them to be.
  32. 32. Visual support with a scenario created to compensate missing inner scenario of a child with autism.
  33. 33. It is very important to know that these steps can be freely rearranged, skipped or repeat if it is necessary for maximum independence and spontaneous use by a person with autism.
  34. 34. Trainining with a person who uses objects of reference Example: Task: Dressing up a coat (5 steps) General objective: Training in daily living skills Specific objective: Dressing up a coat Level: objects of reference Method: modeling and full physical prompt; parallel imitation of the person (teacher / parent), who models with his/her coat according to the steps while providing total physical prompt; practicing can be divided into steps the emphasis is on mastering each step
  35. 35. I take a coat from the hanger. I turn it facing the buttons. I put right hand into right sleeve. I put my left hand into the sleeve. I do the buttons.
  36. 36. Trainining with a person who uses pictures Example: Task: Dressing up a coat (5 steps) General objective: Training in daily living skills Specific objective: Dressing up a coat Level: pictures Method: Chaining from the 1st step to the last; Sequence of individual pictures from left to right or from top to bottom. Accoplished step is visualised by turnig the picture facing down. Prompts are given according individual needs of the person.
  37. 37. Trainining with a person who uses words Example: Task: Dressing up a coat (5 steps) General objective: Training in daily living skills Specific objective: Dressing up a coat Level: words Method: Chaining from the 1st step; Using written instructions of the steps from left to right. Prompts are given only if a person can not continue or requests help.
  38. 38. Some ideas for inspiration....
  39. 39. How to make a ball
  40. 40. How to cut with scissors
  41. 41. How to cut with scissors
  42. 42. How to stamp with different colours
  43. 43. HOW TO PREPARE A SANDWICH
  44. 44. ear, nose and throat examination
  45. 45. Nose smear
  46. 46. Taking pills
  47. 47. How to draw a fish
  48. 48. In the gym: Rolling over the ball.
  49. 49. In the gym: Ball excercises
  50. 50. In the gym: warm up excercises
  51. 51. Mopping the floor Preparation for mopping Mopping Putting mop away
  52. 52. In this presentation we used information and pictures from: VIDIEŤ ZNAMENÁ VEDIEŤ – TO SEE MEANS TO KNOW KATALÓG DIDAKTICKÝCH POMÔCOK – CATALOGUE OF DIDACTIC RESOURCES written by: Karen Gašparových, Jiřina Kántorová, Zuzana Peťovská, Andrea Šedibová, Adela Štrpková, Dagmar Šuranová © Autistické centrum Andreas® n.o., 2010 Thank you for your attention!

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