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Inda Workshop

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Inda Workshop

  1. 1. Communication matters Day one
  2. 2. Timetable  9:30-9:45 Introductions and ice breaker  9:45-10:45 What is Autism?  10:45-11:00 Tea break  11:00-12:00 Introduction to PECS  12:00-1:00 Lunch break  1:00-1:15 Ice breaker  1:15-2:00 Signing workshop  2:00-3:00 Visual support  3:15-3:30 Closing and questions
  3. 3. Introductions  Hello my name is Caroline Winstanley.  I'm a speech and language therapist from the UK.  I have been working with children with all levels of Autism for 5 years.
  4. 4. Ice breaker  Get into partners with someone that you don't usually talk to.  One of the pair will be given a piece of paper. Don't show it to your partner!  The person with the paper has to convey the message to their partner, but they are not allowed to talk or write their message down.  Good luck!  How did it feel?
  5. 5. Questions  When I am talking you may have some questions.  Please could you either: − come and ask me at break or lunch time. − during breaks I will try and answer questions about individual children, but please remember there is one of me and lots of you- I like to be fair!! − write your question down and put it in the question box at the front of the room. The questions will be answered the following day. − There will be a question time at the end of the day. If you have a question that will benefit everyone please could you ask the question then.
  6. 6. Important!  The strategies and interventions that I will recommend are also appropriate for children with out Autism.  Children with learning disabilities also have difficulties with socialisation; understanding language and expressing themselves.
  7. 7. What is Autism?  40 minutes: Caroline talking  5 minute: activity  5 minute feedback  10 minutes: Caroline talking
  8. 8. What is Autism?  How do people with Autism describe their condition?  Can Autism be cured? − effects more men than women − in the UK 1 in every 100 people have Autism − there are many interventions that can help  The Triad of impairments: − difficulties with social communication − difficulties with social interaction − difficulties with social imagination
  9. 9. Difficulties with social communication  Difficulties understanding verbal and non-verbal communication.  Literal understanding of language  Difficulties using and understanding: − facial expression − tone of voice − jokes − common phrases- “It's cool”  some people may not speak  some people may have difficulties understanding − echolalia − only talking about their interests
  10. 10. Difficulties with social interaction  Difficulties understanding and recognising other peoples emotions.  Difficulties expressing their emotions  Difficulties understanding unwritten social rules: − proximity − conversational skills  Prefer to spend time alone.  Don't seek comfort from people  This can make it difficult to form friendships
  11. 11. Difficulties with social imagination  We use social imagination to: − predict other peoples behaviour − understand peoples behaviour − make sense of abstract ideas  People with Autism have difficulties: − understanding and interpreting other peoples thoughts, feelings and actions. − predicting or understanding what will happen 'next'. − imaginative play − understanding change − coping in new situations
  12. 12. Other characteristics  Love following routines  Sensory sensitivity  Reduced body awareness- where are bodies are.  Special interests  Dual diagnosis: − Learning disabilities (MR)- 70% chance − ADHD − Specific learning difficulties- dyslexia or dyspraxia
  13. 13. Activity  Group the following examples in the appropriate part of the triad of impairment. You have five minutes! − laughs when a sibling falls over and hurts themselves − Talks constantly about power puff girls: their favourite television programme − smiles when they are being told off − does not tell anyone when they have hurt themselves − becomes upset when you take him/her to a friends house for the first time − becomes upset when the car breaks down
  14. 14. Causes of Autism  Autism is a developmental condition  The causes are still under investigation  It's not caused by emotional deprivation, or the way that the child has been brought up.  There is some evidence to show that genetics cause changes in brain processes.  Scientists think that their may be multiple genes that contribute to Autism.
  15. 15. Interventions  There are many types of interventions that benefit people with Autism. In this workshop I will try and cover strategies that I know will benefit your children.  At the of the day two handout there is a list of recommended websites that will provide you with more information on Autism.
  16. 16. Introduction to PECS  35 minutes: Caroline talking  15 minute: Caroline demonstration  20 minutes: Your chance to practice
  17. 17. What is PECS?  Picture Exchange Communication System was developed in 1985.  It teaches people with Autism to initiate interaction and make requests.  Can help individuals develop speech.  PECS can be used with a wide range of abilities.
  18. 18. what can I exchange  Exchanges can be made with: − Objects of reference − Tobys − photographs − symbols  Please ask me during lunchtime if you are unsure what level your child is at.
  19. 19. The stages of PECS  Stage one: child learns how to make a single exchange for a single desired item  Stage two: child learns to seek out picture that they want to exchange and travel to make the request.  stage three: child begins to discriminate between several desired items. − in some instances if the child is having difficulties seeking out to make a request. I will swap order of stage two and three.  Stage four: child learns sentence structure to make a request, for example “I want..”  Stage five: child learns to respond to question “what do you want?”  Stage six: child learns to comments about things in the environment and answers questions.
  20. 20. Additional stages  Expanding vocabulary: − colours − shapes − sizes  For example: − I want the red sweet − I see a triangle − I see a big dog
  21. 21. Hierarchy of prompts  physical prompt: − manipulating body through the whole exchange − manipulating body through the beginning of the exchange − guiding arm to required action − Touching hand or arm  Gestural prompt: − gesture full set of actions that are required − point to items − gesture to student to begin or end step- put hand out.
  22. 22. Hierarchy of prompts  verbal prompts: − use language to explain part of step − use command word to explain part of step − use command to begin exchange.  Please remember that if your child has difficulties understanding spoken language a verbal prompt will not be as useful.  Now for the demonstration
  23. 23. Ice breaker  On your own write 5 things that you LOVE.  Don't show them to anyone else.  What does this show us?
  24. 24. Introduction to signing  5 minutes: Caroline talking  40 minutes: Practical
  25. 25. Makaton  Makaton is a form of sign language that uses key word signs and gestures. There is no grammar like the sign language that deaf people use.  It encourages speaking where possible along with signing of key words, but children should not be pressured to speak.  Research demonstrates that the use of sign encourages speech development.
  26. 26. Some key signs  food  car  drink  bus  water  home  toilet  school  like/happy  mummy  sad  daddy  dislike  go  I want  biscuits  more/again  chips  finished  sweets  work  chocolate
  27. 27. Activity  Get with a partner and practice signing the individual words.  Once you feel more confident practice signing these short sentences: − I like sweets − I want toilet − I'm sad − Mum finished work − I hate school − dad go car − I want water − mum works school
  28. 28. Visual support  20 minutes: Caroline talking  20 minutes: Activity  20 minutes: feedback
  29. 29. What is visual support?  Using visual means, for example objects, signs, photographs and symbols to help children make sense of the world.  Visual support can help pupils understand: − where they have to be − what they have to do − how much they have to do − when they are finished − what they will be doing next.  Visual support encourages independence and help pupils find strategies to cope with change and transition.
  30. 30. Practical examples of visual support  Seating arrangements: − a small mat to show where you want the child to sit − a photograph of the child on the chair you want them to sit on  Visual timetables  Clear daily routines  Clearly showing physical boundaries  A 'safe' place  Symbols or photographs showing rules  Clearly showing where activities start and finish
  31. 31. Visual timetables  Showing the structure of the day  Pre-warning changes in routine  Acts as a visual reinforcer for what is happening during the day  Helps reduce anxiety about what is happening next  Promoting independence  Empowering children, as they will know what is happening and when
  32. 32. Visual timetables  Can be made up of objects, photographs and symbols  Positioned where the child can see it  Referred to throughout the day  Make sure pictures are clear and concrete- no abstract concepts  Can be left to right or top to bottom.
  33. 33. Activity  You are taking your child for dinner at a friends house and you want to explain to them where you are going and why. How could you use visual support to help your child understand.  Choose someone from your group to be a spokesperson to share your ideas with the rest of the group.
  34. 34. Closing and questions  5 minutes: Caroline talking  25 minutes: questions
  35. 35. What we have learnt  Everyone communicates using different methods: PECS and Makaton are just as valid as speech  By using alternative methods of communication you are encouraging the development of speech  Visual support is very important
  36. 36. Ground rules for questions  Raise your hand to let me know you have a question.  You can only speak when you have been given the 'magic spoon'.  One question per person, so that we make sure that everyone gets a chance to speak.  If you have more than one question please write it down and put it in the question box at the front of the room. I will do my best to answer them the following day.
  37. 37. Thank you for you participation
  38. 38. Communication still matters Day two
  39. 39. Timetable  9:30-9:45 Welcome and Ice breaker  9:45-10:45 Introduction to TEACCH  10:45-11:00 working tea break if more time needed  11:00-11:30 Group discussion  11:30-12:00 Communication friendly homes  12:00-1:00 Lunch break  1:00-1:15 Ice breaker  1:15-2:15 Developing social interaction  2:15-2:45 Increasing verbal communication  2:45-3:30 Closing and questions
  40. 40. Ice breaker  Find out from three people in the room ONE quality that they especially love about their child (With ASC)  Write them down, as I will ask you to share some of the best examples
  41. 41. Introduction to TEACCH  30 minutes: Caroline talking  30-45 minutes: Activity  30 minutes: Group discussion
  42. 42. Principles of TEACCH  Understanding Autism  Developing an “individualised person”- using person centred learning techniques rather than a whole class curriculum  Structuring the physical environment − work stations − clear boundaries  Using visual timetables  Using visual support to help understanding of language  Teacch can be used anywhere
  43. 43. TEACCH resources  People that use TEACCH make a lot of their own resources  TEACCH is a form of structured teaching, where skills are taught in small steps − child and adult do activity together initially − a task board is used to show the individual steps of the activity − adults uses a hierarchy of prompts like PECS − child does activity with adult near by, but independently − Child can do activity with no supervision
  44. 44. Brief example: TEACCH activity  Mopping the bathroom floor  task boards − a board showing all the aspects of the activity and the order they should be completed in − you may choose to walk through the activity and take photographs of your child doing each stage − board showing all the equipment needed. The child matches real life objects to the objects on his task board  Visual support: − In the bathroom there should be a clear boundary of where you want cleaned. I suggest putting coloured tape down to show an area, so that your child gets used to cleaning to a boundary.
  45. 45. Continued..  Visual support: − A demonstration of mopping from an adult − model to the child cleaning a row of tiles at a time within the boundary, so that once each row is completed they know they have finished. − use arrows to show the direction in which you have to mop.
  46. 46. Activity  In your groups you will be given a skill in which you have to teach a child.  Discuss how you might teach this skill using a structured teaching approach. − what are the stages of the activity? − how will the activity start and finish? − how would you help the child to complete each stage of the skill? − Always be thinking about designing the activity in a way that means the child will eventually be able to do this task independently  Make the activity
  47. 47. Feedback  Select one member of each group to be a spokesperson.  Pick somebody that has not already been a spokesperson for your group.  You will have five minutes to share your work with the group.
  48. 48. Communication friendly homes  10 minutes: Caroline Talking  10 minutes:designing personal action plans  10 minutes group feedback
  49. 49. Communication friendly homes  Make sure that your children have opportunities to communicate  Routines are important!  Use visual strategies.  Special time
  50. 50. Your communication  speak to your child in a clear an consistent way: − short instructions using concrete key words − use visual support including, objects, signs, photographs and symbols  Give them time to process
  51. 51. Action Plan  How are you going to make your house more communication friendly?  Write some ideas that you have to make your house more communication friendly.  Feedback: what are you going to change? Lets share some ideas.  When the timer runs out we need to move on.
  52. 52. Other peoples good ideas at feedback
  53. 53. Ice breaker  Get into pairs with some on your table.  One pair will be given a piece of paper with the name of an object written on it.  Don't show anyone.  Draw the object and see how quickly your partner can guess what you are drawing.  What does this mean?
  54. 54. Developing social interaction  25 minutes: Caroline talking  10 minutes: Activity  10 minutes: Feedback
  55. 55. Social interaction  To improve social interaction everyone needs to work together to ensure the generalisation of skills.  Social interaction to be encouraged in structured situations, as well as the natural environment.  Ensure that your child has regular opportunities to interact with children outside school  Ensure they have experiences of different social settings  Skills that should be developed are: − turn taking and sharing − developing eye contact − developing listening skills − understanding emotions − conversational skills in more verbal children
  56. 56. Activities for developing turn taking  Snap  Adding blocks to a tower  Throwing balls into a box  Rolling a ball backwards and forwards  Putting coins in a money box  Board games like snakes and ladders and dominoes  Pass the parcel  Social stories that explain how people feel when the child does not share  Role plays- acting out how people feel when others don't share  Games that use spinners  Be consistent with the rules- always intervene when the child has snatched a toy  Lots of praise on occasions when they do take turns well
  57. 57. Ideas for developing eye contact  The looking game  Eye contact can be uncomfortable for children with ASC. Encourage them to look at the persons forehead instead  Social describing how people feel when people don't make eye contact or make too much eye contact
  58. 58. Developing listening skills  Simon Says  Musical statues  Barrier games  copying sequences of sounds  Role play good and bad listening- good listening is when we are sitting, looking and being quiet. Symbols can be used to signify these different components. Use these as class rules.  In a very short story jumping up or putting hand up when they hear a pre-selected word.
  59. 59. Developing understanding of emotions  When a child is obviously experiencing an emotion- say 'name is feeling happy' or 'name is feeling sad'. Also show a corresponding symbol or photograph also showing the emotion.  Guess the facial expression  Sorting facial expression- symbols or photographs.  Pass the emotion  Looking at emotion scenario cards and talk about how people are feeling and why
  60. 60. Improving conversational skills  Ask your child to deliver a message to someone  Have conversation cards, so the young person gets use to talking about different subjects  Attending social groups like Scouts  Lots of practice  Help the child write a conversation plan showing explicitly how to start and end conversation and what topics to discuss  Role plays
  61. 61. Action plan  Identify two ways in which you are going to work on your child's social interactions skills  Have a think about what's achievable for your child- don't make it too difficult.  Feedback: what are you going to change? Lets share some ideas.  When the timer runs out we need to move on.
  62. 62. Increasing verbal communication  30 minutes: Caroline talking
  63. 63. Before I continue  Children with ASC often prefer not to talk and are happier using alternative methods of communication like sign and PECS  Your child will talk if and when they feel happy to  They are less likely to want to talk if they feel pressured  The important thing is that they have some method to communicate with us to reduce frustration and challenging behaviour  Not all children have the awareness to do speech work
  64. 64. Increasing verbal communication  The commenting approach  Using an alternative method of communication like sign or a communication book- also advanced stages of PECS  Reducing repetitive questions in order to increase meaningful speech  Reducing echolalia by increasing understanding  lots of praise for talking, as this will encourage them to speak more
  65. 65. Increasing verbal communication  Increasing the child's vocabulary  Increasing the need for them to verbally communicate. If everything is readily available then they have no need to talk − but don't make it so tricky that your child becomes frustrated  Make children feel confident and at ease in conversational situations- don't ask to many questions and be too directive. Have fun!  Ensure that siblings don't talk for them  Communication often improves through play
  66. 66. Closing and questions  5 minutes: Caroline talking  15 minutes: Questions from the question box  25 minutes: New Questions
  67. 67. What have we learnt?  Everyone needs to work together  Its important that we change are communication rather than expecting the child to do all the work, especially as they find communication hard and we are good communicators  Make activities fun, but structured  Enjoy time with your children
  68. 68. Structure and ground rules  First I will answer some of the questions that were put in the question box yesterday.  Then you can ask any new questions.  Same rules as yesterday.....  You can only speak if you have been given the 'magic spoon'.  Only one question per person please! We may not have time to answer everyone's questions, sorry.
  69. 69. Useful websites  The National Autistic Society: http://www.nas.org.uk  Pecs: http://www.pecs.com  The Makaton Charity: http://www.makaton.org  Teacch: http://www.teacch.com  Afasic is a UK charity that support children with speech and language difficulties: http://www.afasic.org.uk  I can is another UK charity that supports children with speech and language difficulties: http://www.ican.org.uk

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