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In Service For Nurses


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In Service For Nurses

  2. 2. <ul><li>Autism is a neurological disorder. There are various theories regarding the cause of autism: </li></ul><ul><li>-genetics </li></ul><ul><li>-abnormal brain development </li></ul><ul><li>-vaccines </li></ul><ul><li>-environmental “triggers” </li></ul><ul><li>None have been scientifically proven. </li></ul><ul><li>Students range in their abilities and skills within the spectrum. </li></ul><ul><li>Autism Affects the following three areas: </li></ul>
  3. 3. <ul><li>1. Communication : </li></ul><ul><li>Non-verbal, minimal speech </li></ul><ul><li>Repetitive speech </li></ul><ul><li>Difficulties with comprehension </li></ul><ul><li>Literal interpretation of language </li></ul><ul><li>May use words without attachment of meaning. </li></ul>
  4. 4. <ul><ul><li>2. Social Interaction : </li></ul></ul><ul><ul><li>Poor eye contact </li></ul></ul><ul><ul><li>Limited facial expressions </li></ul></ul><ul><ul><li>Limited or inappropriate interactions with peers </li></ul></ul><ul><ul><li>Limited understanding of social rules or cues </li></ul></ul><ul><ul><li>Unusual reactions to social situations </li></ul></ul><ul><ul><li>Minimal cooperation with peers </li></ul></ul>
  5. 5. <ul><ul><li>3. Behavior Patterns : </li></ul></ul><ul><ul><li>Repetitive movements, self-stimulation </li></ul></ul><ul><ul><li>Restricted interests </li></ul></ul><ul><ul><li>Inflexible routines/rituals </li></ul></ul><ul><ul><li>Resistance to change/transitions </li></ul></ul><ul><ul><li>Behavior episodes (meltdowns/tantrums) </li></ul></ul><ul><ul><li>Possible aggressive behavior </li></ul></ul><ul><ul><li>Possible Self-injurious behaviors </li></ul></ul><ul><ul><li>Sensory issues </li></ul></ul>
  6. 6. <ul><li>Approximately 1 in 150 children have the diagnosis of autism. It is the fastest growing developmental disability. </li></ul><ul><li>Ratio of 4 boys to 1 girl </li></ul><ul><li>Approximately 560,000 individuals in the United States between the ages of 0 and 21 have autism. </li></ul><ul><li>Autism is increasing at a rate of 10-17% per year. At this rate there could be 4 million individuals with Autism in the U.S. in the next decade. </li></ul><ul><li>(Dr. Jennifer Sellers, Auburn University) </li></ul>
  7. 7. <ul><li>Mental Retardation—75% </li></ul><ul><li>Seizure Disorder– 25% </li></ul><ul><li>Chronic constipation/diarrhea—50-60% </li></ul><ul><li>Sleep Problems—50-60% </li></ul><ul><li>Low muscle tone—30% </li></ul><ul><li>Sensory sensitivities </li></ul><ul><li>Ear infections </li></ul><ul><li>( Dr. Jennifer Sellers, Auburn University) </li></ul>
  8. 8. <ul><li>Weak Processing Speed </li></ul><ul><li>Verbalize more than they understand </li></ul><ul><li>Slow work speed </li></ul><ul><li>Poor writing skills </li></ul><ul><li>Poor organizational skills </li></ul><ul><li>Difficult to see the big picture </li></ul><ul><li>Immature and inappropriate social skills </li></ul><ul><li>Behavior/motivational issues </li></ul><ul><li>Perception and theory of mind issues </li></ul><ul><li>Sensory Integration issues </li></ul>
  9. 9. <ul><li>Challenge for students with autism </li></ul><ul><li>Difficulty seeing the perspective of others </li></ul><ul><li>Isolation from peers </li></ul><ul><li>Difficulty managing day-to-day interactions </li></ul><ul><li>Struggle with communication skills </li></ul><ul><li>Poor problem solving skills </li></ul><ul><li>Confusion with “hidden curriculum” </li></ul>
  10. 10. <ul><li>The ability to pick up and act on social assumptions </li></ul><ul><li>The ability to think about other people’s thinking (Are they interested in what I’m saying ?) Generally have “wrong” perceptions of what others are thinking </li></ul><ul><li>Mind reading (facial expressions, body stance, voice tones) </li></ul><ul><li>They may not realize their comments can offend or embarrass others </li></ul>
  11. 11. <ul><li>Problems with planning, organizing, shifting attention and multitasking </li></ul><ul><li>Difficulties approaching complex tasks, breaking them down into parts and budgeting time </li></ul><ul><li>Waste time talking and worrying about a project rather than planning and working on it </li></ul><ul><li>May lead to losing supplies, forgetting assignments </li></ul><ul><li>Cannot take notes and listen to the teacher </li></ul><ul><li>Need to finish one task before beginning a second </li></ul><ul><li>Unable to leave a task if it is not finished </li></ul>
  12. 12. <ul><li>The ability to draw diverse information together to construct higher level meaning in context </li></ul><ul><li>Understanding the “gist” of a story </li></ul><ul><li>Grasping an underlying theme within a message </li></ul><ul><li>Seeing parts over wholes </li></ul><ul><li>Represents both strengths and weaknesses and should be thought of as a cognitive style </li></ul>
  13. 13. <ul><li>What is it? </li></ul><ul><li>It is the ability to take in sensory information, process the information and then respond to the information. </li></ul><ul><li>What are the sensory systems? </li></ul><ul><li>Tactile-touch Olfactory-smell </li></ul><ul><li>Auditory-hearing Proprioception-knowing </li></ul><ul><li>Visual-seeing where your body is in space </li></ul><ul><li>Gustatory-taste Vestibular-movement </li></ul>
  14. 14. <ul><li>Oversensitivity </li></ul><ul><ul><li>Noises </li></ul></ul><ul><ul><li>Visuals </li></ul></ul><ul><ul><li>Fixations </li></ul></ul><ul><ul><li>Excessive Verbalizations/talking </li></ul></ul><ul><ul><li>Obsessions </li></ul></ul><ul><ul><li>Sensory processing can be affected by medication, lack of sleep, nutrition, holidays, etc. Be aware of what is going on in a child’s life. </li></ul></ul>
  15. 16. <ul><li>May experience sensitivities to textures as in soaps or other “messy things” </li></ul><ul><li>Bothered by certain fabric or tags in shirts, waistbands </li></ul><ul><li>May like to be touched or to feel deep pressure or may want to avoid it </li></ul><ul><li>Experience high or low pain tolerance </li></ul>
  16. 17. <ul><li>May bite which may or may not be caused by sensory issues </li></ul><ul><li>Squint, blink, or rub eyes </li></ul><ul><li>Avoid certain foods or crave others (limited assortment) </li></ul><ul><li>Some require a gluten free diet </li></ul><ul><li>Be aware of sensory needs because over-stimulation and not getting sensory needs met may lead to a behavior “melt-down”. </li></ul>
  17. 18. <ul><li>“ Sensory Diet”: Breaks given for sensory activities, jumping, deep pressure, swinging, music, walking </li></ul><ul><li>Personal space: Be aware of proximity of others, line up first or last </li></ul><ul><li>Bathroom Accommodations: Difficulty with toilet training, (noise issues with flushing, routine in going) </li></ul><ul><li>Provision of fidgets: Helps with over stimulation, May use koosh balls, hand exercisers (some available in health room) </li></ul><ul><li>Social Stories to help with changes and to teach compensatory strategies for deal with sensory issues </li></ul>
  18. 19. <ul><li>Be generous with praise </li></ul><ul><li>Be specific about what the student is doing “right”. </li></ul><ul><li>Use token cards/visual systems to manage behaviors </li></ul><ul><li>Establish reinforcements/incentives for the students to complete work and to maintain positive behavior. These may change throughout the year. </li></ul><ul><li>Consult with Behavior Specialist (Functional Behavior Analysis ) </li></ul>
  19. 20. <ul><li>Remember comprehension is not guaranteed </li></ul><ul><li>Clearly define your expectations, tell the student specifically what you want them to do </li></ul><ul><li>Combine verbal instruction with pictures and/or gestures </li></ul><ul><li>Be specific with directions (call the student’s name, have the student paraphrase directions) </li></ul><ul><li>Encourage the student to clarify any direction he does not understand </li></ul><ul><li>Use simple verbal language </li></ul>
  20. 21. <ul><li>Have “rules” specific for the student and teach him those rules. </li></ul><ul><li>Use “gestures” to help in understanding </li></ul><ul><li>his needs </li></ul><ul><li>Teach him strategies to relax and to use those when he requires them. </li></ul><ul><li>Use social stories to help in understanding situations </li></ul><ul><li>Always prepare student for changes </li></ul>
  21. 22. <ul><li>Class Schedule </li></ul><ul><li>____DOL </li></ul><ul><li>____Reading </li></ul><ul><li>____Snack/Break </li></ul><ul><li>____Math </li></ul><ul><li>____Lunch </li></ul><ul><li>____Recess </li></ul><ul><li>____Science </li></ul><ul><li>____Social Studies </li></ul><ul><li>Rules for Seeing the Nurse </li></ul><ul><li>Come into her room with my teacher </li></ul><ul><li>Sit quietly and wait my turn </li></ul><ul><li>Listen to the nurse and follow her directions </li></ul>
  22. 23. <ul><li>____Close my eyes </li></ul><ul><li>____Take 2 deep breaths </li></ul><ul><li>____Count to 10 </li></ul><ul><li>____Squeeze my arms </li></ul><ul><li>____Take 2 deep breaths </li></ul><ul><li>Ask: </li></ul><ul><li>___A. Am I relaxed? YES. Then go back to class/work </li></ul><ul><li>___B. Am I relaxed: NO </li></ul><ul><li>___Then start over again </li></ul>
  23. 24. <ul><li>“ When you have met one child with Asperger Syndrome, you have met one child with Asperger Syndrome.” </li></ul><ul><li>Stephen Shore </li></ul><ul><li>“ They live in OUR world, but in THEIR OWN WAY rather than “in their own world.” </li></ul><ul><li>“ When I was younger, I didn’t realize that I thought differently; therefore, It didn’t occur to me to ask for help or clarification.” </li></ul><ul><li>Dena Gitlitz </li></ul><ul><li>“ If they can’t learn the way we teach them, let’s teach them the way they learn”. Paula Kluth </li></ul>
  24. 25. <ul><li>“ Students with AS/HFA live in a world that is often puzzling and unpredictable to them and therefore, stressful. In order to help them meet their potential, educators must help these students understand the world around them with strategies and supports that will foster success and independence.” </li></ul><ul><li>Simple Strategies that Work by Brenda Myles </li></ul>
  25. 26. <ul><li>Autism Society of America: </li></ul><ul><li>Autism Research Institute: </li></ul><ul><li>Autism Society of Alabama: </li></ul><ul><li>(Lending library available) </li></ul><ul><li>Center for the Study of Autism: </li></ul><ul><li>Division TEACCH: </li></ul><ul><li>Educational for parents:   </li></ul><ul><li>Asperger Syndrome: </li></ul><ul><li>Tony Atwood: </li></ul><ul><li>Asperger Information: </li></ul><ul><li>Autism-PDD Resource: </li></ul><ul><li>Autism: </li></ul><ul><li>Sensory: </li></ul>