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. 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. 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. 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. 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.
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. 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. 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. 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. 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. 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. 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. 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. Introduction to PECS
35 minutes: Caroline talking
15 minute: Caroline demonstration
20 minutes: Your chance to practice
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. 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. 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. Additional stages
Expanding vocabulary:
− colours
− shapes
− sizes
For example:
− I want the red sweet
− I see a triangle
− I see a big dog
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. 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. Ice breaker
On your own write 5
things that you
LOVE.
Don't show them to
anyone else.
What does this show
us?
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. 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. 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
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. 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. 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. 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. 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.
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. 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.
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. 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. Introduction to TEACCH
30 minutes: Caroline talking
30-45 minutes: Activity
30 minutes: Group discussion
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. 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. 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. 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. 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. 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. Communication friendly homes
10 minutes: Caroline Talking
10 minutes:designing personal
action plans
10 minutes group feedback
49. Communication friendly homes
Make sure that your
children have
opportunities to
communicate
Routines are
important!
Use visual
strategies.
Special time
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. 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.
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?
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. 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. 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. 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. 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. 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. 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.
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. 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. 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. Closing and questions
5 minutes: Caroline talking
15 minutes: Questions from the
question box
25 minutes: New Questions
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. 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. 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
