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5/7/2012




 Maricarmen Saleta                   Miren Oca
Educational Support Specialist         Director
       UM-NSU CARD               Ocaquatics Swim School




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Clinical Characteristics




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Autism Spectrum Disorders:
What We Know
 Autism Spectrum Disorders (ASDs) are neurological disorders that
 can cause significant social, communication and behavioral
 challenges.

 ASDs are "spectrum disorders." That means ASDs affect each
 person in different ways, and can range from very mild to severe.
 Diagnosis is based on observed behavior and social history

 Lifelong disability

 Outcomes are better with early identification            and
 intensive intervention

 No known cause/No known cure

 Often occurs along with other disabilities




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Prevalence: How Common is ASD?
 1 in 88 children has been identified with an ASD

 ASDs are reported to occur in all racial, ethnic,
 and socioeconomic groups.

 5 times more common among boys (1 in 54)
 than among girls (1 in 252).

 Reasons for the increase:
  • Changes in diagnostic criteria
  • Increased public awareness
  • US Dept of Education added autism as
    diagnostic category in 1991
  • Laws promoting early intervention services
  • Research continuing to explore more
    reasons for increase in ASD


*CDC's Autism and Developmental Disabilities Monitoring (ADDM) Network




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The Autism Spectrum “Umbrella”:
Pervasive Developmental Disorders
               5 separate diagnoses




    Autistic                           Childhood
                                      Disintegrative
    Disorder
                                         Disorder

        Asperger’s              Rett’s
         Disorder              Disorder
                     PDD-NOS




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RED FLAGS
 No big smiles or other warm, joyful expressions by six
 months or thereafter

 No back-and-forth sharing of sounds, smiles,
 or other facial expressions by 9 months
 or thereafter

 No babbling by 12 months

 No back-and-forth gestures,
 such as pointing, showing,
 reaching, or waving by 12 months


 Greenspan, S.I., Prizant, B.M., Wetherby, A, and First Signs, Inc. http://www.first signs.org/healthydev/milestones.htm




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RED FLAGS
                                                   No words by 16 months

                                                   No two-word meaningful phrases (without
                                                   imitating or repeating) by 24 months

                                                   Any loss of speech or babbling or social skills
                                                   at any age

                                                   Some children and older individuals
                                                   repeatedly flap their arms or walk on their
                                                   toes. Some suddenly freeze in a position.

                                                   Sometimes they may be disruptive and
                                                   physically aggressive
 Greenspan, S.I., Prizant, B.M., Wetherby, A, and First Signs, Inc. http://www.first signs.org/healthydev/milestones.htm




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Main Areas Affected
                                                                               Restricted &
        Social                         Communication/                           Repetitive
      Interaction                          Play                                 Behaviors




Challenges
   Sensory Processing
   Motor Skills
   Attention
   Organization
   Motivation
   Learning
   Co-Morbid Conditions (anxiety, depression,
   seizures, mental retardation)


 *Affected individuals will vary in the number and severity of specific symptoms exhibited




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Teaching Strategies

 Reinforcement

 Prompting

 Modeling




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Positive Reinforcement
                “When a behavior is
                followed immediately
                 by the presentation
                 of a stimulus and, as
                 a result, occurs more
                  often in the future”
                (Cooper, Heron, Howard, 1987)




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Prompting
Stimuli used to increase the
      likelihood that a
  correct response will be
           emitted.
   Special cues before or
 during the performance of
a behavior in order to direct
attention to an activity and
help the behavior to occur.




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Types of Prompts

 Physical Prompts
 Modeling
 Gestural Prompts
 Verbal Prompts
 Visual Prompts
 (pictures, words)




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Visual Prompts
Anything that we see
 that:

 Enhances the
 communication process

 Helps us gain
 information

 Improves organization




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Why use visuals?
Children with autism learn visually

Reduces anxiety and fears

Enhances comprehension

Helps reduced inappropriate behaviors

Helps them to predict what is coming

Teaches independence

Helps with attention and learning




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Introductory Books
 Called Social Stories-Created by
 Carol Gray

 Short stories to visually convey
 expectations

 Use for self-help, changes in
 routine, behavior, etc.

 Introduce to a new event or
 activity




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                                     An Introductory Book for our Swimming Lessons


                   Welcome to Ocaquatics Swim School!
The mission of Ocaquatics Swim School is to teach families to love swimming and
     to become safer, more comfortable and responsible around the water.
   This introductory book will help your child come more relaxed, excited, and
                      prepared for his/her swimming lessons.

                                   The Schedule goes as follow:
                 Welcome and warm-up                Arms/Rainbows and Rollovers
                         Kicking                          Backstroke kicks
                     Arms/Rainbows                   Backstroke arms/rainbows
                      Back floating                               Jumps
                        Rollovers                          Playtime/ Rings


 Please print this book at least a week before the lessons starts and read it with
                                 him/her everyday.
                  We can’t wait to have FUN in the water!




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Positive Behavior Support
 Environmental Design
    Boundaries

 Visual Supports
    Schedules
    Choice boards
    Show them what to do (task strips)

 Clarify Expectations
    First /Then (verbal or visual)
    Timer, count down (verbal or visual)
    Be prepared ( know your goals, have
    materials ready)

 CATCH THEM BEING GOOD!!!!!!!!!!




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Schedules-Choice Boards Why?
Give information on
  What is going to happen
  When it’s going to happen

Increase
  Independence
  Structure of the environment
  Predictability

Decrease
  Fear and anxiety
  Surprises




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Responses to Challenging Behaviors
  Ignoring

  Redirecting

  Removal from current
  activity or remove desired
  item

  Reinforce appropriate
  behaviors




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Pilot Swimming Program
 24 Children (Autism and other disabilities) split into 3
 groups

 10 Week program. Swimmers came once per week.




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Pilot Swimming Program
4 Ocaquatics staff in the
water. 1 Ocaquatics staff
member on deck. 1 from
UM-NSU CARD. 2-3 from
Beyond Expectations
School in and out of the
water for support.

Before the program
started, UM-NSU CARD
provided training for
Ocaquatics staff
members.




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Waiting for a Turn
  WAIT BOARD
  Preferred toy
  Squeeze ball
  Ring to STOP ring to GO
  STOP sing
  Give verbal cues
  (one or two words)
  Peers (buddy system)
  Bobs
  First-Then




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Bubbles
 Model
 Prompt
 Peers (buddy system)
 Straw for blowing




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How Many Laps
 Numbers on board
 Instructional Tools
 Ducks
 First-Then




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Kicking
 Model
 Prompt
 Doll
 Peers (buddy system)




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Back and Front Floating
 Model
 Prompt
 Doll
 Peers (buddy system)
 Sensory-Squeeze
 forehead
 “Shuuu” sound
 Mirror
 Kickboard
 Float under mat




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Front and Back Arms
 Model
 Prompt
 Doll
 Peers (buddy system)




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Jumps and Diving
 Model
 Prompt
 Instructional Tools
 Peers (buddy system)
 Hoola Hoop




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     46

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"Teaching Swimming to Children with Autism" by Maricarmen Saleta- Adapted Aquatics Conference 2012

  • 1. 5/7/2012 Maricarmen Saleta Miren Oca Educational Support Specialist Director UM-NSU CARD Ocaquatics Swim School 1
  • 3. 5/7/2012 Autism Spectrum Disorders: What We Know Autism Spectrum Disorders (ASDs) are neurological disorders that can cause significant social, communication and behavioral challenges. ASDs are "spectrum disorders." That means ASDs affect each person in different ways, and can range from very mild to severe. Diagnosis is based on observed behavior and social history Lifelong disability Outcomes are better with early identification and intensive intervention No known cause/No known cure Often occurs along with other disabilities 3
  • 4. 5/7/2012 Prevalence: How Common is ASD? 1 in 88 children has been identified with an ASD ASDs are reported to occur in all racial, ethnic, and socioeconomic groups. 5 times more common among boys (1 in 54) than among girls (1 in 252). Reasons for the increase: • Changes in diagnostic criteria • Increased public awareness • US Dept of Education added autism as diagnostic category in 1991 • Laws promoting early intervention services • Research continuing to explore more reasons for increase in ASD *CDC's Autism and Developmental Disabilities Monitoring (ADDM) Network 4
  • 6. 5/7/2012 The Autism Spectrum “Umbrella”: Pervasive Developmental Disorders 5 separate diagnoses Autistic Childhood Disintegrative Disorder Disorder Asperger’s Rett’s Disorder Disorder PDD-NOS 6
  • 7. 5/7/2012 RED FLAGS No big smiles or other warm, joyful expressions by six months or thereafter No back-and-forth sharing of sounds, smiles, or other facial expressions by 9 months or thereafter No babbling by 12 months No back-and-forth gestures, such as pointing, showing, reaching, or waving by 12 months Greenspan, S.I., Prizant, B.M., Wetherby, A, and First Signs, Inc. http://www.first signs.org/healthydev/milestones.htm 7
  • 8. 5/7/2012 RED FLAGS No words by 16 months No two-word meaningful phrases (without imitating or repeating) by 24 months Any loss of speech or babbling or social skills at any age Some children and older individuals repeatedly flap their arms or walk on their toes. Some suddenly freeze in a position. Sometimes they may be disruptive and physically aggressive Greenspan, S.I., Prizant, B.M., Wetherby, A, and First Signs, Inc. http://www.first signs.org/healthydev/milestones.htm 8
  • 9. 5/7/2012 Main Areas Affected Restricted & Social Communication/ Repetitive Interaction Play Behaviors Challenges Sensory Processing Motor Skills Attention Organization Motivation Learning Co-Morbid Conditions (anxiety, depression, seizures, mental retardation) *Affected individuals will vary in the number and severity of specific symptoms exhibited 9
  • 10. 5/7/2012 10
  • 11. 5/7/2012 11
  • 13. 5/7/2012 Positive Reinforcement “When a behavior is followed immediately by the presentation of a stimulus and, as a result, occurs more often in the future” (Cooper, Heron, Howard, 1987) 13
  • 14. 5/7/2012 Prompting Stimuli used to increase the likelihood that a correct response will be emitted. Special cues before or during the performance of a behavior in order to direct attention to an activity and help the behavior to occur. 14
  • 15. 5/7/2012 Types of Prompts Physical Prompts Modeling Gestural Prompts Verbal Prompts Visual Prompts (pictures, words) 15
  • 16. 5/7/2012 Visual Prompts Anything that we see that: Enhances the communication process Helps us gain information Improves organization 16
  • 17. 5/7/2012 Why use visuals? Children with autism learn visually Reduces anxiety and fears Enhances comprehension Helps reduced inappropriate behaviors Helps them to predict what is coming Teaches independence Helps with attention and learning 17
  • 18. 5/7/2012 Introductory Books Called Social Stories-Created by Carol Gray Short stories to visually convey expectations Use for self-help, changes in routine, behavior, etc. Introduce to a new event or activity 18
  • 19. 5/7/2012 19
  • 20. 5/7/2012 An Introductory Book for our Swimming Lessons Welcome to Ocaquatics Swim School! The mission of Ocaquatics Swim School is to teach families to love swimming and to become safer, more comfortable and responsible around the water. This introductory book will help your child come more relaxed, excited, and prepared for his/her swimming lessons. The Schedule goes as follow: Welcome and warm-up Arms/Rainbows and Rollovers Kicking Backstroke kicks Arms/Rainbows Backstroke arms/rainbows Back floating Jumps Rollovers Playtime/ Rings Please print this book at least a week before the lessons starts and read it with him/her everyday. We can’t wait to have FUN in the water! 20
  • 21. 5/7/2012 21
  • 22. 5/7/2012 22
  • 23. 5/7/2012 23
  • 24. 5/7/2012 24
  • 25. 5/7/2012 25
  • 26. 5/7/2012 26
  • 27. 5/7/2012 27
  • 28. 5/7/2012 28
  • 29. 5/7/2012 29
  • 30. 5/7/2012 Positive Behavior Support Environmental Design Boundaries Visual Supports Schedules Choice boards Show them what to do (task strips) Clarify Expectations First /Then (verbal or visual) Timer, count down (verbal or visual) Be prepared ( know your goals, have materials ready) CATCH THEM BEING GOOD!!!!!!!!!! 30
  • 31. 5/7/2012 Schedules-Choice Boards Why? Give information on What is going to happen When it’s going to happen Increase Independence Structure of the environment Predictability Decrease Fear and anxiety Surprises 31
  • 32. 5/7/2012 Responses to Challenging Behaviors Ignoring Redirecting Removal from current activity or remove desired item Reinforce appropriate behaviors 32
  • 33. 5/7/2012 33
  • 34. 5/7/2012 34
  • 35. 5/7/2012 Pilot Swimming Program 24 Children (Autism and other disabilities) split into 3 groups 10 Week program. Swimmers came once per week. 35
  • 36. 5/7/2012 Pilot Swimming Program 4 Ocaquatics staff in the water. 1 Ocaquatics staff member on deck. 1 from UM-NSU CARD. 2-3 from Beyond Expectations School in and out of the water for support. Before the program started, UM-NSU CARD provided training for Ocaquatics staff members. 36
  • 37. 5/7/2012 37
  • 38. 5/7/2012 Waiting for a Turn WAIT BOARD Preferred toy Squeeze ball Ring to STOP ring to GO STOP sing Give verbal cues (one or two words) Peers (buddy system) Bobs First-Then 38
  • 39. 5/7/2012 Bubbles Model Prompt Peers (buddy system) Straw for blowing 39
  • 40. 5/7/2012 How Many Laps Numbers on board Instructional Tools Ducks First-Then 40
  • 41. 5/7/2012 Kicking Model Prompt Doll Peers (buddy system) 41
  • 42. 5/7/2012 Back and Front Floating Model Prompt Doll Peers (buddy system) Sensory-Squeeze forehead “Shuuu” sound Mirror Kickboard Float under mat 42
  • 43. 5/7/2012 Front and Back Arms Model Prompt Doll Peers (buddy system) 43
  • 44. 5/7/2012 Jumps and Diving Model Prompt Instructional Tools Peers (buddy system) Hoola Hoop 44
  • 45. 5/7/2012 45
  • 46. 5/7/2012 46