Sevier County Department of Special Education
TECHNICAL
ASSISTANCE MANUAL ON AUTISM FOR
SEVIER COUNTY SCHOOLS
Updated October 11, 2000
Congratulations! You have taken the first step toward meeting the educational needs of students with autism. You have put yourself on an exciting pathway of personal and professional growth. This road will pose some challenges, increase your knowledge and understanding that all children are learners, allow you to apply your collaborative skills, and further enhance your skills as an educator of all children.
Teachers sometimes think, "I can't have this student, I have never been trained on autism", "I'm not a special education teacher, I don't know how to teach a student who has autism", or "I'm afraid I can't teach students with autism, I don't know what to expect." These are common concerns that need to be acknowledged. These worries are understandable because what most people know about autism comes from knowing one individual with autism or from the media. Unfortunately, the media often perpetuate myths and stereotypes about individuals with autism and knowing one individual with autism does not provide a complete picture of the broad spectrum of characteristics (strengths and weaknesses) a student with autism might possess. Students with autism are as diverse as typical students. Student diversity in our schools has never been as great as it is now. We hope that this manual is only the beginning of your journey to becoming informed and educated about serving another diverse group - students with autism.
Parents of children with autism want teachers who understand their child from the child's perspective, and who apply positive, carefully planned teaching strategies based on this understanding to help their child learn and succeed. It takes more than good teaching to understand a student with autism. Good teaching combined with accurate knowledge about the disability builds the foundation for meeting the educational needs of students with autism.
The purpose of this manual is to provide information and knowledge necessary to appropriately serve students with autism. To accomplish this purpose the manual:
1.provides answers to frequently asked questions about autism in Sevier County
2.describes a framework for understanding autism through a competency model, and
3.applies the competency model to the development of individual educational programs (IEPs) and behavior management/discipline plans.
The manual is written in question and answer format using the most commonly asked questions about autism. Each question is listed in the Table of Contents and answered within the manual. In addition to the questions and answers several appendixes are provided to help you evaluate, plan, and implement appropriate instructional experiences for students with autism.
Sevier County has also participated in the State of Tennessee’s Triad training through Vanderbilt University. Sandy Enloe and Kathy Shockley are certified as being trained in the Triad method and currently serve as trainers for teachers in Tennessee systems. Either of these two individuals may be consulted for additional information or advice on the subject of autism. The county also operates an Autism Evaluation Team comprised of these two individuals, a physical therapist, occupational therapist, and a speech pathologist when appropriate. They may be contacted at 453-1036 through the Department of Special Education’s main office.
What is autism?
Domains Assessed for Determining Eligibility
Criteria for Autism
Do all students with autism share the same characteristics?
What causes autism?
What is their educational history?
How Many People Have Autism?
Who should be involved in the education program of the student with autism?
Roles of ARC and Multidisciplinary Team Members
Is there any model or method that could help the IEPand S-teams design and implement the IEP for a student with autism?
Understanding Risk Factors
Understanding Protective Factors
Sixteen Types of Enhancements
Common Areas of Support for Students with Autism
Supports for Social and Behavioral Competency
Supports for Communication
Supports for Physical Needs
Supports for Organizing Information
What is an Individual Education Program?
What information is in an IEP for a student with Autism?
Will there be similarities among IEPs for students with autism?
What are some strategies that might address the student’s deficit areas
social competence
comm functioning
cognitive functioning
physical functioning
How do you develop appropriate behaviors for students with autism?
What do we do when a student with autism engages in inappropriate behaviors?
Other Possible Reasons for Problem Behaviors
Are the same standards of discipline that are applied to students who are not disabled applied to a student with autism?
Figure 1: Domain and Potential Range of Functioning
Figure 2: Three Diagnostic Criteria
Figure 3: Examples of Range Differences
Figure 4: Possible IEP and S-Team
Figure 5: Functions of IEP and S-Team
Figure 6: Autism Competency Model
Figure 7: Personal Challenges
Figure 8: Environmental Challenges
Figure 9: Unbalanced Competency Model
Figure 10: Personal Resources
Figure 11: Environmental Resources Appendixes
Autism Society of America Chapters
Some Autism Newsletters and Journals
A few recommended 1990's Books on Autism
What is Autism?
Autism is a neurologically based syndrome described by a combination of behavioral characteristics. Autism can coexist with other conditions. The most common condition coexisting with autism is mental retardation. Other coexisting conditions include fragile-X syndrome, neurofibromatosis, tuberous sclerosis, cerebral palsy, seizure disorders, blindness, deafness, and other syndromes such as Down, DeLange, or Tourette's. A number of research studies indicate that about 70% to 80% of children with autism also have mental retardation, about 50% are nonverbal or minimally verbal, and about 25% to 30% develop seizures by adulthood.
Current literature documents a number of issues surrounding autism. Autism can be a difficult and confusing disability to identify due to the numerous classification schemes (Volkmar & Cohen, 1988). The clinical picture of autism varies across individuals, especially in the preschool years, to the extent that there is often a lack of understanding or misdiagnosis of the disability. Individuals who manifest the classic symptoms of autism are more likely to be diagnosed than those who exhibit less apparent symptoms (Allen, 1991). Parents of children with less serious deficits are often told that their child is autistic-like, obsessive-compulsive, schizophrenic, oppositionally-defiant, communication disabled, emotionally disabled, learning disabled, or has a pervasive developmental disorder. Diagnosticians who lack experience with a large number of cases of autism may miss the elusive features of autism (Frith, 1989).
To determine if a student is eligible for special education and related services, information is collected across eight domains: cognitive functioning; physical functioning, communication functioning, social competence, educational functioning, environmental influence, vocational functioning, and recreation and leisure functioning. A brief description of each domain follows.
Cognitive Functioning - includes intelligence and thinking processes (e.g., knowledge, comprehension, application, analysis, synthesis, and evaluation).
Physical Functioning - includes vision, hearing, speech mechanism, health and motor/psychomotor (e.g., gross motor, fine motor, locomotion).
Communication Functioning - includes expressive (what is spoken/signed), receptive (what is heard/interpreted), nonverbal communication, articulation, mode of communication, voice and fluency.
Social Competence - includes social psychological development, interpersonal behavior, personality, and adaptive behavior (personal living skills, community living skills, communication and social skills).
Educational Functioning - includes basic skills and achievement in content areas and school/study skills.
Environmental Influence - includes home, educational experience, cultural and economic influences, and interactions in the home, school and community.
Vocational Functioning - includes general work behaviors, dexterity, following directions, working independently or with job support, socialization skills, job interests/preferences, career awareness, job interview and application skills, and job specific work skills.
Recreation and Leisure skills - includes use of free time, personal hobbies, use of community recreation resources, physical fitness, and degree of social involvement.
Autism has been described as a spectrum disorder because its characterization in these domains ranges from people who have severe deficits to those who have mild deficits. Many classification systems have been used to diagnose a person with autism. To classify students as eligible for special education and related services, most states use diagnostic criteria from one, or a combination, of three sources: (a) the Diagnostic and Statistical Manual for Mental Disorders - 4th Edition (DSM-IV), (b) the Individuals with Disabilities Education Act (IDEA) P. L. 101-476, or (c) state laws and requirements. The criteria for autism found in these sources follow.
DSM-IV Criteria for Autistic Disorder - as found in the Pervasive Developmental Disorders Category
A student is considered to have autism if he/she meets the following:
A. A total of six (or more) items from #1, #2, and #3, with at least two items from #1, and one each from #2 and #3:
1. Qualitative impairment in social interaction, as manifested by at least two of the following:
(a) marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial
expression, body postures, and gestures to regulate social interaction;
(b) failure to develop peer relationships appropriate to developmental level; and/or
(c) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest).
2. Qualitative impairments in communication as manifested by at least one of the following:
(a) delay in, or total lack of, the development of spoken language (not accompanied by an attempt to
compensate through alternative modes of communication such as gesture or mime);
(b) in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others;
(c) stereotyped and repetitive use of language or idiosyncratic language; or
(d) lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level.
3. Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:
(a) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is
abnormal either in intensity or focus;
(b) apparently inflexible adherence to specific, nonfunctional routines or rituals;
(c) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements); or
(d) persistent preoccupation with parts of objects.
B. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years:
1. social interaction;
2. language as used in social communication; or
3. symbolic or imaginative play.
C. The disturbance is not better accounted for by Rett's Disorder or Childhood Disintegrative Disorder.
CRF 300.7(b)(1)
(1) "Autism" means a developmental disability significantly affecting verbal and nonverbal communication and social interaction generally evident before age 3, that adversely affects a child's educational performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences.
Figure 2 offers a graphic comparison of the sources of criteria for determining if a student has autism in relationship to three areas (social interactions, communication and behavior skills) found within the three areas typically impacted by autism: social interaction, communication functioning, and behavior skills. There is little difference between the descriptions of deficit areas between the various sources.
1. Social Interaction
2. Communication Functioning
3. Behavior Skills
qualitative impairment in social interaction
qualitative impairment in communication
restricted repetitive and stereotyped patterns of behavior, interests, and activities
The three classification systems focus on the classic symptoms of autism. There are also characteristics that are commonly present but are not necessary for a diagnosis of autism. These characteristics include:
In Tennessee, determination of eligibility for special education and related services is made using the criteria set forth in state law, which reflects the requirements of Federal law. While not required, the use of the criteria set forth by the DSM-IV to distinguish the student’s characteristics can support other information discussed during the eligibility determination phase to determine if the student meets Tennessee’s eligibility requirements.
There are many myths that surround the disability of autism which are sometimes reinforced by characterizations such as in the movie Rainman. While this movie increased the awareness of autism and the effect autism may have on a family, its portrayal of an individual with autism was more stereotypical than representative. Two common myths that were reinforced by this movie were (a) that people with autism cannot show affection to others and (b) that people with autism have unusual abilities. Students with autism are a diverse group with varying degrees of ability, social interest, and communication. Students with autism share a core set of features that sets them apart from other students with disabilities who have social, communication, or behavior problems.
A student without disabilities would be expected to perform similarly across the various domains. The age equivalent scores would be about the same as the student's chronological age. In this example, a student 17 years and 2 months old would be expected to obtain similar age scores across the assessment domains, as noted by the dotted line.
For students with autism, disparities are often noted in the difference between chronological (actual) age and age equivalent scores from performance measurements. Differences across the five domains are typical. In Figure 3, the students with autism were all 17 years and 2 months old at the time of assessment. Student E has relatively high cognitive performance indicated by his obtained IQ score, which was above the expected age equivalent score of 17 years. Student A, however, performed below his expected age equivalent of 17 years in the cognitive domain. Student A is identified as having both autism and mental retardation, while Student E has autism without mental retardation. For both Student E and A, relative weaknesses were noted in communication and social domains. Students with autism may also have other disorders such as seizure disorders (20% - 30% of individuals with autism develop seizure disorders by age 18, according to Gillberg and Steffenburg (1987), and affective (psychological) disorders, particularly depression. Students with autism will also have other personality factors similar to students without disabilities. A student with autism might be quiet, shy, boisterous, action oriented, impulsive, reflective, or any other characteristics that people have. Paired with the challenges presented by autism, these factors can become additional challenges and risks.
Overall, people with autism can have strengths in daily living skills, motor skills, and sometimes, cognitive performance. Lower performance in social competence and communication functioning are characteristic of autism and noted across all individuals, regardless of their performance in other domains. However, the strength of an individual with autism in academic and cognitive skills varies with each individual ranging from very high functioning to low functioning mastery of skills.
Autism was first described in the research literature in 1943 by Leo Kanner. There are multiple suspected causes of autism. Autism has been found in children whose mothers contracted rubella or cytomegalovirus during pregnancy. Severe infections during very early infancy have been associated with autism. Some environmental factors are also believed to contribute to autism. There is also a form of autism that seems to follow a double recessive gene. Autism occurs about four times more often in males than in females.
There is no relationship between autism and social economic status, race, ethnic or geographic origin. In addition, autism is not due to psychological factors or parenting style. It is both a delay in development and a process of atypical development. Autism is a distinct disorder that is meaningfully different from emotional disabilities, behavioral disabilities, mild mental disabilities, schizophrenia, and specific developmental language disorders (Minshew, 1992; Rutter & Schopler, 1992).
Medical studies have implicated a neurological basis for the disorder. Numerous abnormalities have been identified in individuals with autism. Some believe that these abnormalities can result in problems of attention, memory, information transfer, and complex information processing (Minshew & Rattan, 1992).
Although the incidence level for autism ranges from 5 to 20 of 10,000 births depending on the criteria used, it is estimated that at least 1 out of 1,000 individuals has autism. Autism is the third most prevalent developmental disability in America, not nearly as rare as one might think (Autism Society of America, 1994).
Twenty-five to 30 years ago, 90% of those identified with autism lived in institutions and were educated in segregated school buildings or segregated classes. Now the opposite is true. Almost all students with autism live in their communities and attend public schools. When unique needs are understood and individualized supports are put in place to specifically teach skills that most peers learn from experience, correction, or study students with autism benefit from learning with peers.
WHO SHOULD BE INVOLVED IN THE EDUCATION PROGRAM OF A STUDENT WITH AUTISM?
The number of people and roles of individuals who work with a student having autism varies from one student to the next because the needs of each individual student are different. As the student grows and changes throughout the educational and post secondary years the people responsible for supporting will likely fluctuate. Families are faced with a lifetime of helping their child grow and develop into a competent citizen. Family members are often the interpreters and strongest advocates for their child. Therefore, families benefit from having a network of people who can support and advocate for them when necessary. Parents need to know there are other people trying to help their child become a capable citizen.
Federal and State requirements clearly outline the membership of a decision making multidisciplinary team for a student who has a disability. This multidisciplinary team, called the IEP Team, consists of a wide range of individuals who have direct and indirect contact with the student and family. There can be an unlimited number of individuals involved in an IEP meeting, ranging from the regular education teacher to a social worker.
Any individual who has information that is educationally relevant to the student may become a member of the team or provide critical information without becoming a member. However, Tennessee State law, which reflects federal law, requires that the IEP Team consists of at least the following:
parent; child, when appropriate; regular education teacher of the child; teacher of exceptional children who is knowledgeable of the disability or suspected disability; administrator or designee; and others as requested by members of the IEP Team.
Most students with autism receive services and instruction from a variety of people in a variety of educational settings. To be successful, students with autism need a multidisciplinary team working collaboratively to meet their unique needs. Such a team will assess, brainstorm, problem solve, and create ideas together to provide needed services. A list of potential members of the IEP Team is offered in Figure 1. This list is by no means exhaustive or final.
FIGURE 1: Possible IEP Team Members
Student with autism, Family Members Regular education teacher(s), Psychologist, Special education teacher(s) , Physician Physical therapist, Nurse practitioner Speech language pathologist , Friends, School administrator, Advocates, Occupational therapist, Agency Personnel , Social worker or Counselor, Autism experts , Community members Friends from student’s class(es), School Psychologist/Evaluator
Each member of the IEP team provides unique expertise and supports to the educational services of the student with autism. The following information is a summary of the typical role(s) individual members of an IEP Team may take when serving a student with autism.
The Student with Autism participates in the decision and choice-making whenever feasible. Family members are vital members of the team. Usually parents, sometimes grandparents, aunts and uncles, brothers and sisters are the most intimately involved with the student with autism throughout life. They are friends, advocates, models, and teachers. They provide a view of the student’s needs from the longitudinal perspective.
Regular Education Teachers who teach the student provide information from observations, interactions, and informal and formal evaluation. It is vital to know the expectations of teachers, their ability to individualize, and the support they require to assure student success.
A Psychologist/School Psychologist assesses the student through formal and informal means and suggests individualized strategies for teaching and for helping the student learn the skills needed to engage in appropriate behavior.
Special Education Teachers provide input and expertise in assessment or evaluation, the development of particular objectives; the design and implementation of individualized strategies; and modifications or accommodations to techniques, materials or teaching methodology. The special education teacher provides direct (e.g., teaching) or indirect (e.g., materials, consultations) services to students and teachers.
A Physician or Nurse Practitioner shares the medical history and current concerns. For example, they can explain medical conditions, effects of medication, and assist with the monitoring and administration of medication.
Occupational Therapists and Physical Therapists provide direct therapy to the student and/or indirect therapy (consultation) to parents and teachers. Assessment input into objectives and evaluation are important roles for these therapists.
A Building Administrator commits personnel and fiscal resources to support the special education and related services.
A Speech/Language Pathologist provides continual assessment related to the communication needs of the student. The pathologist assists and supports communication methods and techniques, provides direct therapy, indirect services (e.g., consultation), and training for educators and parents.
A Social Worker or Counselor provides individual or small group instruction on identified objectives such as social interaction skills, learning what to do when frustrated, or desensitization to fears. In addition, these individuals provide support and information to families, peers, and staff.
Friends, Advocates, and Other Community Members offer a unique perspective. Individuals from the community provide realistic perspectives on how the student with autism can be a productive member of the community. Friends and advocates provide realistic perspectives about how the student can be a productive member of a family, a close group of friends, and the community.
Agency (Non-School District) Personnel working with the Student and/or Family (e.g., social services) provide support, ensure smooth transition (e.g., job coach), allow for consistency, and ensure success during transition.
Autism "experts" provide insights and current research information to ensure that best practices are being planned and implemented.
Friends of the student in her/his class provide their perspective of the student’s abilities and capabilities .
IS THERE A DIFFERENCE BETWEEN AN IEP TEAM AND AN S-TEAM?
The difference between an IEP Team and an S-team is often misunderstood. State regulations require that the membership of the IEP team be multidisciplinary - thus making it a multidisciplinary group of individuals specified by regulation who work together to make educational decisions for the student with disabilities and to ensure the educational success of the student. An S-team is a group of individuals who work together to determine if a student is actually a student with disabilities who needs special education or related services or if that student’s needs can be met through the general education program.
The confusion over an IEP and S- team seems to grow out of the purpose each team serves. The IEP Team is responsible for making specific decisions related to the student, including evaluation issues, development of an IEP, and determining placement in the least restrictive environment. S-teams gather evaluation data to address issues raised by the regular education teacher, school, parents or others. An S-team also may do instructional planning and provide strategies for the regular education classroom. In some cases, S-teams plan, implement, and evaluate the day to day instructional strategies, which support the student in meeting goals and objectives in the regular education program. This means that they can be primarily the teachers and others who work in individual schools on a daily or weekly basis with specifically identified students prior to the initial referral.
The IEP Team must meet at least once each calendar year (365 days) to review the student’s IEP, evaluate ongoing progress, develop new strategies, and as needed, revise the IEP. The discussion of ideas and reasons for decisions are documented on an IEP Conference Summary Report. The IEP Team may meet as often as needed throughout the year to discuss concerns about the IEP and make decisions based upon educationally relevant information. Ideally, each member is present for each IEP meeting. Sometimes
it is difficult for every member to meet at the same time for an IEP meeting. When this happens, prior to the IEP meeting the members who will attend the IEP meeting have the responsibility to gather pertinent information from others who do not attend the meeting. Their information is presented at the IEP meeting.
The S-team plans, implements, and evaluates the day to day instructional strategies, which support the student in meeting his or her goals and objectives. This team can, and should, meet on a regular basis, (such as weekly instructional planning during a teacher’s planning period) to design instruction and make modifications to meet the needs of the student. Such meetings allow the team to plan for weekly concerns about the student’s continuing progress. Such planning meetings are not considered to be IEP meetings, so they are not documented on Conference Summary Reports. Meetings such as this may take the form of planning, informal conversations, telephone conversations, teleconferencing, email, shadowing, or written communications. Decisions from these meetings are documented via informal means (e.g., lesson plans, data charts, reflective logs, meeting notes, etc.). It is important that the results of such meetings be shared with the IEP Team. Some schools also refer to these teams as Support Teams. The semantics are much less important to Sevier County’s Department of Special Education than the actual work being done by each team.
These planning meetings and the communication system for the team serving a student with autism are considered vital to the implementation of the annual goals and objectives on the student’s IEP. The day to day instructional decisions are considered essential for student progress. The results of those decisions (meaning the progress that the student makes each week) are presented and discussed during IEP meetings and documented as ongoing progress data.
Each person involved in the life of the student with autism plays a critical part in the student’s success. To guarantee student success, State regulations require that an IEP Team is formed so that there is adequate representation of the student’s needs from a variety of perspectives. Regulations specify membership of the IEP. The S-Team is flexible, based upon services needed at a specific time and may include individuals who also serve as IEP members.
As part of the IEP process the team collects and examines current ongoing progress data concerning the student’s progress on specific goals. This allows the IEP Team to conduct long term planning for the student. S- team members use the long term planning as a guide for developing the short term, or day to day instructional strategies, that will support the student. It is possible that there will be individuals (e.g., consultants) who become a temporary member of the team to develop day-to-day strategies. For example, a consultant on behavior management for students with autism might come in to the school and home to work with the team on developing positive behavior management plans. The consultant may work with the team for only a few hours or a day. The consultant may temporarily become part of the S-Team, but might not attend the IEP meeting because the parents and educators feel they can adequately represent the information gained through the consultation. Figure 5 offers a graphic representation of the differences between the functions of an IEP Team and an S-team.
|
IEP Team |
S-Team |
|
Collaborate on long term planning (IEP). |
Collaborate on short term planning (instructional and daily lesson plans). |
|
Assure due process is followed. |
Provide services to the student. |
|
Meet at least every 365 days to determine educational needs based upon State and Federal law. |
Meet weekly t plan strategies to support the student. |
|
Provide data related to student’s progress. |
Provide data related to student's education progress. |
|
Document information and decisions in IEPs and Conference Summary or other Reports. |
Document information and decisions in lesson plan format. |
|
Create the IEP goals and objectives. |
Plan instruction based on objectives. |
|
Communicate to all individuals. |
Communicate to all individuals. |
|
Analyze evaluation data using informal and formal evaluations to make long-range educational decisions |
Collect and analyze evaluation data using informal and formal methods for instructional |
To effectively teach a student with autism it is necessary to understand how the qualitative impairments associated with the disorder affect each student. Because of the neurological nature of autism, there are a number of behaviors that the student cannot change without specific supports. These supports are similar to wheelchairs for students who are paraplegics, hearing aides for students who are partially deaf, or eye glasses for students who have vision problems. While students who use wheel chairs or eye glasses have physical or visible needs, the student with autism may not have problems that are obvious from a visual perspective. When working with a student who has autism, the multidisciplinary team has to understand and interpret the cognitive (mental) processing problems that affect the way the student translates what is seen, heard, and felt into functional, useful information and behavior.
The task of learning creates major stresses and anxieties for a student when the personal challenges of autism are combined with the environmental challenges. The personal challenges for a student with autism are core deficits which impact the eight domains described previously in Section One. These core deficits are most often found in four domains: Cognitive functioning, Social interaction, Communication functioning, and Physical functioning (particularly in motor and sensory skills). Identifying the Student’s strengths and weaknesses within these domains with precision and accuracy is the first step to designing and implementing successful educational experiences for the student.
IS THERE A MODEL THAT COULD HELP THE ADMISSIONS AND RELEASE COMMITTEE AND MULTIDISCIPLINARY TEAM DESIGN AND IMPLEMENT AN IEP FOR A STUDENT WITH AUTISM?
To successfully design education experiences for students with autism, the IEP Team must understand the strengths and weaknesses of the individual student as well as what resources (materials, strategies, and people) are necessary to support the student. The link between the challenges of autism and appropriate educational supports is conceptualized using the Autism Competency Model developed by Ruble and Dalrymple (1995). The role of educators and family is to understand how to apply the Autism Competency Model so that every student with autism has the environmental resources needed to succeed.
The Autism Competency Model is based upon the concept that the education program for a student with autism describes what the student needs to work on to achieve the outcome of functioning as a competent person in society. It is important for the IEP Team to recognize that being competent does not require the person to be completely independent, but does require the person to be a contributing member of a community. The IEP Team must also recognize that students with autism will be successful to different degrees with jobs, leisure activities, and daily living skills in the community and that the context of his or her community will likely consist of family members, close friends and others.
Being considered competent requires the ability to interact successfully with other people and to succeed in activities that are valued in the community. Therefore, when developing the IEP the IEP Team should identify what students who are not disabled and are the same age and grade level are mastering. Once these are known, the team can prioritize the skills for the student with autism and then determine which will require individualized supports so the student can be successful based upon the student’s current skill level.
The Autism Competency Model suggests that there are two major factors that influence student success: Risk Factors and Protective Factors. Risk Factors are those factors within the student (Personal Challenges) and within the environment (Environmental Challenges) that pose great obstacles for a student. Protective Factors are those factors within the student (Personal Resources) and the environment (Environmental Resources) that counterbalance the risk factors and assist the student in overcoming challenges to be successful. Protective factors are the resources, both personal and environmental that allow the student to be successful.
Protective factors, on the left side of the scale, are the accumulation of both personal and environmental resources, which allow the student to be successful. Protective factors include the personal resources, (strengths) a student with autism brings to the educational experience and the environmental resources (materials, strategies, people) which are provided for the student to ensure success with the educational experience. Risk factors, on the right side of the scale, are the personal and environmental challenges
that could prevent the student from being successful in typical educational experiences. Risk factors include both the personal challenges (areas of weakness) and environmental challenges (materials, strategies, people) which interfere with the student's ability to be successful.
The student with autism can be competent when the protective factors counterbalance the risk factors. To know what and how to teach a student, it is important to understand the protective and risk factors and how these affect the learning of a student with autism. Using the Autism Competency Model as the format for understanding how to design appropriate educational opportunities for a student with autism the ARC should begin by exploring the risk factors facing the student. Once the risk factors have been identified, the ARC explores the protective factors available and appropriate for the student. Understanding the tentative balance between an individual's resources and challenges helps educators know what and how to teach a student with autism. The balance is tentative. In different situations or at different times the challenges become more significant, or the student’s response to the challenge is inconsistent or regressive.
Risk Factors fall into two categories. The first category, personal (within-person) challenges, is comprised of characteristics that affect a student's ability to learn and achieve educational success. The second category is environmental challenges that also contribute to the student being at risk for educational failure. This section of the manual addresses the risk factors facing students with autism. Personal challenges will be addressed first, then environmental challenges will be explained.
Personal challenges that must be addressed so the student can develop competence are the within-person factors that result from having autism. Minshew and Rattan (1992) suggest these challenges include:
deficits in normally comprehending social interactions, language, and the meaning of information or events; deficits are always concurrent and generally proportionate; developmental progress in the three areas appears linked; deficits are first and most severely manifested between birth and 5 years of life with a wide divergence in function thereafter; and the signs and symptoms of this disorder are lifelong and are revealed in a manner characteristic of the age and IQ or developmental level of the individual. Personal challenges that in combination are unique to the disability of autism include impairments in:
Each of these personal challenge areas is discussed in the following section.
Neither the quantity of interactions nor the desire for social interaction define the social impairment in autism (Minshew & Rattan, 1992). The social impairment may be confusing to teachers because often they may observe the student interacting with peers at recess or in the classroom. However, it is the quality of the interactions that must be examined. Students with autism have difficulties learning social interaction in an unstructured fashion, initiating social behavior without supports, and sustaining social interactions in a reciprocal manner (Lord, 1984; Smith, 1990; Walters, Barrett, & Feinstein, 1990).
Social Impairments common across students with autism include:
1. Perceiving and predicting the reactions of others
joint perspective taking with others, including joint attention
understanding social conventions
2. Understanding the meaning of social cues and overtures
turn-taking and sharing
learning by interpreting others reactions to self and/or other's behavior
being aware and knowing what to do when partner signals end or desire for change
interpreting social events
reacting to invitations
reading nonverbal behavior of others
3. Producing appropriate social responses
playing around a common theme
expanding conversation, behavior, or actions of partner
repairing breakdowns in interactions
negotiating and resolving conflicts
initiating interaction
joining the play or activity of others
4. Understanding that other people have views of the world that are different from one's own, as well as predicting what these views are and how these views affect another's behavior.
In educational environments students are expected to attend to a multitude of social cues and to interpret and respond to these cues in a manner that is appropriate to the social context. However, students with autism have difficulty developing skills needed to differentiate and classify emotions, communicate accurately and competently with another person, take the perspective of another individual, and consider their own and others' view points (Howlin, 1986).
It is important for students with autism to develop social interaction skills. How well the student with autism participates in the community as an adult is related to social skills and positive peer friendships. Community inclusion and community-based jobs are often restricted or eliminated for individuals with autism due to difficult social behaviors and interactions. Wing and Gould (1979) state that in adolescence and adulthood, individuals with autism who are aware of their difficulties and failures are at risk for depression, anxiety, psychotic breaks from severe stress, and even incarceration. Hartup (1983) confirms that the adequacy of social peer relationships in childhood is a strong predictor of mental health status in adulthood. The gap between social interest and social competency needs to be addressed as part of the school curriculum.
Impairments in social competencies lead to difficulty understanding what other people are thinking, understanding another's point of view, and most importantly, knowing how to modify and regulate one's own behavior based on what other people know and expect. This cognitive skill allows people to predict the behavior of others by interpreting their emotions and thoughts. Recent research on
the social impairments suggests the impairments are thought to be the result of a specific problem in perspective-taking. The ability to consider other people's viewpoints is lacking in most children and adults with autism. The description which follows illustrates the concept.
Researchers, Baron-Cohen, Leslie and Frith conducted a formative study in 1985 investigating social impairment in children with autism. Using puppets, the investigators asked children with autism, children with Down Syndrome, and normally developing children to respond to questions that required them to take the perspective of another. The children observed a scene involving two puppets named Sally and Anne. Sally had a basket in front of her, and the experimenter placed a marble in the basket. Then Sally left, and the marble was moved to Anne's box during Sally's absence. When Sally returned, the experimenter asked the children, "Where will Sally look for her marble?" The children passed the test if they considered Sally's perspective by pointing to the marble's original placement (where Sally left it). If they pointed to its current spot (in Anne's box), they failed to take into account Sally's perspective (that Sally didn't know her marble was moved while she was gone).
About 85% of the children with Down Syndrome and 85% of the non-disabled children passed the test. In contrast, 20% of the children with autism passed. These results are even more striking when the characteristics of the children are considered. The average age of the children with autism was 7 years older than the comparison children, and their average intelligence level was higher than that of the children with Down Syndrome.
Since this original study, several other researchers have replicated the finding that a majority of children with autism perform significantly worse than other groups on perspective-taking tasks. The poor performance of individuals with autism on perspective-taking tasks has led researchers to propose the existence of a specific cognitive deficit that is particular to autism and explains the observed social impairments.
A student with autism may appear selfish, egocentric, aloof, or rude because he or she does not understand that other people behave in ways that are based on their own feelings, emotions, and knowledge, that is, that they have a different perspective. It is important that educators, parents and friends of the student with autism understand that the student often lacks information that other students learn incidentally (e.g., perspective taking). Understanding the fact that students have difficulty with perspective taking should dispel the notions that the student is in control or chooses such negative behavior.
Once it is understood that students with autism are missing critical information and that they often do not know that we have information different from their own, the educators can gain insight as to the student’s perspective and then consider how to give the student the information needed. Learning the perspective of the student with autism is a useful strategy, which allows the multidisciplinary team to carefully consider and design the best instructional supports for the student. An example of this strategy follows.
Keith is a 17 year old with autism who is considered "high functioning" because he does not have mental retardation. His teachers organized a group of peer buddies to take him out for pizza on Friday evenings.
Soon his peer buddies were tired of taking him out and began to make excuses for not wanting to go.
After asking the peers what happened, his teacher discovered that Keith always made the sole decision for what kind of toppings to get on the pizza. One of the peers didn't even like what was ordered. The teacher asked the students why they allowed him to do this. They said, "Because we don't want him getting upset in public." The teacher talked to Keith, and he said that he didn't know that they wanted something different. To get this information, each student’s preference was written down. Once Keith had this information, he became aware that his peers had different ideas about pizza and he began asking them what they wanted.
For students with autism, many of the difficulties with perspective-taking are observed in social situations that require sharing, cooperating, and negotiating. Other perspective-taking situations such as explaining oneself, asking for input from others on how to solve a problem, and defending one's own actions are often difficult for the student with autism. The student is often misunderstood by teachers, parents, and peers, because he/she does not share relevant information and does not recognize that the teacher or parent is lacking important information about events the student has experienced.
Typically students with autism have little interest in toys and often do not use toys in the intended way. They may line up toys, spin parts, or use them in a repetitive manner. Later, they learn to use toys as they have seen them used, but may focus on detail and parts of play. A student with autism has trouble adding creativity and flexibility to the play. Memory and focus on detail may appear to be imaginative activity. The student’s interest in video and TV sequences, TV game shows, video games, and letters and numbers reflects the need for sameness, predictability, and sequences.
The difference in imaginative play, if not understood, could pose problems at home, school, work, and the community in relationship to the student’s ability to interact with peers, use materials, problem solve, and display acceptable behaviors in learning environments. For example, in a preschool class where the students are asked by the teacher to role play or demonstrate the behaviors of their favorite animal, the student with autism may not be able to engage in the role playing (acting out), but might pick up a toy monkey and name the animal. While the example suggests that the student is participating in the activity, educators and peers, through understanding the difference in imaginative play could improve the student’s performance of the required task.
Another area of social competence that is of great importance for a student with autism is safety skills. It may be necessary to teach specific safety skills (e.g., staying in boundaries, safe use of materials, understanding about strangers, knowing about drugs and sexuality, and refraining from harming others) across multiple environments. Students with autism may not understand safety rules and may not transfer the rules from one situation to another unless they are concrete and specifically taught in multiple environments.
Implications of Deficits in Safety Skills
Deficits in safety skills can pose direct and indirect problems for the student with autism and for the others who work or play with the student. If a student fails to follow a rule which sustains personal safety to self or others the risk of injury increases. If the student does not follow safety rules which sustain socially acceptable behavior (e.g., keeping hands to self) the risk of negative interactions increases. For example, if the student does not follow the rule of "Keep your hands to yourself." and inappropriately touches other students it is likely that the student will receive a negative social response such as being ignored or avoided or punished.
It is important for educators, family, and peers to use consistent and concrete safety rules with the student who has autism across all environments and teach the student the rule using positive teaching strategies. By using consistent and concrete rules and teaching strategies the student will be better able to engage in appropriate social interactions and feel positively reinforced, thus building social competence.
People with autism have impairments in both receptive (understanding what is heard) and expressive (communicating what is known) communication. Expressive communication impairments often appear in early childhood as delayed and disordered patterns of language, and in functional and social use of verbal and nonverbal language (Minshew & Rattan, 1992). Receptive communication impairments are exhibited by problems with comprehension. These communication impairments include:
1.Deviant sequence of language development. For example:
Delayed and difficult use of gestures
Use of echolalia, immediate, delayed and more complex with stereotypic language developing; usually a stage of pro nominal reversal
Delayed use of communicative eye contact
Begin use of language, then regress
Delayed development of language from the beginning
2.Prosodic problems in volume (too loud, soft, monotone), cadence (an unusual pattern of word emphasis, no emphasis), and pitch (too high, erratic, unvarying).
3.Deficits in the functional and social use of language that seem to reflect the deviant development of language comprehension and social cognition. For example:
Problems generalizing meaning of words; understanding only in the context learned. (Young children have trouble with yes and no or one phrase may be used to mean one concept, such as "Time to go home" being used any time the child wants to leave a place.)
Deficits in verbal and non-verbal problem solving
Odd or unusual use of eye contact and facial expression that doesn't enhance communication or signal an interest
May not use language for communication or social purposes, yet may make requests or ask questions when no one is around
Seldom comments, rarely volunteers information or asks "wh" questions for information, stereotypic repetitive comments and questions
Has difficulty with initiation
Lacks understanding of speech etiquette
Talks about any topic anywhere with anyone
Has trouble understanding beginning and ends of conversation
Preoccupation with certain topics
4.Deficits in language comprehension often go unrecognized in the more verbal student with autism and are misunderstood in other students with autism. For example, students who read are often stronger in decoding skills than in comprehension. For example:
Misunderstands or does not generalize word and phrase meanings
Unable to follow pace of conversation and/or the back and forth nature of conversation
Inability to understand or translate questions
Problems with abstract concepts
Literal interpretation of words and experiences
Inability to perceive themes, thus sees stories and experiences as unrelated
Impairment in conceptual and inferential levels of information processing
Deficits in expressive language can lead to misunderstanding the intention of expressed language and to inappropriate prognosis of the student’s actual knowledge base. This means that the student’s communication may be misunderstood by peers or adults, leading to frustration for the student and the peers or adults. Misunderstanding communication could lead to a misinterpretation of what the student wants or knows. For example, Ginny uses the phrase ‘Go now’ for any situation in which movement from one place to another is involved. When the teacher asked Ginny what we used cars, planes and buses for, she replied "Go now." The teacher misinterpreted her response to mean that Ginny wanted to leave the room and go home. In reality, Ginny knew that cars, trains and buses were used to go from one place to another - transportation.
Deficits in receptive language can lead to inability to follow directions, learn critical skills, and interact appropriately in all environments. If a student has difficulty with receptive communication the educational environment will pose great challenges for the student. For example, Jamal’s preschool class was working on the concepts of over and under. Each student was supposed to crawl under the table and then climb over the padded therapy tube. Jamal did not understand the teacher’s request to crawl over and under the objects, thus he did not perform the task.
It is important for educators, family, and peers in a student’s life to learn about the student’s communication abilities - both receptive and expressive - so that the student will experience success, and less frustration at home, school, work and the community. In Ginny’s case, once the teacher and peers understood that ‘Go now’ meant moving from one place to another the teacher could reward Ginny for the response when she used the phrase appropriately. In Jamalís case the preschool teacher demonstrated the concepts with him several times to help him understand what ‘over the tube’ and ‘under the table’ meant. Many students with autism learn language and other concepts in one setting but do not generalize the information to other settings. Therefore it is important to teach the student to use the language or concepts across settings.
The repetitive and stereotypic behaviors often noted in autism may appear to be a collection of odd behaviors. However, they reflect a particular cognitive deficit that characterizes the disability. "This deficit is characterized by a nearly photographic memory for details on the one hand and, on the other, by a deficit in the processing of information." Minshew and Rattan (1992). This dichotomy leads to problems in detecting complex patterns as well as cause and effect relationships. "In the biological process of information analysis, the brain achieves in essence a "figure ground" transformation of incoming information in which certain details are suppressed to allow the emergence of a pattern." This means the student can see part of the picture in intense detail, but not the whole picture. The implication is that a student might focus on one object (e.g., ball on the floor) and not see other objects around
the ball (e.g., toys, desks, people). Another implication is the ability of the student to see cause and effect, either concrete (e.g., a stack of books falling when the bottom one is pulled out) or abstract (e.g., being ignored by peers when behaving poorly).
The development of this cognitive process appears to be disturbed, which accounts for both the remarkable quality of memory for details in all sensory modalities and problems with information analysis.
Characteristics of this deficit include:
1.Interest in parts of objects.
2.Negative reaction to change.
attempts to control
change through rituals
inability to predict
the consequence of change.
trying to direct the
behavior of others and the environment (e.g., desire for rigid scheduling of
activities, need for specific routines, becoming upset by changes in seasons,
foods, room arrangements, movement of people within environments)
increased dependence on familiar adults as the student ages
3.Lack of awareness of danger may reflect the inability to predict consequences.
4.Idiosyncratic fears may reflect memory for isolated events that were frightening and the inability to bring perspective to these events in the absence of reasoning ability.
5.Preoccupation with particular topics or interests with an intense focus on details may reflect the lack of understanding of concepts which might lead to a broader range of interests.
6.Stereotypic motor movements seen in younger students and in students with lower IQ scores (e.g., body rocking, hand flapping, pacing, posturing, twirling, humming, and screeching); older and higher functioning students may have muted and channeled this motor behavior. Students with autism usually have more frequent and less easily redirected stereotypic behavior than other students with the same IQ levels. (Minshew and Rattan, 1992)
For students with autism, transitions from one focus to another, whether it is an object, person, event, or environment may be very difficult without the appropriate supports in place to help the student make the transition. While most students who are non-disabled will eventually learn to accept transitions (e.g., from the classroom to the lunchroom) easily, the student with autism will need supports (e.g., information and time to prepare for the transition) to successfully shift focus. For example, Erik had a copy of the class schedule taped on his desk. He had learned that his class left for lunch each day at 11:30. One day his class was going to leave for lunch at 11:00 instead of the normal time. In the morning, to prepare Erik for the change, his teacher placed a new schedule on his desk over the old schedule and discussed the change with him before class started, during each transition, and when lunch time drew near. This preparation for the change gave Erik a chance to prepare for the transition to the new lunch schedule.
Sensory skills must be considered if the student has such problems. Any or all of the student’s senses (sight, sound, touch, smell, taste) may be very sensitive and interfere with the student’s ability to fully or partially participate in learning activities. For instance, sound sensitivity (e.g., keen awareness, troubled by certain sounds) and tactile defensiveness (e.g., not wanting to touch certain textures/objects) are fairly common in younger children with autism and needs special attention. Depending upon the sensitivity of the student, there may have to be control of some sensory input within educational environments until a student can become desensitized. For example, if the student is hyper sensitive to high pitched tones and the school bell rings in a high pitch, it may be necessary to disconnect or reduce the sound of the school bell tone from the classroom until the student has built up tolerance for the sound.
If a student has sensory impairments every environment can pose a challenge to successful learning. Educators, family and friends should carefully analyze environments in which learning will occur to determine which sensory inputs may interfere with the student’s learning and either reduce or eliminate the sensory challenge (e.g., tone of a bell) or, when sensory input can not be eliminated or reduced to a satisfactory level, provide the supports necessary to help the student compensate for the problem. In addition it is critical to understand what sensory input the student needs to be successful.
Motor skill problems are also prevalent in students with autism. These problems can include motor planning (e.g., moving around a room), poor muscle tone (e.g., difficulty holding a crayon or pencil), spatial skills, or general understanding of body-in-space (e.g., understanding self in relationship to other objects in a room). Students with motor skill impairments will have difficulty with some activities while seeming to excel in other areas (e.g., a student who cannot hold a pencil but can perfectly spin objects smaller than a pencil).
If a student has impairments in motor skills simple tasks become large challenges. It is important for educators, family, and peers to understand the motor skills of each student so that learning experiences do not present tasks which the student is incapable of accomplishing without supports. Motor skills should be evaluated and considered in the planning of instruction for the student with autism.
Health and cleanliness are areas that may be impacted by the core deficits of autism and may be addressed on an IEP. Students with autism may have problems with these skills in part because the skills involve sensory and motor skills as well as following established routines in sequence.
Poor health skills put the student at risk for physical problems (e.g., poor care for teeth - loosing teeth) and social criticism. If a student has poor health habits it is likely student will receive a negative social response such as being ignored or avoided. It is important to keep in mind the student’s sensory and motor skills and or impairments and their potential impact on the student learning health skills. For example, if a student has poor motor skills using a comb or brush to tidy hair may be a difficult task. Educators, family, and peers can teach the student specific concrete steps for personal health and cleanliness.
Academics, functional application of facts, computer skills, and other curricular issues will vary across students with autism since their cognitive abilities and skill profiles are so different from each other and from peers. It is important to build and expand upon each student’s strengths.
Each IEP and S- team will need to address the implications of a student’s educational functioning differently based upon the needs of the student and the requirements of the learning situation.
For students with autism, it is necessary to understand how the challenges of autism affect learning and the ability to function in a competent manner. Personal challenges unique to students with autism fall into four main domains: social competency, communication functioning, cognitive functioning, and physical functioning. Analyzing assessment information, observations, and personal reports on these four domains collected across multiple settings will provide an accurate picture of the student’s major personal challenges.
The personal challenges previously described are the factors within the student that jeopardize the development of competence. Because of these within-person characteristics, the student with autism is potentially at-risk in any environment. Sometimes when people cannot ‘see’ the disability, they discount its existence, and ‘label’ the student as noncompliant, lazy, or behavior disordered. The misconception that the student with autism is noncompliant or obstinant is a good example of the environmental challenges, the second quadrant of the competency model, that poses challenges for students with autism.
This section will focus on the challenges within the environment that put a student at risk. Environmental
challenges include the people, places and things with which the student must interact to be successful. The environmental challenges which put each student at risk will be quite varied. However, it is the student’s response to those challenges that draws the attention of educators, family, and peers. The environmental challenges become evident through the behavior, or response of the student with autism to the environment.
The basis of many behavior problems in students with autism is fundamentally different in origin from other students with similar behavior responses. Therefore, attempts to use behavior management programs and approaches typically used for individuals without autism may not be successful with students with autism and may in fact aggravate the behavior. To address environmental challenges, a positive behavior management system must be developed based on an understanding of the deficits and abnormal behavior associated with autism.
Perhaps the most important point educators and parents must understand is that the nature of autism inhibits adaptability and generalization of behaviors across settings. Thus deficits and abnormal behavior must be considered in relationship to each environment so that the supports are in place, which allow the student to be successful. This means that each different environment poses a challenge for a student with autism. The student will not automatically take appropriate strategies from one environment and apply them to another environment. Therefore supports and adaptations must exist in each environment in which the student interacts.
Conditions within the environment that may pose challenges for a student with autism include the following:
1.People who do not understand the nature of the deficits of autism; how to provide the supports and modifications for the student; appropriate b