On the Road With Autism

My journey of discovery. I welcome your comments!

So Many Important Questions for Families & Professionals

1)What is the proper way of learning for a child with autism?   Every child with autism may have a different learning profile as autism is a spectrum disorder. Their way of learning will be influenced by their communication levels, cognitive levels, sensory challenges, motor challenges & social awareness. It is believed that the best program for all on the spectrum is some level of structure, emphasis on visual supports, addressing executive functioning challenges, understanding, addressing & accommodating sensory challenges, supporting motor challenges, developing joint attention & social reciprocity, teaching social rules & identifying the interests of the student & using those interests to engage them. A program must address the anxiety of the student with autism, his or her challenges with starting tasks or getting stuck, the child’s black & white view of situations & their ability to assess how big a problem really is & to find solutions.

2) How does one set academic targets for students with autism in an inclusive classroom? Every student should be assessed in order to identify their cognitive levels, identifying strengths & weaknesses. Academic targets should be set from the results of the assessment. Teachers need to look at reading levels (decoding and comprehension), writing skills (motor & composition), mathematics (calculation & problem solving), spelling & their cognitive levels (comprehension is key to setting realistic academic targets)

3)Are there any home treatments for children with autism whose parents are busy working? Many families must work all of the world. In some parts of the world, there are agencies who can come into the home & train the parents or someone that the parents have hired to support the child when the parents are working. These support people need to understand autism & particularly the specific child being supported.   These people could go to school & observe & learn from the teachers how to support learning (reading, math, homework). These people could be trained to help develop the child’s independent living skills. Some parents may need to decide not to work & become the child’s teacher of home skills. In some countries parents keep their child at home & work with the home school associations. They have on line curriculums they can access.   Home treatment is up to the parents to develop & guide. They must locate organizations, pay organizations to come in to help support their son or daughter’s home learning.

 4)When is it the right for teachers to encourage children to maximize their potential? A teacher’s job is to inspire a child to learn when they are very little. Learning should be fun and engaging. Parents and teachers should encourage a child to learn all the time. It is a matter of making learning meaningful to the child. So one must know where the child is developmentally. Then learning can be structured around their level of understanding, communication and interests. I believe that children with autism need to start young to learn.

 5)How do we help children with autism learn better?   First teach at their level of understanding. Next make learning fun. Next make learning meaningful. Use their interests. Then structure each learning activity visually. Then praise for every little step forward. Work with a speech therapist. Work with an occupational therapist. Work with an educational specialist.

 6)How do we deliver effective education to children with autism and mental retardation? Once again, every child learns differently. A child with lower cognitive ability must have things presented at their level of understanding. A child with lower cognitive ability will need more practice more, have smaller amounts of work & many visual supports. They must have a way to communicate first &foremost. (Signs, Pictures, Technology). All teaching must be meaningful. Use their interests. What is taught should be functional (truly occur in their daily lives). Teaching must be structured. Small classroom size. Calm environment to learn in.

 7)What is the impact when a child learns one thing from one center and something different from another center? I believe that there needs to be collaboration. If a child is going to two or more centers for treatment then a collaboration time needs to be designed. All specialists should be sharing what they are doing & how on a regular basis!!!!! Children need consistency. The interventions that work should be shared & embraced by all.

 8)How to teach children with sensory integration challenges? Once again, each child has differing sensory challenges. Some are visually distracted. Some auditory distracted. Some are sensitive to touch, taste or smell. A sensory profile should be completed, identifying the challenges & then a sensory diet develop by the Occupational Therapist.   Some students are over aroused while others under aroused & different exercises & supports need to be put in place depending on the sensory integration issues they present.   Teachers need to then modify the classroom environment to accommodate sensory challenges. Teachers may need to modify the learning schedules in the classroom due to sensory challenges. Special equipment may need to be used to support sensory needs. Sensory integration is an individually based intervention.

More Questions From Java

Here are the 2nd set of questions from my participants in Jakarta. It was interesting to learn what they were thinking.

1)What kind of activities should be planned for 17 to 20 year olds who never have a great deal of treatment early? Once again this depends upon the level of communication, behavior, sensory challenge, cognition and social skills. All students should receive a program that addresses independent living skills, social skills, leisure skills, pre-vocational skills, communication skills and community access. Lower cognitive students need it earlier. The education system needs to help them prepare to learn how to live, work and recreate in their own communities.

2)How does one implement a curriculum for a non-verbal child? We all communicate differently. Some through gestures, some pictures, some sign and now many through technology. The teacher needs to adapt the curriculum based on the form of communication system the student has or is developing. Signs need to be taught. Pictures need to be arranged for easy access for responding and technology needs to be programed. Sometimes an extra staff person is needed to help support these children so their communication system can be created and implemented. Non-verbal children are not deaf!!! They hear. They just need a way to respond and we need to structure teaching allowing them to access their own communication systems.

3)What types of activities should be taught to non-verbal children? All (social skills, pre-vocational skills, communication skills, skills of daily living, hygiene, academics, leisure, community access, academics)

4)How do we improve communication skills? There are many activities that can be done to improve the communication skills of our students. Here are only a few. Read to them and take them on field trips to museums, art galleries, parks, hikes, bike rides etc. Point out new objects and information. Work on wh questions with them (who, what, where, why, when and how). Have them problem solve more? Have them make up shopping lists, find things in stores and pay for things at the market. Have them read recipes and prepare meals. They will learn new words in context.   Teach them to greet others, ask questions and have a conversation. When they read have them underline the words they do not know. They discuss meanings of words with them. Teach them to use email and write letters to family members. Have them call friends and family on phones and ask questions. Take them to the library and have them ask where something is located.

5)School learning and home learning is needed. Parents need to stop thinking and doing for their sons or daughters. Learning should continue at home. They should have jobs around the house. They should help shop and meal plan. They should clean their rooms, bath, brush teeth, comb hair, do their laundry and dress themselves. They should set the table, load a dishwasher, vacuum, sweep, dust, and mop. Skills of daily living are very important to becoming independent and learning to problem solve. Parents should get them into the community to see new places and learn new words and rules for engaging in the places they visit. Perhaps the teacher can send home some small assignments at first. A special place set up to do homework is needed.

6)How do we teach children with autism to have a conversation in English…. First make sure they can speak their regular language well. Make sure they are interested in learning English. Then make it fun!!!!. Teach it in context.   When you shop, name things in native language and then English.   Find their interests and have a game of finding out the name of their interest in English. Once they are learning then perhaps get a tutor to work with them privately, slowly.

7)How do we decrease anxiety for children with ASD in the classroom? There needs to be a schedule visually on his/her desk. They need the right seat. Maybe on the end not in the middle of everyone. Look at the noise levels in the classroom. Look at the visual distractions.   Don’t have too many transitions. Let them know when things are going to change, before they change. Let them go first to recess or last or stay inside away from crowds if they like. Give directions visually and verbally. Make sure they understand your directions. Maybe have someone there to help them in the classroom. Give them frequent breaks. Connect with the parents often and have them go over reading assignments the night before. Have parents help make sure they have all the things they need each day for school. Help them keep their space organized. Make sure there is not too much on the page of work they have to do. Keep it simple. Help them get started. Sometimes they get stuck. Give warnings before the end of the assignment time. Let them have more time if needed.

8)Is there an effect of diet or supplements? We all know that less sugar is always best. Less caffeine is best as well. We know some children are sensitive to gluten or casein. This should be tested. We know that they need good oils (not corn oil). Seeking knowledgeable help in this area is always a good thing. All children are different. Not one supplement works for all.

9)How can you prepare your child to go back to school after a long holiday? Put up a calendar. Show him/her visually how the days are moving forward with an X. Put a big mark on the day he/she returns to school. Ask the teacher for some repeat work that your son/daughter could do over the break. Set up a routine at home during the break with school type activities. Read together, visit interesting places, and practice what he/she has learned just prior to the holiday.


Questions on Autism in Jakarta, Java

There were 285 guests at the day long Autism Workshop in Jakarta. The participants were asked to list an important question they had before attending the workshop. Many were answered thorugh the presentation. Here are 7 additional questions.  They give you an idea where autism understanding & education is in Indonesia.

1)Can we use similar curriculum to teach children with autism & teach typical children?Yes, of course to those who have the cognitive ability to understand it but the way you teach the curriculum must be adjusted as well. Curriculum might need to be presented in more creative ways. No one learns well if they must sit all day, listen to someone speak and then answer questions on a piece of paper, or in choral style with everyone. It is important to find out the learning style of each student and adapt the way one teaches. Sometimes lessons need to be shortened. Sometimes using art, music, technology will help engage a student learn. It is important to check in with the student to see if they are understanding. Comprehension of words and their meanings are very, very important. Teachers may have to teach new vocabulary first, before a lesson.

The student with autism may need help organizing, starting and stopping the assignment. Transitions are hard.

Children with less language, less comprehension may need to curriculum simplified. Teachers can pick one theme from the lesson and focus on it with a student. Teachers can find the most meaningful piece of the lesson and offer that to the student. Teachers can have the families read with the student the night before so they have heard the material before. Using pictures is so important to ensure comprehension. Asking the student what they saw after they read something is very helpful.

Some students need a very functional based curriculum.

2)How long will it take for someone with ASD to integrate into society? I think society must accept differences. No two people are alike. Some are more social than others. We must help people with autism understand the social rules. We must teach each social rule and explain its purpose. Then we must help our students practice it. We must find the parts of society that they feel comfortable integrating into. Not everyone integrates in every part of society. A child’s ability to integrate will depend upon their communication level, their social skills, their sensory levels and their anxiety levels. Noise & crowds will influence integration. Interests will determine integration. We must help society to understand and accept these amazing children with autism. We must be patient. We must find ways to help them lead a life with purpose and happiness and safety.

3)How can we tell when a child is ready for school? Children are ready when the school is ready for them. Children with autism require early education. The sooner they are supported to learn the better. The teacher must understand them. The school site must accept them. The education and home must work together. Perhaps the child needs a half day at first to get use the environment, routine and expectations. Perhaps the child needs speech therapy and occupational therapy to begin prior or at the same time to support school access. Will the school accept someone who isn’t toilet trained? Will they accept a student who needs frequent breaks and an adjusted curriculum? 

4)How to decrease self-injurious behavior or hurting others?   It is very important to make sure the child is not ill in any way (stomach ache, headaches tooth aches). It is very important that a child have a communication system to express frustration, confusion, anxiety. It is very important that the environment be structured and predictable for the child. It is very important that the diet be considered and that the child is getting enough sleep at night. All above must be reduced first. It is always important to look at the activities or people that seem to cause the self-injurious behaviors. What happens right before? Are you taking something away? Are you placing too many demands on the child? Hurting oneself is an expression of frustration or it can be trying to get out of doing something that is non-preferred and each time they self-jury they get out of doing that task. They will then continue. They have learned that if they self-jury, it gets them what they want. We must always remain calm and try to redirect.

When it comes to hurting someone else we must again find out what the motive is. What are they saying to you? (go away, no, I am confused, I am frustrated, I don’t understand, I need attention?).   We must give them another way to communicate these things. We must also not reinforce these behaviors when they occur. Structuring the environment is key. Building a communication system is key. Sleep, eating, exercise is very helpful. Having the student do meaningful lessons also helps.

5)What type of curriculum is good for a student in an inclusive environment? This depends on their level of academic ability, social levels, sensory challenges.   Some students can do the same curriculum with some accommodations. Some students need a functional based curriculum. Some students need more breaks when included. Some students need some additional support in one or more subjects.

6)How does one develop the IEP? There is a simple formula. Good assessments in all areas lead to strengths and challenges. A goal should then be written to address each challenge. Additional therapeutic support should be included to support sensory needs, executive functioning needs, communication needs, & fine motor & motor planning needs. The type of educational environment should be described in the IEP. Parent training should be in the IEP. Teacher education is important. Understanding of Autism should be considered as well. Academic support should be provided where needed. Behavioral support should be provided where needed.

7) What should be done by the school and teacher to help student who enters puberty? This is a sensitive area. The parents should really take the lead on this. They should meet with the teaching staff & explore beliefs & values & determine the best approach for helping this child. Just like any other child, this student will need help in understanding how his or her body is changing. Parents need to explain this. Teachers in secondary programs can help as well with parent permission. Social Stories are a good tool to explain how our body is changing. Sometimes doctors can help. Sometimes outside counselors can help. There are several great curriculums for helping all special needs learn about body changes.


Seminar in Jakarta / Mayabada Hospital

I could hardly believe that there would be 275 guests at my first presentation in Jakarta. IMPATI, the Indonesian Autism Society, had made all the arrangements for a full day of learning at the Mayabada Hospital in Ang Boen Ing assembly room. They had informed me that about 150 guests would be there, but the day before the numbers had risen to 275.

Two full size screens were being loaded with my 4 part training on how to address the educational needs of children with Autism. A podium was set up on stage structuring my engagement with 275 guests hungry for any type of information that will help them teach their student, client or son or daughter with Autism.

Not me behind a podium like a statue, nope. I would feel much better moving across the stage, sitting on the edge connecting with my guests.

A short movie on IMPATI’s work in Indonesia bringing awareness. A welcome from the head of the development department at the hospital second, followed by a welcome from my friend, the president of IMPATI. Finally I was introduced & the stage was mine.

I remember hoping that I would be able to offer each of the 275 just one new idea or one piece of information that would help them. This I would be grateful for.

I introduced myself in a way that would help them understand my 40 years of experience. Then I found out what percentage of them were teachers, administrators, government guests, therapists or parents. I asked them all to identify what time they had gotten up (4am, 5am, 6am) & how they traveled (bus, train, motor bike) & from what distance. Many had risen early and traveled far.

I had them stand up, stretch, takes some deep breaths & then return to their seats, explaining that movement helps not only our students with Autism but us as well, stay alert & ready to learn.

The first power point explained special education levels in America (mild/moderate, moderate/sever), the types of classrooms offered & the teacher certification skills & process of assessing student levels.

The second power point shared curriculum areas (Language Arts, Math, Science, Health etc.) & objectives to reach in each area plus possible functional based ideas for meeting goal areas.

I also discussed understanding the sensory challenges of students & how to support in the classroom while implementing a curriculum.

I asked the entire group to close their eyes & stop all engaging with each other. I asked them to take several deep inhales & long exhales, keeping their eyes closed. We kept this up for about 5 minutes. The room was very quiet. Before I had them re-open their eyes I explained how much sensory information our eyes take in & our brain identifies & by just closing our eyes once in a while we can reduce the sensory overloading & offer us some calmness to ourselves, our teams & our children.

During the 2nd half of the day, I opened the seminar up to questions. Any participant could feel free to ask any question. These were their questions. In future blogs I will provide my answers.

  1. Will using a voice device stop my son from learning to be verbal?
  2. How can we help our student to stop touching himself & others inappropriately?
  3. How can I teach my son to ask questions?
  4. How can we develop or son’s talents?
  5. How can we teach our students about puberty?
  6. How can I develop a home program?
  7. How can we expand our son’s Math skills? He only counts to 10.
  8. How can we expand our son’s eating? He only eats dry things.
  9. If our genetics is part of the reason for our son’s Autism, what can we do?
  10. How can I expand my son’s communication? He just leads me to what he wants.

In the final hour & half together we discussed how to reduce behavior challenges & how to develop a social story to increase comprehension or change a behavior.

I believe that each person that day walked away with at least one new piece of information to help them.  I know that I walked away with new information that would help me continuing my work.