Tag: Learning about autism

Sight

• Can be sensitive to bright lights so educators may need to let child wear hat or sunglasses inside. Also ensure that all lights work properly. A flickering light may not be noticeable to others but can be very distracting to a person with sensory processing disorders
• Can be overwhelmed and uncomfortable in a room with too much stimuli, colours and clutter. Ensure the environment is calming and has uncluttered spaces with neutral colours.

Auditory

• Noises from air conditioners, vacuum cleaners or a far off train can cause sensitivity and distraction. Where possible warn children in advance about unexpected sounds and be aware of how they are affecting the child
• Unexpected noises like cries or screams can be distressing so offering children head phones or time outside is necessary (take out a small group to ensure ratios are maintained).

Touch

• Can strongly dislike being touched by others so consider where the child is placed when in lines or group times
• May avoid getting their hands dirty so encourage but don’t force
• Can feel uncomfortable with clothing tags or in particular clothing so ensure they always have a spare change of clothes in their bags.

Smell & Taste

• Has a limited diet so offer lots of praise and encouragement for trying new foods
• May detect smells that others don’t notice or gag at the smell and taste of certain foods. Working with the child’s OT and family is essential. Look out for a change in a child’s behaviour when cooking or when new people wearing strong perfumes enter rooms.

Hyposensitivity

Sight

• May flap hands or objects in front of eyes, or watch repetitive movements like running water or fans spinning, so use these types of sensory toys (eg fan with flashing lights) as a reward or to settle
• Can fixate on certain images and bright colours so visual media can be a great way to engage the child. Educators can also grab their attention by wearing some novelty glasses
• May use their peripheral vision to stare at or down objects. Will often line those objects up. Play parallel to the child, colour coding or lining objects up by size to support learning.

Auditory

• Seeks out and makes repetitive sounds, so use music, song, and rhythm to teach curriculum areas like ABCs and counting
• May not notice surrounding noises like children screaming but can be distressed by loud or sudden sounds such as a siren or a vacuum. Help the child to identify noises that make them uncomfortable by using visuals. Point to the quiet visual when sounds become too much
• May fixate on certain songs and tunes so ensure you give children time to focus before giving directions
• Will not always respond when being called or given instructions so vary tone and volume to maintain children’s attention.

Touch

• Enjoys sensory play. Include lots of finger-painting, sand, salt, shaving cream
• Constantly touches everything, including other children. Role model appropriate physical contact with peers
• May not realise they bump into objects and are not always aware when they get hurt. Can appear insensitive to pain. Ensure close supervision so educators are aware if child injures themselves.

Smell & Taste

• May explore objects by smell or taste. Bring lots of sensory materials into the room and place them near during other experiences to support child’s participation
• Enjoys food with strong flavours or textures. May also eat different substances like glues, play dough and sand so ensure only non-toxic materials are used
• May not easily detect odours so monitor older children’s hygiene and work closely with families.

Things we take for granted become a huge problem for a child with Autism Spectrum Disorder.  Imagine if all the voices you heard were really loud to the point of hurting your ears. How would you feel if you jumped in fright every time a door shut because you were over sensitive to sounds?

It’s important we identify how a child processes information so that we can put clear plans in place to minimise a child having a sensory meltdown.

• Use visual cue cards (picture or photo cards) individually or in a sequence of steps with verbal language
• Break instructions down into simple, precise steps until child is ready to process more than one instruction at a time. Role model what is expected
• Use visual boards with two steps – ‘first’ and ‘then’
• Create a visual routine for the room and if necessary individual children
• Give children time to process your verbal and non-verbal communication. Always use child’s name when speaking to them
• Role model in achievable steps how child can interact with peers
• Give children warning about what’s coming next before ending an activity or routine (use visuals if necessary) so they have time to process what’s going to happen and can decrease their anxiety
• Give clear, concise, literal instruction – make sure what you are saying is actually what you want child to do or hear
• Avoid sarcasm and idioms -statements like ‘crying your eyes out,’ ‘piece of cake,’ and ‘you’re ok,’ don’t make sense to children with Autism who  take what you say literally and don’t understand the meaning behind these types of sayings
• Model language correctly to help with lip reading
• Don’t stop the child and correct communication. Give them time and model correct structure/ words in your reply
• Work with families to learn and use the basics of visual sign languages like Auslan or Makaton to support your verbal communication
• Be consistent with communication within the whole group or centre so every child can communicate with all children at the service
• Don’t insist on eye contact – just because a child is not looking at you doesn’t mean they’re not listening
• Provide one on one support and create a list of words the child uses in order to build and increase vocabulary – this can go into a child’s ‘planning matrix’
• Regularly communicate with parents and professionals involved. Be positive but honest. A communication book is a great idea!

‘Welcome to Holland’ c 1987 by Emily Perl Kingsley.

I am often asked to describe the experience of raising a child with a disability – to try to help people who have not shared that unique experience to understand it, to imagine how it would feel. It’s like this……

When you’re going to have a baby, it’s like planning a fabulous vacation trip – to Italy. You buy a bunch of guide books and make your wonderful plans. The Collosseum. The Michelangelo David. The gondolas in Venice. You may learn some handy phrases in Italian. It’s all very exciting.

After months of eager anticipation, the day finally arrives. You pack your bags and off you go. Several hours later, the plane lands. The stewardess comes in and says, “Welcome to Holland.”

“Holland?!?” you say. “What do you mean Holland?? I signed up for Italy! I’m supposed to be in Italy. All my life I’ve dreamed of going to Italy.”

But there’s been a change in the flight plan. They’ve landed in Holland and there you must stay.

The important thing is that they haven’t taken you to a horrible, disgusting, filthy place, full of pestilence, famine and disease. It’s just a different place.

So you must go out and buy new guide books. And you must learn a whole new language. And you will meet a whole new group of people you would never have met.

It’s just a different place. It’s slower-paced than Italy, less flashy than Italy. But after you’ve been there for a while and you catch your breath, you look around…. and you begin to notice that Holland has windmills….and Holland has tulips. Holland even has Rembrandts.

But everyone you know is busy coming and going from Italy… and they’re all bragging about what a wonderful time they had there. And for the rest of your life, you will say “Yes, that’s where I was supposed to go. That’s what I had planned.”

And the pain of that will never, ever, ever, ever go away… because the loss of that dream is a very, very significant loss.

But… if you spend your life mourning the fact that you didn’t get to Italy, you may never be free to enjoy the very special, the very lovely things … about Holland.

Compare your families and their emotional and physical challenges.  Looking through their eyes, what is their emotional state at this point?

Can’t versus won’t

I may not be ignoring you on purpose when you tell me to do something. Perhaps I just can’t understand what you’re saying. Remember my language is not as developed as yours. If you say, for example, “Matt we need to wash our hands. Can you see that lunch is being served?” I might just hear “Matt lunch” and then wonder why I get in trouble when I wander over there. Please make sure you use simple words. Tell me exactly what to do and why, so it’s easy for me to do the right thing. For example: “Matt, wash hands then lunch.”

Literal language

I may be confused when you say something to me because I only understand the literal meaning of the words. I don’t understand that there may be another meaning. If you say, for example, “You bit off more than you can chew” when I’m not eating I don’t know you mean “You took on a very big task”. When you say something “costs an arm and a leg” I see someone missing those body parts, and if you say “It takes two to tango” I don’t know you mean it takes more than one person. Please say exactly what you mean.

 Visual learner

I’m only learning about language so I don’t always understand what you say unless there are pictures to help me or you show me how to do things.  Please don’t get angry if I need to be shown many times. I am a visual learner so simply telling me things makes it very hard for me to learn. I often get stressed trying to remember my next activity or managing my time. A visual routine with photographs or drawings helps me with this. See for example https://www.cesa7.org/sped/Autism/structure/str11.htm. When I’m older I may have words instead of pictures – or even a combination – but pictures and drawings are what I need at the start.

Can do not can’t do

I have my own way of doing things, so please don’t get angry when I don’t follow the “right” way. I have many strengths, and I can do many things. Don’t focus on what I can’t do as this makes me feel I’m being judged for being ‘broken’. Please help me excel in the things I can do and encourage me to try new things. If you constantly tell me or correct the way I’m doing things I will not let you into my world. I am smart, but in my own way.

 Social learning

I’m not very good at reading people’s or my own feelings and emotions, and I need help learning how to socialise with others and how to respond in social situations. You may have to teach me, for example, not to laugh at inappropriate times. If I’m on my own don’t assume I want to be by myself and that I don’t like playing with other children. Please remember I may need help learning how to join in the play, and how to respond to other children’s emotions. You may also need to show other children how to ask me to join in. Structured play activities work well for me because they have a clear start and end.

Managing meltdowns

I don’t enjoy having meltdowns, but sometimes I get so frustrated not having the language to communicate how I feel or what I need that this is the only way I have to communicate. Sometimes my senses just get so overloaded and a meltdown happens. Please take notice when I have a meltdown and try and work out what is causing them eg a particular activity, time, person or setting. Keep a record of your observations.

Self-regulation is a person’s ability to adjust and control their energy level, emotions, behaviours and attention. Some of the indicators children may have difficulty self-regulating include where children:

• Be under-reactive to certain sensations (eg not noticing name being called, being touched, high pain threshold)
• Appear lethargic/disinterested, appear to mostly be in their ‘own world’
• Have difficulty regulating their own behavioural and emotional responses eg increased tantrums, emotional reactive, need for control, impulsive behaviours, easily frustrated or overly compliant
• Have meltdowns that last for longer than typical
• Have more meltdowns or behavioural episodes per day than typical
• Be difficult to discipline
• Not respond to typical behavioural strategies
• Be easily distracted, show poor attention and concentration
• Have poor sleep patterns
• Love movement, seek out intense pressure (eg constant spinning, running around, jumping, crashing into objects/people)
• Have delayed communication and social skills, be hard to engage in two-way interactions
• Prefer to play on their own or have difficulty knowing how to play with other children
• Have difficulty accepting changes in routine or transitioning between tasks
• Have difficulty engaging with peers and sustaining friendships.
• Heightened reactivity to sound, touch or movement
• Have poor motor skills eg appear clumsy, have immature coordination, balance and motor planning skills, and/or poor handwriting skills
• Have restricted eating habits or be a picky eater
• Become distressed during self-care tasks (eg hair-brushing, hair-washing, nail cutting, dressing, tying shoe laces, self-feeding)
• Avoid movement such as avoiding movement based play equipment (eg swings, slides etc).
• Appear floppy or have ‘low muscle tone’, tire easily and show a slumped posture
• Perform tasks with too much force, have big movements, move too fast, write too light or too hard
• Display risky behaviours in play
• Flit between play activities instead of sticking with one long enough to actually engage in it
• Seem less ‘mature’ than others of the same age
• Be emotionally labile (showing rapidly fluctuating emotion levels in a short time).

Children on the Autism spectrum do not know how to respond to social and emotional situations. They often find it difficult to regulate their behaviour and calm down or in some instances get active.

Lots of reinforcement will help educators achieve the desired behaviour.

This will be different for each child. It may be one of the experiences mentioned above or it could be something a bit more challenging to identify that requires lots of trial and error.

Creating a reinforcement kit for that child for the times when the child is displaying appropriate behaviour can be a very effective strategy.

You need to look at the enrolment of a child on the autistic spectrum as a three step process. Completing the enrolment form is only one small part of these steps. The three steps includes;  Step 1 Preparing the environment and review the educators practices, Step 2 Preparing for the transition from home to the centre, Step 3 Building relationships with families. Let’s look at these steps in more detail.

Step 1 Preparing the environment and review the educators practices

• How does your room look and feel for an autistic child? All educators need to critically reflect upon the room and outdoor play area. This involves closely examining all aspects of events and experiences from the autistics child’s perspective.
• Educators need to ensure the room routine flexible to meet the needs of the child.
• Nominated Supervisors need to ensure educators understand Autism & how children on the autism spectrum process information.

Step 2 Preparing for the transition from home to the centre

• Create social stories with the parents. Ensure they include the child preparing for their day in the morning at home, their trip to the centre in the car and what the child’s first day looks like.

• Ensure the room is not overstimulating. When the child settles in you can progressively add more to the physical environment.
• Work with the parents and professionals in your local area to discover if you need other resources to meet the child’s needs

Step 3 Building relationships with families

• Get to know the family, their situation, goals, challenges and achievements. Again, critically reflect and try and see from the parent’s perspective.
• Give families a visual matrix to complete for their child.
• Find out what services the child is attending and gain written permission for the service to liaise with specialist and inclusion support services.
• Allow for a gradual transition. The child and parent/ carer may attend the service for 2 – 4 hour visits for 2 weeks leading up to their first day of care.

Change, can be overwhelming for people on the autistic spectrum. We need to remember the everyday hustle and bustle that most people view as ‘normal’, is difficult for children on the spectrum. With this in mind, children need to a part of the transition preparation so the change is not a surprise for them. Don’t forget you are not alone and there are many services in your community and state/territory to help you identify and develop a range of support strategies that can make the transition process smooth and successful for your new children on the autistic spectrum.

Inclusion Support Goal Steps

We can use ‘Inclusion support goals’ when working with children with Autism. These goals should be made up of real life situations and routines where the child is displaying challenging behaviours.  You choose, plan, practice and evaluate using the challenges that children are facing on daily basis.

Start slowly, begin with very small steps, celebrate and build on each achievement and don’t give up.

Step 1 Choose an everyday event or part of a room routine which the child is finding challenging, exhibiting behaviours or that you feel will support the child’s inclusion ie transition from home to the centre or participating in small group activities.

Step 2 Plan with the families, other professionals and if possible the child the steps they need for the goal. Start simple – no more than three steps at a time. Later you can build upon these steps and include more.

Step 3 Prepare all educators and ensure that everyone s consistently implements the plan. If everyone is not following the same practice it won’t work and becomes confusing for the child.

Step 4 Practice the plan. Make sure it includes preferred language, checklist and visuals/photos so the child can readjust when needed, have some space and have the option to communicate using verbal or non-verbal communication. For example, when a child needs a break from group activities they can bring the visual that represents quiet time or can say “Quiet time now”.

Step 5 Reflect on the work goals with the child, family and educators after they have been implemented and have practised it a few times. Offer support and add another step to the work goal. Try to see it from the child’s perspective and evaluate its success.

If the behaviour is serving a purpose, we cannot take it away, but we can replace it.

For many families, the identification of a child’s disability is a gradual process that occurs over many months or years. For some children, a clear diagnosis of a specific condition or disability (or multiple disabilities) is possible. For others, the diagnosis may not be possible or may be reliant on further tests/ observations in future years.

Our role as educators is to support families by communicating with them about their child’s progress towards learning outcomes and their overall development.

How families respond to our concerns with depend on our relationships we have built with our families and how much we understand their perspective, concerns, beliefs and culture.

Some families are relieved when we notice, some will be finding it challenging to come to terms with the diagnosis, some won’t believe us, some won’t help us and some will take immediate action to get outside assistance.

However, just because the child doesn’t have a diagnosis it doesn’t mean we can’t start trialling strategies to help them.

Before we start we need to remember some important points:

• No two children are alike, what works for one probably won’t work for the other
• There is no magic bullet. This takes time and lots and lots of hard thinking and planning
• Just because one strategy didn’t work doesn’t mean you should give up. Professionals need to test and trial 20 – 30 strategies before they make a break through
• Remove your adult concept of behaviour and think outside the box. Critically reflect on the situation with brainstorming ideas. Think the weirdest thoughts, causes and solutions, because they are the ones most likely to work

We need to do something until parents are ready to seek professional help.

Some of the following may be the early indicators of autism. However, it is important to note that no single indicator necessarily signals autism – usually a child would present with several indicators from some of the following categories:

• Behaviour
• Sensory
• Communication
• Social Skills
• Play

The following is only a guide to what a child should typically be doing at 18 – 24 months of age:

• Shows interest in his / her siblings or peers
• Brings you items to show you
• Follows your gaze to locate an object when you point
• Engages in “pretend play” (e.g. feeding a doll or making a toy dog bark)
• Uses many spontaneous single words and some-two word phrases

The effects of autism can often be minimised by early diagnosis and with the right interventions, many children and adults with autism show marked improvements.

There is only one diagnostic category under DSM-5. The diagnosis – autism – replaces the three previous autism diagnostic categories of Autism, Asperger’s Syndrome and Pervasive Developmental Disorder – Not Otherwise Specified.

www.autismspectrum.org.au

While we may suspect or know a child is on the spectrum, we should always make sure the child is not affected by any underlying health problems.

Arrange a meeting with all relevant educators and staff to discuss the possible causes of the behaviour.

First – Consider physical/medical issues eg

• Hearing – can child hear properly, are child’s ears infected, inflamed, blocked
• Throat – is it inflamed/constricted
• Nose – can child breathe properly, are sinuses infected/inflamed
• Eyes – can child see properly, is there conjunctivitis etc
• Bottom-does child need medical attention for nappy rash
• Bowel – is child constipated – this can cause pain and fear of going to the toilet
• Scratching – does child have nits/lice, allergies which need treating
• Eczema – is there a rash causing pain, scratching and discomfort
• Asthma – are there breathing issues causing stress for the child

Second– Consider environmental issues eg

• Diet – what is child eating, is there too much sugar, is at served at the wrong times, is it contributing to child’s allergies, is child eating enough, has child had breakfast
• Sleep – is child sleeping at night, is child being forced to sleep at service instead of rest/quiet activities.

Looking at health issues in practice

The first thing educators do is look for out of the ordinary explanations, like illness, new baby at home, grandparents visiting etc. If these events are short episodes, educators shouldn’t have concerns and will work together to support the child through the change.

However, if there is an untreated illness like an ear infection, educators will see an increase in behaviours displayed over a period oftime.. An ear infection is a good example because some children can cover up the typical sore ear or sometimes we don’t see them pulling at the ear which could indicate an infection.

A family’s role in raising a child with Autismcan be endless, and includes advocating for their child and trying to find the best possible care, to supporting their child when they try tocommunicate their feelings and cope with situations.Families can understand the causes of the behaviour and may develop corresponding solutions and strategies. But families alone cannot guide and support a child with Autism. There are many organisations and professionals within the community that support children and families, and create opportunities for children to be involved in activities and events. Some of the professionals include:

Educators –provide high quality education where every child is viewed as a capable learner.

Inclusion supportservices eg KU–The Inclusion Support Programme helps  services include children with additional needs alongside their peers, by providing tailored inclusion advice and support from Inclusion Agencies and access to specialist equipment and funding to support more challenging inclusion barriers where required.

Paediatricians–Will make a diagnosis of Autism made on the basis of careful observations of a child’s behaviour.

Psychologists ‘psychs’–Support children who are finding it hard to manage their emotions by introducing new thinking,and teaching new skills and behaviours. This can be done in groups or by themselves. They also guide families on how best to support their child.

Speech Pathologists/ ‘speechies’ – Support a child’ to communicate. They can find out if a child is learning how to talk at the same rate as other children and help if there are problems with speech sounds/ words or the way they talk to different people.

Local area coordinator National Disability Insurance Scheme (NDIS)– Help participants and families to get the support they need.

Occupational Therapists/ ‘OTs’–Help children cope with or understand the environment eg fussy eaters, loud sounds. They can also help with things like toilet training, sleeping, getting dressed, playing with others, learning gross and fine motor skills like writing, cutting, climbing and jumping.

Social Workers– Help people cope with problems and support them in difficult times. They can provide counselling and emotional support, as well as practical support eg accessing social services.

Audiologists –Are specialists who can diagnose many types of hearing problems, and improve hearing for people of all ages.

Physiotherapists/’physios’– Help people of all ages to move and function better.