Transcript Document

Strategies That Support Persons with
Social Cognitive Disorders
Lisa Kunelius
October 31, 2012
Presented to
AVW Staff
Quick Review of Social
Cognitive Deficits
Just who are we?
We are your kids who have:
• ASD…The whole range!
• Tourette’s Disorder, Anxieties
• NonVerbal Learning Disorder
• ADHD
• And for all others in the murky gray
area of social thinking!
Quick Review of ASD Characteristics
 Qualitative impairment in social interaction such as:
 Marked impairment in the use of multiple nonverbal behaviors such as eye to
eye gaze, facial expression, body postures, gestures to regulate social
interaction
 Failure to develop peer relationships appropriate to developmental level
 Lack of spontaneous seeking to share enjoyment, interests or achievement
with other people
 Lack of social or emotional reciprocity
Quick Review of ASD Characteristics
 Qualitative impairments in communication as manifested by at
least one of the following:
 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)
 In individuals with adequate speech, marked impairment in the ability to
initiate or sustain a conversation with others
 Stereotyped and repetitive use of language or idiosyncratic language
 Lack of varied spontaneous make believe play or social imitative play
appropriate to developmental level
Quick Review of ASD
Characteristics
 Restricted, repetitive and stereotyped patterns of behavior,
interests, and activities, as manifested by at least one of the
following:
 Encompassing preoccupation with one or more stereotyped and restricted
patterns of interest that is abnormal either in intensity or focus
 Apparently inflexible adherence to specific, nonfunctional routines or rituals
 Stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping
or twisting, or complex whole body movements)
Quick Review of ASD
Characteristics
 Delays or abnormal functioning in at
least one of the following areas prior to
3 years:
 Social interactions
 Language as used in social communication
 Symbolic or imaginative play
Social skill challenges are
hallmark characteristics
REMEMBER THE RANGE:
 Range from withdrawn to active
 Socially awkward and stiff
 Emotionally blunted
 Self centered
 Unable to understand nonverbal social cues
 Inflexible
 Lacking in empathy and understanding
Social skill challenges are
hallmark characteristics
Even when children and adolescents with social
cognitive characteristics actively seek out
others, they usually encounter social isolation
because of their failure to understand the rules
of social behavior, including eye contact,
appropriate proximity to others, gestures,
posture and so forth.
Challenges interacting with
others
Lack of understanding social cues
Tendency to interpret words and/or
phrases concretely
Difficulties comprehending abstract
language
Challenges with Incidental Social
Learning
Don’t pick up the cues from the environment for
appropriate behavior and if they learn social
skills at all, they often do so without fully
understanding their meaning and context
Challenges with Behavior
Commonalities in terms of distractibility
and inattentiveness:
 Attention is fleeting
 Withdrawal into inner world
 May be related to stress, a focus on obsessive
interest or overstimulation
Rigidity
Either an inherent ability to set up and adhere
to a rigid set of structure or they rely totally
on others to help them get organized.
Needs:
Predictable schedules
Uniform assignment formats
Consistent teacher affect
Special Interests
Interests which are most often narrowly
focused can be
• Tangible such as collecting rocks made of mica or
automobile hood ornaments
• Topical such as knowing everything about the Civil
War
Motivation
Often difficult to motivate:
Withdrawn
Uninterested in exploring NEW environments
Preoccupied with obsessive interests
INTERESTS MAY BE THE KEY TO MOTIVATION!!!
What Are Social Cognitive Deficits?
Social Cognitive Deficits…
• Occur when there is not a development of social
skills
• Interpret the social nuances of those around
them
• Brings deep and lifelong challenges
• Impacts life in a multitude of ways: socially,
emotionally, recreationally and vocationally
• Personal safety and decision making are impaired
• Failure to understand the hidden curriculum
Failure to understand
the hidden curriculum
Definition: the do’s and don’t of everyday living
that are not spelled out or directly taught but
that everyone somehow picks up on.
Rule for:
Bathroom
Birthday parties
Clothing
Eating
Friendships
Church
Pranks
Etc……..
Locker room
Recess and PE
Lunchroom
Fire drills
Rules when talking to the teacher
Bullying/Tattling
Telling jokes
And then there’s…….
The hidden curriculum of………
• Body language
• Differs across age
• Differs across gender
• Depends upon who you are with
• Differs within culture
What to do????
Well…………..What do we do when our students
have a learning disability?????
WE TEACH THEM!!!!!!!
“Lisa”, you ask, “how do we teach this?”
Well….we have gotten together today to
learn about social thinking and how to
teach it!!
What is social thinking???
What is social thinking???
• Social thinking develops from birth, much like walking; it is
intuitively “hard wired” into most people to work at learning how
the social world works.
• Social thinking is what we do when we interact with people: we
think about them. And how we think about people affects how we
behave toward them, which in turn affects how others respond to
us, which in turn affects our own emotions.
• Whether we are with friends, sending an email, in a classroom or at
the grocery store, we take in the thoughts, emotions and intentions
of those around us.
What is social thinking???
• Most of us have developed our communication
skills from birth onwards, steadily observing and
acquiring social information and learning how to
respond. Because social thinking is an intuitive
process, we usually take it for granted!
• But for many individuals, this process is anything
but natural. And this often has nothing to do with
conventional measurements of academic
intelligence
How does it happen?
• A milestone of infancy is called “joint attention.” This
occurs when babies naturally learn to look at people’s
eyes and follow what they are looking at to figure out
what they are thinking about. Communication usually
develops rapidly once this milestone is reached. Also
evolving from this core skill of joint attention are play
skills, including cooperation, sharing an imagination
and working as part of a group.
• Being able to play effectively with peers in preschool
provides children with a skill base necessary to sit and
learn in a classroom.
Core philosophies of social thinking
• We “think with our eyes” to figure out other
people’s thoughts, intentions, emotions, plans,
etc.
• Our thoughts and emotions are strongly
connected. How we think affects how we feel,
how we behave affects how others think and feel.
If “your friends are people who make you feel
good about you over time,” then you must learn
how to make friends and how to make other
people feel good using your actions and your
language.
Core philosophies of social thinking
• We think about people all the time, even when we
have no plans to interact with them. We adjust our
own behavior based on what we think the people
around us are thinking. (This is how we drive our cars!).
• As part of our humanity, each of us is on a daily quest
to avoid each other’s “weird thoughts.” We constantly
consider people around us and adjust our behavior to
help people have “normal thoughts about us.”
• Most of the core social thinking lessons operate
BELOW the level of cultures, meaning that all people
engage in these thoughts and social behavioral
adjustments.
Core philosophies of social thinking
• How we adapt our behavior changes as we age
and are in different situations and cultures. The
nuance and sophistication of our behaviors
(which we refine greatly by 3rd grade and then
across our entire lives) is constantly evolving.
• Social thinking is something all of us do every day,
all day, even when we are alone in our homes. To
understand a TV drama or sitcom one has to
think about the character’s emotions, thoughts,
reactions, etc. Even reading novels requires social
thinking.
Core philosophies of social thinking
• Social thinking, therefore, plays into our
academic world, requiring us to think about
the motives and intentions of people we read
about in literature and history.
• Social thinking affects us in adulthood. To hold
a job, most of us have to adapt our own social
behavior based on the perceived thoughts of
the people we work and live with.
Think of a social situation……
Social Stories, Power Cards and
other cool stuff….Oh My!!
Comic Strip Conversations
• Comic strip conversations utilize simple
drawing to illustrate what people say, do, and
think. Developed by Carol Gray in 1994, comic
strip conversations are possibly the most
widely used cartooning strategy.
Comic Strip Conversations
• Who? Students with trouble interpreting
social situations and understanding speech as
quickly as most social interactions require.
• What? A conversation between two or more
people using simple illustrations in a comic
strip format
• Why? Show children how to behave in a
socially acceptable manner and conform to
social standards
• How? Effectiveness can be enhanced by
incorporating a child's favorite cartoon
character into the illustration
How can comic strip
conversations be used?
•to convey important information
•for problem-solving and conflict
resolution
•to learn social skills
•to follow simple classroom rules
•to communicate perspectives, feelings,
and ideas
Elements of comic strip
conversations
•a description of the event that caused the
problem
•feelings and thoughts of everyone involved
•a solution to the problem and ideas on how
to avoid it in the future
•reinforcement
•appropriate symbols (stick figures, smiley
faces, thought bubbles)
•colors used to express feelings (greenhappy, blue-sad, black-angry)
An Example……
Gather your information:
• Where are you?
• Who else is here?
• What are you doing?
• What happened? What did others do?
• What did you say?
• What did others say?
• What did you think when you said that?
• What did others think when they said that/did that?
How does this all work???
The following structure is
recommended for use in creating
comic strip conversations:
1. Engage in small talk:
Gray suggests that the adult and the individual
with SCD engage in small talk unrelated to the
problem situation for a few minutes prior to
starting the comic strip conversation. This is a
time when individual-teacher rapport can be
enhanced
2. Draw about a given situation:
The individual with SCD or the teacher can draw
about the situation using simple stick figures to
represent a given situation. The adult can assist
the individual's drawing or recollection of the
event by asking questions such as, "Who else
was there?", "What did you do?", or "What did
others do?".
3. Present perspective:
Gray recommends that the individual have as
much control as possible during the cartooning
session. Adults can share insight into the
situation when an opportunity presents itself
but should not dominate the discussion. The
goal is to achieve some balance between the
collecting information about the individual's
perspective and perception of the situation and
the adult's responsibility to share accurate social
information
4. Provide sequence or structure:
Comic strip boxes may be used in which the
individual with SCD (or the adult) draws figures.
This is particularly helpful if the individual has
organizational problems. Additionally, the boxes
can be reordered if an event is drawn out of
sequence.
5. Summarize the cartoon:
The overall information from the comic strip
conversation is synthesized into a summary. The
individual with SCD should communicate this as
independently as possible with the adult
clarifying when needed. The summary helps
ensure that the adult and individual have the
same understanding of the situation described
in the comic strip conversation
6. Identify new solutions:
The individual with SCD, as independently as
possible, begins to think about new outcomes of
the event described in the Comic Strip
Conversation. Each solution is written down and
discussed by the individual and the adult in
terms of advantages and disadvantages.
Because it is written down the individual can
keep the list of outcomes and make a plan for
future situations.
Carol’s Example
web example:
http://www.autisminternetmodules.org/mod_view.php?nav_id=1147
Lisa’s example
The fire alarm!!!!!!
What are Social Stories (and
Narratives)
• http://www.thegraycenter.org/social-stories/what-are-socialstories
The definition….
A Social Story™ describes a situation, skill, or
concept in terms of relevant social cues, perspectives,
and common responses in a specifically defined style
and format. The goal of a Social Story™ is to share
accurate social information in a patient and reassuring
manner that is easily understood by its audience. Half
of all Social Stories™ developed should affirm
something that an individual does well. Although the
goal of a Story™ should never be to change the
individual’s behavior, that individual’s improved
understanding of events and expectations may lead to
more effective responses.
Social Stories: 10 Criterion
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
The Goal
Two Part Discovery
Three Parts and a Title
FOURmat
5 Factors Define Voice and Vocabulary
6 Questions Guide Story Development
7 Types of Sentences
A Gr-eight Formula
Nine Makes it Mine
10 Guides to Editing and Implementation
The Goal
Share information using a process,
format, voice and content
Is descriptive, meaningful
Is physically, socially and emotional
safe
Has an overall patient and soothing
tone
Two Part Discovery
• Keep goal in mind
• Relevant information that
– Improves understanding of the audience’s relation
to a situation, skill or concept; and
– Identifies the specific topic and type of
information to be shared
• 50% of all social stories must applaud the audience
• Three types of social story information: The News; Ways to Think About
the News; and Connections and Implications
Three Parts and a Title
• Title
• Introduction
• Body
• Conclusion
FOURmat
• Individualization
• Organization
• Presentation of text
• Presentation of illustrations
5 Factors Define
Voice and Vocabulary
• 1st person perspective
• Positive and patient tone
• Past, present and/or future tense
• Literal accuracy
• Accurate vocabulary
6 Questions Guide
Story Development
•
•
•
•
•
•
Where?
When?
Who?
What?
How?
Why?
7 Types of Sentences
• Descriptive
• Perspective
• Coaching
– Coach the audience
– Coach the team
– Self coaching
• Affirmative
• Partial
A Gr-eight Formula
# of Descriptive sentences
+ # of Perspective sentences
+ # of Affirmative sentences
# of Sentences that DESCRIBE
# of sentences that DESCRIBE > 2
# of sentences that COACH
Nine Makes it Mine
Whenever possible the social
story is tailored to the individual
preferences, talents and
interests of its Audience.
10 Guides to Editing
and Implementation
These ensure that the goal that guiides social
story development is also evident in its editing
and use.
See attachment for further description……..
Carols example of …..
When its my turn to listen
Back to the fire drill
Sometimes the fire alarm rings when I’m at
school. The bell is very loud. Everyone in
the school goes outside when the fire
alarm bell rings. I know I try to follow my
teacher and go outside to the spot where we
practiced standing. If it’s too loud for me, I can
grab my headphones to make it quieter. When the alarm stops
ringing, I can wait for my teacher to tell me that it is okay to go
back into the building. I will try to remain calm during the fire
alarm.
What Are Power Cards
(and WHO is Claudia?)
Power Card Strategy involves including special interests
with visual aids to teach and reinforce academic,
behavioral and social skills to individuals with Autism
Spectrum Disorders. Since many children with Asperger
Syndrome and autism tend to have highly developed
special interests, this strategy is especially beneficial for
this population. By using their special interest, the
individual is motivated to use the strategy presented in
the scenario and on the power card. It is a positive
strategy that is often entertaining as well as inexpensive
and simple to develop
The Script:
• In the first paragraph the hero or role model
attempts to solve a problem and experiences
success.
• The second paragraph encourages the
student to try a new behavior which is broken
down into 3-5 manageable steps
About Power Cards
◦ visuals that incorporate a child's special
interest in a brief scenario that deals with
a situation that is difficult for the child.
◦ written in the first person from the
perspective of a child's hero and describe
how the hero solves the problem.
◦A small card recaps how the child can
use the same strategy to solve a similar
problem of her own.
Special interests..
The Script……….
A brief script of the special interest and the
situation being addressed for the individual is
created. It should be written at the individual's
comprehension level and should include relevant
pictures or graphics. Initially, the script should be
read on a scheduled basis as the student learns to
use the power card.
The Card………..
The power card is the size of a trading card and
includes a small picture of the special interest and
the solution to the problem situation broken into
three to five steps. The power card is created
from the script and can be carried by the student
Helpful Hints……
• Ask them (or parents!) what shows, movies,
special interests they have…go online together to
find just the right visual!
• I write the 1st script with an activity the child
already performs well at.
• You can use the business card template from
Microsoft Office to write the power card on.
They are the perfect size!
• Don’t forget to laminate them!
Back to the fire drill
1.
A Very Simple example………
Hermione Granger always listens to the teacher when there is a
fire drill and wants you to be safe when you have a fire drill, too.
1.
2.
3.
Grab your headphones and follow the teacher outside to the
safe place.
Stand in the safe place until your teacher says it is safe to go
back inside.
Hermione Granger will like it when you stay safe during a fire
drill
A Very Simple example…
1.
Hermione Granger wants you to be safe when you have a fire drill:
1.
2.
3.
Grab your headphones and follow the teacher outside to the
safe place.
Stand in the safe place until your teacher says it is safe to go
back inside.
Hermione Granger will like it when you stay safe during a fire
drill
The Survivors play a game
The contestants on Survivor love to play games! In fact, playing games on the
show is how they win rewards or win immunity. Sometimes the players and
teams win their games, but sometimes, they lose. When they win, they give
each other "high fives," smile or say, "Alright!" When they lose their game,
the Survivors might not be happy. They could take a deep breath and say,
"Maybe next time," or say "Good job" to their opponent. The contestants on
Survivor think everyone should have fun playing games. They also want you to
remember three things when playing games with other people:
• 1.Games should be fun for everyone.
• 2.If you win a game, you can: Smile, give high fives, or say, "Alright!"
• 3.If you lose a game, you can: Take a deep breath and say, "Good job" to
the opponent or say, "Maybe next time."
• Play games the Survivor way and your friends will have fun playing games
with you
The Survivors want you to learn to play a game!
1.Games should be fun for everyone.
2.If you win a game, you can: Smile, give high fives, or say,
"Alright!"
3.If you lose a game, you can: Take a deep breath and say,
"Good job" to the opponent or say, "Maybe next time."
Play games the Survivor way and your friends will have
fun playing games with you
On to the 5 Point Scale
Developed by Buron and Curtis
What it is…..
A simple 5-point scale can help students
understand and control their emotional
reactions to everyday events. The
objective of the scale is to show how to
break down a given behavior and, with the
student's active participation, develop a
scale that identifies the problem and
suggests alternative, positive behaviors at
each level of the scale.
Why we use it…….
It is not uncommon for individuals with autism
spectrum disorders (ASD) to have problems with
social competence and understanding how their
behavior impacts themselves and others. In
addition, they frequently battle with anxiety and
have difficulty regulating their emotions and
stress levels. As a result, they repeatedly
struggle in social situations
How we use it……….
• identify the behavior, whether it be reducing anxiety
around a situation by providing 5 steps or strategies, or
labeling the levels of voice from whispering to shouting.
• needs to be task analyzed or broken into concrete parts.
Working with the individual with ASD, these parts need to
be assigned a label.
• an example could deal with understanding emotions from
happy to angry. For their example faces are used to identify
the feelings for the child. The child, working one on one
with an adult, is taught what "angry" looks like, what it
"feels" like, and how to get help or what to do when they
are angry
How we organize a Scale
• http://www.autisminternetmodules.org/mod
_view.php?nav_id=181
Missy’s Example
An example………
Another example…..
Rating
Looks/sounds Feels like
Like
5
Wide eyed,
maybe
screaming, and
running hitting
Threaten others
or bump them
4
3
2
1
I am going to
explode if I
don’t do
something
Safe people can
help/I can try
to
I will need an
adult to help me
leave. Help!
People are talking
about me. I feel
irritated, mad
Close my mouth
and hum. Squeeze
my hands. Leave
the room for a
walk.
You can’t tell I’m I shiver inside.
scared. Jaw
clenched
I still look
My stomach
normal
gets a little
queasy.
Write or draw
about it. Close
my eyes
Slow my
breathing. Tell
somebody safe
how I feel.
Enjoy it!
Normal-You can’t I don’t know,
tell by looking at really.
me
What is against the law????
And how did I get there??
What is a 1?
Very informal social behavior:
This is like waving to someone or smiling to someone
in the hallway at school. If you just say “Hi” and keep
on walking, that is also a 1. This is totally OK and is
the way most people first notice each other .
And how did I get there??
A 2 is
Reasonable behavior.
This type of behavior is like going to a party you have
been invited to and talking to someone you know. It
might be playing a planned board game with
someone, working with someone in a group at
school, or eating lunch together. People enjoy each
other’s company at this level. This is where people
get to know each other better.
And how did I get there??
But a 3 is Odd Behavior!
This behavior could make some people feel uncomfortable. It
might include sitting too close to someone or putting your
face too close to someone who was not expecting it. It could
also include showing up to a party that you were not invited
to. You might get fired from a job because this behavior makes
other people nervous. This is not against the law.
And how did I get there??
Here is a 4.
Scary Behavior!
This could include swearing or staring. You would
probably get fired from a job for this behavior or
suspended from school. This behavior could also
end up being against the law.
And how did I get there??
And this is a 5!!!!!!!
Physically hurtful or threatening behavior:
These are behaviors that are against the law. For
example, hitting someone or grabbing them in a
private place is at a 5. You will get fired from a job,
suspended from school and maybe even go to jail if
you engage in such behavior.
Ideas for keeping your body calm or for pulling
yourself down from a 4 to a 2, or from a 3 to a 1.
• Yoga in the classroom at least two times a
week
• Learn to breath out a balloon
• Photos of relaxing things to look at
• A calming sequence
• Listen to calming music
Social Behavior Mapping
• use with 3rd graders - adulthood
• tools of Social Thinking
• offers cognitive behavior strategy to teach
individuals about the specific relationship
between behaviors, others' perspectives, others'
actions (consequences) and the student's own
emotions about those around him or her
• 3rd-12th grade students, this strategy is most
effective for students with solid language skills
Social Behavior Mapping
• Expected Behaviors are the ones that help a
student learn and be seen in a positive light by
his peers and educators.
Social Behavior Mapping
• Unexpected behaviors are those that cause a
student to be perceived as “weird” by peers
and may cause frustration to those who try to
support her.
Social Behavior Mapping
Expected behaviors vs. Unexpected behaviors
Staying in your chair
Falling out of your chair
Sitting upright in your chair
Wandering around in the class
Keeping your feet on the floor
Putting your feet in someone’s chair
Looking at the teacher when she is talking
Looking in a direction other than where the
teacher wants you to
All thoughts and feelings are
connected
All thoughts and feelings are
connected
Social Behavior Mapping
• All behaviors have consequences
• Consequences are tied to others’ emotional
feelings about our students
• If I am good then others will acknowledge that
state of being and reward me with attention, a
smile or a tangible reward
• If I am displaying an unexpected behavior
then……..
Social Behavior Mapping
1. List at the top what behavioral set
you are describing in a specific context
(e.g. “behaviors for learning in the
classroom).
Social Behavior Mapping
2. List the “expected” set
of behaviors.
Social Behavior Mapping
3. List how his behaviors make
other people feel (their
perspective). Use emotional words
or phrases such as “pleased”,
“proud”, or “happy Paul is working
as part of the group”.
Social Behavior Mapping
4. List the consequences (these are
generally the more positive ones)
evolved from making people feel
good about what he is doing, e.g.
friendly face, calm tone and voice,
praise, etc.
Social Behavior Mapping
Social Behavior Mapping
Steps to incorporate:
• Review maps as a team b4 the student sees them
• Copy the approved ones for various
classrooms/teachers
• Use the maps to explain situation to the student
• Catch the student in the act of as many expected
behaviors as possible!!! Use your PBIS!!!
•
Social Fortune
the anime illustrations to capture the attention of teens and
tweens
teach the core concepts related to Michelle Garcia Winner’s
Social Behavior Mapping
(SBM) teach how our own behaviors, expected and
unexpected, impact how others feel about us, ultimately
treat us which then affects how we feel about ourselves
teaches CHOICES
1st we have to
figure out the rules
• Obvious rules: people are expected to walk
(not crawl or slither or roll down the hall);
people are expected to carry their own stuff
(rather than grab someone else’s backpack or
things).
• Hidden rules: It’s also expected that kids will
accidentally bump into a crowded space. Kids
may do things in the halls that aren’t OK in
class (talk in a loud voice) but are OK here.
There are 10 examples
•
1.
Been there, know that: participating in the class discussion
•
2.
Speaking nothing but the truth: someone you like does something different with their appearance
•
3.
Bored outta my brain: being part of the learning group during the boring moment
•
4.
It’s doomsday: time to finish homework
•
5.
Clue me in! - figuring out what to say to others
•
6.
Huh? –getting help in the classroom
•
7.
You talkin’ to me? – classroom lesson when you know the answer
•
8.
My way or the highway: working in a small group
•
9.
Who changed the rules? – breaktime
•
10. Know when to take a detour: sharing ideas/opinions
Who are the characters?
• Auto pilot reactor: person reacts quickly and
keeps making the same social mistakes.
• Option resister: thinks about the situation but
its her way or the high way
• Coin flipper: doesn’t want to think….
• Social thinker: uses his brain to THINK….many
social thinkers in this book!!!!
Social behavior map
• What you do affects how another person feels
• Others have feelings about what you do
• How people feel about your behavior affects
how they treat you
• How people treat you affects how you feel
about yourself
TIPS…..
• Think about what other people think about
you
• The size of the problems (big one or small
one?)
• Emotion expression compression
– FBI ESP: Feel it Big on the Inside but Express it
Smaller when in Public!!!!!
Tuesday,
February 7, 2012
During rehearsal for a concert, it is important to
listen so you know the procedures for walking
in, where to sit, and how the teacher will get
your attention during the actual concert.
Other cool stuff we can use…