Session 5

Factors that Affect Learning and Development

National Professional Development Center on Autism Spectrum Disorders (2008). Session 5: Factors that affect learning and development. In

Foundations of autism spectrum disorders: An online course

. Chapel Hill: FPG Child Development Institute, The University of North Carolina at Chapel Hill.

May 7, 2008

Session 5 Introduction

• Factors affecting approach decisions  Goals and objectives on IFSP or IEP  Age and developmental level    Current skills and needs Learning style Families’ concerns and priorities May 7, 2008

Session 5 Topics: Factors that Affect Learning and Development

• • Educational/Intervention Factors  Settings for Intervention    Curriculum Needs Transition Planning Collaboration among Practitioners and Families via Tiered Teaming Other Factors    Related Health Issues Psychopharmacology Complementary and Alternative Interventions May 7, 2008

Factors that Affect Learning and Development: Learning Objectives

After completing Session 5, participants will:

1.

identify and describe three placement options/settings where children/students with ASD receive intervention and/or education.

2.

3.

identify curriculum areas that are important for students with ASD. describe transition processes for infants and toddlers with ASD and for children with ASD who transition from preschool to kindergarten.

May 7, 2008

Factors that Affect Learning and Development: Learning Objectives

After completing Session 5, participants will:

4.

identify the elements of successful programmatic transitions for students with ASD in middle and high school. 5.

6.

describe the required components of a programmatic transition plan for students with ASD graduating from high school. discuss the tiered team approach and identify team members at each level.

May 7, 2008

Factors that Affect Learning and Development: Learning Objectives

After completing Session 5, participants will:

7.

8.

identify four related health issues that often occur with ASD.

identify the major behavioral/emotional symptoms in ASD that are sometimes targeted by psychotropic medications. 9.

explain the difference between complementary and alternative therapies.

May 7, 2008

Placement Options/Settings

• • • Intervention/placement setting options vary across states and school districts.

Settings/placement options for intervention and education are based upon federal legislation (IDEA 2004).

A continuum of placement options must be available to identify the most appropriate least restrictive environment (LRE) for individuals.

May 7, 2008

Continuum of Intervention Settings

Self-Contained Combination of Settings Full Inclusion

May 7, 2008

Inclusive Programs and Classrooms

• • • Settings where children and youth with ASD receive services with typically developing peers Available from early childhood through high school Related services are typically provided within classrooms or through a pull-out model May 7, 2008

Self-Contained Programs and Classrooms

• • • These settings include children and youth with ASD and/or other disabilities Often housed in public schools Often available from early childhood through high school May 7, 2008

Resource Rooms

• • • Elementary-aged children and adolescents receive supplemental instruction in resource rooms.

Instruction is provided either one-on-one or in small groups.

Often used with children who can successfully participate in some inclusive classes, such as science and math.

May 7, 2008

Other Intervention Settings

• • • Include home-based intervention and community resources for older students with ASD Settings fall along the intervention continuum Often used in combination with inclusive and self-contained settings May 7, 2008

Home-Based Intervention

• • • Home-based intervention is often considered the least restrictive environment for toddlers with ASD.

Older children and adolescents with ASD also can receive services in this setting.

Certain intervention programs, such as discrete trial training, often are implemented in the home.

May 7, 2008

Community Resources for Adolescents with ASD

• • • Services provided in the community outside of the school setting Can help to bridge the transition from high school to community Can help develop recreational, social, and vocational skills May 7, 2008

Curriculum Areas

• • Access to the general curriculum is required by IDEA 2004.

 Same content and subject areas as typical peers  Curriculum may require modifications, accommodations Other curriculum areas needed due to:  Core characteristics of ASD   Cognitive and learning needs of ASD Preparation for becoming as independent and socially responsible as possible May 7, 2008

Social and Communication/ Language Skills

• Social and communication/language skill development are priorities because:  these skills are needed at all ages and functioning levels.

  these skills promote engagement.

systematic instruction is usually required to help individuals with ASD acquire these skills.

May 7, 2008

Curriculum Areas: Play and Leisure/Recreation Skills

• Play and leisure/recreational skills are important because they:    are needed across the life span.

facilitate social development, relationships.

improve quality of life.  decrease behavioral difficulties.

May 7, 2008

Curriculum Areas: Self-help and Adaptive Skills

• • Self-help and adaptive skill development should be considered in current and future settings.

Self-help and adaptive skills:  are necessary for success at school, in the community, and in the workplace.

 are required for independence in daily living skills in school, community, leisure/recreation, and work settings, and in managing different environments that will increase success in the future.

May 7, 2008

Curriculum Areas: Self-advocacy and Coping Skills

• Self-advocacy and coping skills  vary by age, individualized needs, and settings in which individuals receive support and services.

 become increasingly important in middle and high school May 7, 2008

Curriculum Areas: Generalization and Motor Skills

• • Individuals need opportunities to apply academic skills to real life situations to generalize skills.

Some individuals with ASD need help with motor planning and motor skill development. May 7, 2008

Programmatic Transition Planning

• • • • Transitions are difficult for individuals with ASD.

Communication and collaboration within and across agencies, and with families, enhance positive outcomes.

IFSP/IEP provides framework for collaboration.

Planning is key for successful transitions and for academic and functional achievement.

May 7, 2008

Early Childhood Transitions

• IDEA (2004) requires:  Interagency coordinating councils to develop plans for transition  IFSP that includes a transition plan,  Transition planning meeting to occur at least 90 days prior to transition to Part B  Local educational agency (LEA) must participate May 7, 2008

Elementary Transitions: From Preschool to Kindergarten

• • Plans are part of child’s IEP, including a transition evaluation Coordination among regular and special education teachers, autism specialists, and other team members can make the process much easier and much more efficient May 7, 2008

Middle and High School Transitions

• • • IDEA requires  Involvement of the student in the process  Transition plan to be in effect when youth is 16 years of age  Transition plan is a required component of IEP Career planning, vocational assessments, self-determination Involvement of outside agencies (e.g., vocational rehabilitation) May 7, 2008

Life After High School

• • • • Movement from an entitlement to programs that require determination of eligibility for services Contrast of fairly immediate access to services in schools to lengthy waiting lists for services Applications for post-high school supports and services are typically required Transition team should include members of IEP team, the learner, the family, and representatives from adult agencies that provide services May 7, 2008

Transition from Student to Adult

Transition refers to a change in status from behaving primarily as a student to assuming emergent adult roles in the community

.

These roles include employment, participating in post secondary education, maintaining a home, becoming appropriately involved in the community, and experiencing satisfactory personal and social relationships. (Halpern, 1994, p. 117) May 7, 2008

Enhancing Transitions

The process of enhancing transition involves the participation and coordination of school programs, adult agency services, and natural supports within the community. The foundations for transition should be laid during the elementary and middle school years, guided by the broad concept of career development. (Halpern, 1994, p. 117) May 7, 2008

• • •

Programmatic Transition Planning: A Review

Essential process that  identifies, develops, and documents skills, challenges, goals, and tasks  is required for successful movement toward independence and community participation Planning and supporting transitions can be time consuming and lengthy Many different people may be involved at various stages of planning--only constant is the child and the child’s family May 7, 2008

Collaboration Among Practitioners and Families

• • • Collaborative, interdisciplinary team model recommended Team members work together and with the family, including the child or youth when appropriate Applies to assessment, goal development, intervention, and evaluation processes May 7, 2008

Collaboration among Practitioners and Families: Team Membership

• • Tiered team membership model for collaborative teams  Core team   Extended team Situational team Membership determined by  Age/needs of individual with ASD   IFSP/IEP goals Skills and experiences of professionals May 7, 2008

Collaboration among Practitioners and with Families

• Core team  Persons who have almost daily contact and interaction with the child or youth and with the family  Members include the family and child, special and general educators, early interventionists, paraprofessionals May 7, 2008

Collaboration among Practitioners and with Families

• Extended team  Persons who have regular but less frequent contact, such as weekly or biweekly, with the child or adolescent with ASD.

 Members include related services personnel who provide regularly scheduled interventions with children  Services delivered in homes, child care programs, or school settings and through a variety of approached May 7, 2008

Collaboration among Practitioners and with Families

• Situational team  May be defined by the circumstances or situation related to the child, youth, and/or family, the individual’s age, or skills  Members might include psychologist or behavior specialist, audiologist, nutritionist, vision specialist, vocational rehabilitation specialist, school nurse, pediatrician, assistive technology specialist, or career counselor May 7, 2008

Health Considerations

• • • Related Health Issues Psychopharmacology Complementary and Alternative Interventions May 7, 2008

Related Health Issues: Seizure Disorders

• Seizure disorders   affect 1/4 to 1/3 of individuals with ASD.

 peak during preschool and adolescence.

 result in prescriptions for anticonvulsant medications. should be closely monitored by teachers to note activity.

May 7, 2008

Related Health Issues: GI Problems and Allergies

• • Gastrointestinal problems  Conflicting reports of prevalence  Includes gastro-esophageal reflux, diarrhea, and constipation Allergies  Sensitivities to gluten and casein reported  No data from controlled studies to validate special diets as effective treatments May 7, 2008

Related Health Issues: Sleep Disturbances

• Sleep disturbances  Sleep induction (getting to sleep)   Staying asleep (awakening during the night) Awakening early in the morning   Challenging for parents Efficacy of medication use not established May 7, 2008

Related Health Issues

• For a review of treatment options, visit the American Academy of Pediatrics website at the url below.

http://www.aap.org/healthtopics/Autism.cfm

May 7, 2008

Psychopharmacology

• Research supports drug treatments for three symptom groups:   Repetitive behaviors Hyperactivity  Irritability, aggression, and self-injurious behaviors May 7, 2008

Potential Medication Options for Selected Behavioral Symptoms Associated with ASD

Symptom(s) Repetitive behaviors and behavioral rigidity Hyperactivity Irritability, aggression, self-injury Class of Medication

Selective serotonin reuptake inhibitors (SSRIs)

(e.g., fluosetine, sertraline, fluvoxamine)

Atypical neuroleptics

(e.g., risperidone, olanzapine)

Stimulants

(e.g., methylphenidate, dextroamphetamine)

Alpha-2 adrenergic agonists

(e.g., guanfacine)

Atypical neuroleptics

(e.g., risperidone, olanzapine)

Alpha-1 antagonists

(e.g., naltrexone) May 7, 2008

Complementary and Alternative Interventions (CAI)

• • • Complementary – used in addition to conventional prescribed intervention to enhance effect(s) Alternative – substituted for more traditional behavioral and educational interventions Used by up to 50% of families of children with ASD May 7, 2008

Categories of CAI

• Biological treatments   Specialized diets: gluten-free/casein-free Nutritional supplements: B6/magnesium,folic acid, and vitamins C, B12, and A  Detoxification regimens: chelation, secretin May 7, 2008

Categories of CAI

• Non-biologic treatments  Interactive metronome therapy   Auditory integration training Craniosacral manipulation or therapeutic massage  Hyperbaric oxygen therapy   Dolphin-assisted therapy Facilitated communication May 7, 2008

Complementary and Alternative Interventions

• • A set of guidelines can be useful for families who are considering nontraditional therapies.

One example of such a guideline,

Evaluation Guidelines when Considering Nontraditional Therapies in Autism,

can be found at the url below.

http://www.teacch.com/info_evaluation.html

May 7, 2008

Factors that Affect Learning and Development: A Review

• Educational/intervention characteristics  Placement/settings  Curriculum   Transition Planning Collaborative teaming Other issues  Health concerns   Psychopharmacology Complementary and alternative interventions May 7, 2008