Appropriate Placement and Programming for Children on the Autism Spectrum

"What are the important factors for parents to consider when looking for suitable therapeutic programming for their child on the autism spectrum?"

Authorities who decide on entitlement to services are usually unaware of the extent of the challenges faced by children with Asperger’s and High-Functioning Autism (HFA). Many of these young people are placed in educational settings for kids with conduct disorders, thus allowing for the worst mismatch possible (i.e., boys and girls with a very naive understanding of social situations in a mix with those who can - and do - manipulate social situations to their advantage).



Although young people with Asperger’s and HFA often present with disruptive behaviors in social settings, these behaviors are often a result of their narrow, concrete understanding of social situations, and the confusion they experience when trying to meet the demands of interpersonal life. Thus, the social problems exhibited by these children should be addressed in the context of a comprehensive intervention needed to address their social deficits – as a curriculum need, rather than willful behaviors deserving reprimands that in fact mean very little to them, and only further damage their already poor self-esteem.

Problematic situations for children with Asperger’s and HFA include unstructured social situations (especially with same-age peers) and unique situations requiring social problem-solving skills. Thus, any evaluation intended to determine the need for special services should include detailed interviews with parents and therapists knowledgeable of the youngster in naturalistic settings (e.g., home and school), and direct observations of the youngster in unstructured settings (e.g., recess, lunch).

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

Parents of children on the autism spectrum should become well acquainted with the following factors involved in securing appropriate placement and programming for their “special needs” child:

1. Knowledge of “model” programs: Moms and dads should make an effort to locate programs (public or private) that are thought to provide high quality services according to local experts, parent support organizations, or other parents. Regardless of whether or not they would like for their youngster to be placed in that program, a visit to it will provide parents with a model and criteria with which to judge the appropriateness of the local program offered to them.

2. Knowledge of the Planning and Placement Team (PPT) process: Moms and dads need to become acquainted with the PPT process so they can become effective advocates for their youngster. They should be counseled by clinicians, parent advocates, or legal aides as to their rights as parents, and as to the alternatives available to them. The most effective approach is to secure independent evaluations and to present the case for appropriate programming based on evaluation findings and recommendations.

Across the country, a number of service providers are making a special attempt to better acquaint themselves with the special needs of kids with “social learning” challenges, to train themselves and their staff, and to creatively establish better individualized programs. Nonetheless, if parents do not get the support they need, they should seek the advice of other moms and dads, parent advocates, and if necessary, resort to the services of lawyers experienced in the area of challenges associated with autism spectrum disorders.

3. The range of services available in their school district: Both mother and father should make an attempt to visit the various suggested educational placements and service providers available in their school districts so they can obtain first-hand knowledge about them (e.g., physical setting, staffing, adult-student ratio, range of special services, etc.).

Below are program specifications to bear in mind when deciding on appropriate placements and programs for children with Asperger’s and HFA. They may not be applicable to every child, nor are they practicable in some parts of the country; nonetheless, they can be seen as ideal conditions to consider when dealing with program specifications:

1. There needs to be a concern for the acquisition of real-life skills in addition to the academic goals, making use of creative initiatives and the child’s interests and talents. For instance, given the fact that young people on the autism spectrum often excel in certain activities, social situations can be constructed to give them the opportunity to take the leadership in the activity (e.g., explaining, demonstrating, or teaching others how to improve in the particular activity). Such scenarios are ideal to help these young people to: (a) follow coherent and less one-sided goal-directed behaviors and approaches; (b) follow conversation and social interaction rules; and (c) take the perspective of others.

2. There should be a willingness to adapt the curriculum content and requirements in order to flexibly provide opportunities for success, to nurture the acquisition of a more positive self-concept, and to foster an internalized investment in performance and progress. This may mean that the child with Asperger’s and HFA is provided with individual challenges in his or her areas of strengths, and with individualized programs in his or her areas of weakness.

3. Opportunities for social interaction and facilitation of social relationships in fairly structured and supervised activities should be provided.

4. A relatively small setting with ample opportunity for individual attention, individualized approach, and small work groups should be offered.

5. A communication specialist should be available. This professional should (a) have a special interest in pragmatics and social skills training, (b) be available for individual and small group work, and (c) make a communication and social skills training intervention an integral part of all activities (implemented at all times, consistently, and across staff members, settings, and situations). This specialist should also act as a resource to the other staff members.

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

6. A thoughtful counselor who can focus on the child’s emotional well-being and who can (a) serve as a coordinator of services, (b) monitor progress, (c) serve as a resource to other staff members, and (d) provide an effective and supportive liaison service with the family should be available.

Specific interventions should be implemented in a consistent and individualized manner (i.e., across settings, staff members, and situations). Also, the benefit of specific recommendations should be assessed in an empirical fashion (i.e., based on an evaluation of events observed, documented or charted) with helpful techniques being maintained and unhelpful ones discarded in order to promote a constant adjustment of the program to the specific needs of the child.




Below are some suggestions to be considered when discussing interventions:

1. Adaptive skills intended to increase the child’s self-sufficiency should be taught clearly with no assumption that general explanations will suffice, nor that the child will be able to generalize from one concrete situation to similar ones. Frequently occurring problems should be addressed by teaching the child verbally the exact sequence of appropriate actions that will result in an effective behavior. Rule-sequences for certain tasks should be taught verbally and repeatedly rehearsed with the help of the specialist and other adults involved in the child’s care. There should be constant coordination and communication between all those involved so that these routines are reinforced in the same way. Verbal instructions, rote planning and consistency are essential.

2. Generalization of learned techniques and social concepts should be instructed from the therapeutic setting to everyday life.

3. Self-evaluation should be encouraged. Awareness should be gained into which situations are easily managed, and which are potentially problematic. Self-evaluation should also be used to strengthen self-esteem and maximize situations in which success can be achieved. Kids with Asperger’s and HFA often have many cognitive strengths and interests that can be used to their advantage in specific situations and in planning for the future.

4. Skills, concepts, and appropriate procedures should be taught in an explicit and rote fashion using a parts-to-whole verbal teaching approach, where the verbal steps are in the correct sequence for the behavior to be effective.

5. Social awareness should be developed, focusing on the relevant aspects of given situations, and pointing out the irrelevancies contained therein. Discrepancies between the child’s perceptions regarding the situation in question and the perceptions of others should be made clear.

6. Specific problem-solving techniques should be taught for handling the challenges of frequently occurring problematic situations.

7. Teaching guidelines should be derived from the child’s neuropsychological profile of assets and deficits. Specific intervention techniques should be similar to those usually employed for many subtypes of learning deficits.

8. The ability to interpret visual information simultaneously with auditory information should be strengthened, because it is important not only to be able to interpret other people's nonverbal behavior correctly, but also to interpret what is being said in conjunction with these nonverbal cues.

9. The child should be instructed on how to identify a novel situation and to resort to a pre-planned, well-rehearsed list of steps to be taken. This list should involve a description of the situation, retrieval of pertinent knowledge, and step-by-step decision making.

10. Lastly, the link between specific frustrating or anxiety-provoking experiences and negative feelings should be taught to the child in a concrete, cause-effect fashion so that he or she is able to gradually gain some insight into his or her feelings. Also, the awareness of the impact of his or her actions on other people's feelings should be fostered in the same fashion.

More resources for parents of children and teens with High-Functioning Autism and Asperger's:

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book


==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism

Crucial Skills-Acquisition for Children with Asperger’s and HFA

"How can parents help their child on the spectrum to improve behavior and cope with sensory sensitivities/problems related to anxiety?"

Parents often know that their child on the autism spectrum needs to be taught certain skills to improve behavior, sensory sensitivities, anxiety-related issues, and so on ...but they may not know exactly what skill-set will work best in any given situation.

There is a specific set of skills that children with Asperger’s (AS) and High Functioning Autism (HFA) need to be taught in order to insure their long-term success. The progression of skills-acquisition proceeds as follows:

1. In the first stage of skills-acquisition, the AS or HFA child follows rules as given, without context, and with no sense of responsibility beyond following the rules exactly.
2. In the second stage, competence (i.e., active decision making in choosing a course of action) develops, and the child acquires organizing principles to quickly access the particular rules that are relevant to the specific task at hand.
3. In the third stage, the child develops intuition to guide his decisions and devise his own rules to formulate plans. 
4. In the fourth and final stage, the child (a) has an intuitive grasp of situations based on a deep, tacit understanding, (b) has a vision of what is possible, (c) transcends reliance on rules, guidelines, and maxims, and (d) uses "analytical approaches" in novel situations or in solving problems.

The progression is thus from rigid adherence to rules to an intuitive mode of reasoning based on tacit knowledge. Below are the crucial skills that children on the autism spectrum so desperately need to be taught:

Social and Communication Skills—

Social and communication skills are best taught by a communication specialist with a focus on pragmatics in speech. Alternatively, social training groups may be used if there are enough opportunities for individual contact with the teacher and for the practicing of specific skills. Teaching may include:

• Verbal decoding of nonverbal behaviors of others
• Social awareness
• Perspective-taking skills
• Correct interpretation of ambiguous communications (e.g., nonliteral language) 
• Processing of visual information simultaneously with auditory information
• Understanding the appropriate social context of an interaction 
• Appropriate nonverbal behavior (e.g., the use of gaze for social interaction, monitoring and patterning of inflection of voice)
• Imitative drills (e.g., working with a mirror)

  
==> Teaching Social Skills and Emotion Management

Adaptive Functioning—

The acquisition of self-sufficiency skills in all areas of functioning should be a priority in any plan of intervention. The tendency of children with AS and HFA to rely on rigid rules and routines can be used to foster positive habits and enhance their quality of life and that of family members. The teaching approach should be practiced routinely in naturally occurring situations and across different settings in order to maximize generalization of acquired skills.

Maladaptive Behaviors—

Specific problem-solving techniques (usually following a verbal rule) may be taught for handling the requirements of frequently occurring, problematic situations (e.g., involving novelty, intense social demands, frustration, etc.). Training is usually necessary for recognizing situations as problematic and for selecting the best available learned strategy to use in such circumstances.

Learning—

Concepts, appropriate procedures, cognitive techniques, etc., are more effectively taught in an explicit and rote fashion using a “parts-to-whole” verbal instruction approach, in which the verbal steps are in the correct sequence for the behavior to be effective. Additional guidelines should be derived from the child's neuropsychological profile of assets and deficits. Specific intervention techniques should be similar to those usually employed for learning disabilities, with an effort to thwart the identified difficulties by means of compensatory techniques (usually of a verbal nature).

==> Teaching Social Skills and Emotion Management

If significant motor and visual-motor deficits are discovered during the evaluation, the child should receive physical and occupational therapies. Occupational therapies should not only focus on traditional techniques designed to address motor deficits, but should also reflect an effort to integrate these activities with learning of visual-spatial concepts, visual-spatial orientation, and body awareness.

Self-Support—

As children and teens with AS and HFA are usually self-described as loners (despite an often intense wish to make friends and have a more active social life), there is a need to facilitate social contact within the context of an activity-oriented group (e.g., church communities, hobby clubs, self-support groups, etc.). The little experience available with social groups suggests that these children and teens enjoy the opportunity to meet others with similar problems, and may develop relationships around an activity or subject of shared interest.

Vocational Training—

Oftentimes, older teens and young adults with AS and HFA may fail to meet entry requirements for jobs in their area of training (e.g., college degree) or fail to maintain a job because of their poor interview skills, social disabilities, eccentricities, or panic attacks. Having failed to secure skilled employment, these young people may be helped by well-meaning friends or relatives to find a manual job. As a result of their typically poor visual-motor skills, they may once again fail, leading to devastating emotional consequences. Thus, it is important that these individuals are trained for - and placed in - jobs where they are not neuropsychologically impaired, and where they will enjoy a certain degree of support and shelter. Also, it is preferable that the job does not involve intensive social demands.

Once the skills listed above have been mastered, parents may find that their “special needs” child functions at such a “normal” level that his or her symptoms of Asperger’s or HFA go unnoticed by others (e.g., peers, teachers, etc.).

==> Teaching Social Skills and Emotion Management

Blind Rage in Children with Asperger's and High-Functioning Autism

Video discusses blind rage in children on the autism spectrum, and what parents can do to help:




==> How to Prevent Meltdowns and Tantrums in Children with Aspergers and HFA