Monday, August 13, 2018

Transitioning Back to School: Tips for Parents of Students with Autism

Transitioning Back to School: Tips for Parents of Students with Autism

Students throughout the country will soon be making the transition to a new school year. This includes an increasing number of special needs children identified with autism spectrum disorder (ASD). Since Congress added autism as a disability category to the Individuals with Disabilities Education Act (IDEA) in 1990, there has been a dramatic increase in the number of students receiving special education services under this category.  In fact, the number of students receiving assistance under the special education category of autism over the past decade has increased from 1.5 percent to 9 percent of all identified disabilities. Autism now ranks fourth among all IDEA disability categories for students age 6-21.

The beginning of a new school year is an exciting yet anxious time for both parents and children. It typically brings a change in the daily routine established over the summer months. This transition can be especially challenging for families with children on the autism spectrum. While change can be difficult, the followng tips will help prepare a child with ASD for the new school year. 

1. Prepare and reintroduce routines.
  • Familiarize and reintroduce your child to the school setting. This may mean bringing your child to the school or classroom, showing your child a picture of their teacher and any classmates, or meeting the teacher before the first day of school. If possible, arrange to visit the teacher or the school a week or two before the first day. If this isn’t feasible, visit the school building or spend some time on the playground. Driving by the school several times is another good idea. You may also want to drive your child on the first day as well if they ride a bus to school. For many children with ASD, riding a bus to school on the first day can result in a sensory “overload.” Gradually easing them into the transportation routine will be helpful for everyone.
2. Review your child's Individualized Education Plan (IEP).
  • The IEP is a legal document and the cornerstone for your child’s education. It includes academic goals, appropriate accommodations and modifications and a description of all specific special education and related services, including individualized instruction and related supports and services (e.g., counseling, occupational, physical, and speech/language therapy; transportation), together with the specific setting in which the services will be provided. Parents should always have the IEP available to reference this essential information throughout the school year. If you do not have a copy, request one from the Special Services Department in your school district.
3. Expect the unexpected.
  • Parents cannot anticipate everything that might happen during the school day. Allow more time for all activities during the first week of school. Prepare your child for situations that may not go as planned. Discuss a plan of action for free time, such as lunch and recess. Use social stories to familiarize your child with routines and how to behave when an unexpected event occurs. Anticipate sensory overload. The activity, noise and chaos of a typical classroom can sometimes be difficult to manage. Establish a plan of action for this situation, possibly a quiet room where the child can take a short break. If your child has dietary issues, determine in advance how this will be managed so as to avoid any miscommunication.
4. Review and teach social expectations.
  • Although many children may transition easily between the social demands of summer activities and those required in the classroom, children on the autism spectrum may need more clear-cut (and literal) reminders. Review the “dos and don’ts” of acceptable school behavior. You can also create a schedule of a typical school day by using pictures and talk about how the school day will progress. Create a social story or picture schedule for school routines. Start reviewing and practicing early. If possible, meet with teachers and administrators to discuss your child’s strengths and challenges. Remember, you are your child’s best advocate. Establish communication early to develop positive relationships with your child’s teacher and school. Rehearse new activities. Ask the teacher what new activities are planned for the first week. Then, prepare your child by performing, practicing, and discussing them. This rehearsal will reduce anxiety when new activities take place during the beginning of school.
In summary, do everything possible to help reduce the stress level for your child and family during this transition time. Don’t forget to prepare yourself! Children sense anxiety, worry, and negativity in others. A calm, collected, and positive approach will help your child make a successful transition back to school.

Lee A. Wilkinson, PhD, NCSP is a licensed and nationally certified school psychologist, registered psychologist, and certified cognitive-behavioral therapist. He is author of the award-winning books, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools and Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT, both published by Jessica Kingsley Publishers. He is also editor of a best-selling text in the APA School Psychology Book Series, Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools. Dr. Wilkinson's latest book is A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition).

Sunday, July 29, 2018

Tips to Help Manage Noise Sensitivity in Autism


Tips to Help Manage Noise Sensivity
Unusual sensory responses (i.e., sensory over-responsivity, sensory under-responsivity, and sensory seeking) are relatively common in autism (ASD). While no single type of sensory problem is consistently associated with ASD, one of the most commonly reported challenges for people with autism spectrum conditions is hypersensitivity to noise. Many of the daily sounds that other people take for granted can be very intrusive and painful to children and adults on the spectrum. This article from Friendship Circle lists the types of noise sensitivity and offers some tips on how to help a highly sensitive person cope with everyday noisy situations.
1. Know the types of sensitivity
There are several different types of noise sensitivity, and there are different treatments for each type. Consult with an audiologist to pinpoint which type of sensitivity is affecting your quality of life. These are the 5 most common types of sensitivities, but keep in mind that a person may be affected by more than one issue. For example, my son has hyperacusis in addition to phobias of specific sounds.
  • Hyperacusis is an intolerance of everyday environmental sounds and is often associated with tinnitus, a ringing in the ears.
  • Hypersensitive hearing of specific frequencies is often (but not always) associated with autism. A person is able to tolerate most sounds at normal levels, but certain frequencies are intolerable, especially above 70 decibels. For example, a person may have no difficulty being near a noisy dishwasher, but the higher frequency and higher decibel level of the vacuum cleaner will be painful.
  • Recruitment is directly related to sensorineural hearing loss. It is defined as an atypical growth in the perception of loudness. Hair cells in the inner ear typically “translate” sound waves into nerve signals. Damaged or dead hair cells cannot perceive sound, but at a certain decibel level, surrounding healthy hair cells are “recruited” to transmit, and the person experiences a sudden sharp increase in sound perception that can be shocking and painful.
  • Phonophobia (also called ligyrophobia or sonophobia) is a persistent and unusual fear of sound, either a specific sound such as an alarm or general environmental sounds. People with phonophobia fear the possibility of being exposed to sounds, especially loud sounds, in present and future situations, and sometimes become homebound due to this anxiety.
  • Misophonia is an emotional reaction, most often anger or rage, to specific sounds. The trigger is usually a relatively soft sound related to eating or breathing and may be connected to only one or a few people who are emotionally close to the affected person. For example, my friend Lisa’s son Nate becomes angry and runs out of the dining room because his father makes sounds while chewing food, but Nate does not become angry when his mother and sister make similar sounds.
2. Provide relief
Headphones and earplugs offer instant comfort and relief. Noise-canceling headphones are the most effective, because they replace irritating environmental noise by producing calming white noise. Earplugs are usually made of either foam or wax, and it is worth trying both types to determine which is more comfortable.
However, most audiologists, physicians, therapists and educators recommend against frequent use of headphones and earplugs, because a person can quickly become dependent on them. In the long run, blocking out noise can reduce coping skills and increase social withdrawal.
3. Identify safe environments
One of the first steps that I took for my son was to make a list of his “safe” places and increase his participation there. Depending on an individual’s needs, this could mean:
  • volunteering at the library
  • attending library storytime
  • taking a walk in a nature area every day
  • visiting a park that is near a railroad crossing or helicopter landing pad
  • attending services, prayers or social events at the Shul more often
4. Allow control over some types of noise
At its heart, anxiety is a fear of being unable to control reactions and situations. When my son had a phobia of bells, I gave him several different types of bells to handle and experiment with at home. When we saw bells at customer service desks or in other public places, I allowed him to ring the bell. He gradually became comfortable with the sounds, and he even began identifying speaker systems, alarm systems and other sources of sounds everywhere we went.
5. Allow distractions
When my husband and I took a Lamaze childbirth class many years ago, we learned about the power of distraction in pain management. By giving a person something like an iPad to focus on or an unusual privilege such as bringing along a favorite toy from home, it becomes possible to direct attention away from the offending noise.

[Source: Wang, K. (2014). Noise Control: 11 Tips for Helping your Child with Autism Deal with Noise. Special Needs Resources. Friendship Circle. https://www.friendshipcircle.org/]

Lee A. Wilkinson, PhD is a licensed and nationally certified school psychologist, registered psychologist, and certified cognitive-behavioral therapist. Dr. Wilkinson provides consultation services and best practice guidance to school systems, agencies, advocacy groups, and professionals on a wide variety of topics related to children and youth with autism spectrum disorder. He is also a university educator and trainer, and has published widely on the topic of autism spectrum disorders both in the US and internationally. He is author of the award-winning books, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools and Overcoming Anxiety on the Autism Spectrum: A Self-Help Guide Using CBT. He is also editor of a best-selling text in the APA School Psychology Book Series, Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools. His latest book is A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition).

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