Tuesday, September 20, 2016

Self-Help for Young Adults on the Autism Spectrum

Overcoming Anxiety and Depression on the Autism Spectrum is available from Jessica Kingsley Publishers, AmazonBarnes & Noble, Book DepositoryBooks-A-Million and other online book retailers.
Lee A. Wilkinson, PhD, CCBT, NCSP is author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools, 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.

Friday, September 9, 2016

The IEP: Educating Children with Autism

Education has been shown to be among the most effective treatments for children with autism spectrum disorder (ASD). The most recent reauthorization of the Individuals with Disabilities Education Act (IDEA 2004) entitles all students with disabilities to a free appropriate public education (FAPE). In fact, the National Research Council (2001) recommends that all children identified with ASD, regardless of severity, be made eligible for special educational services under the IDEA category of autism.
The individualized education program or plan (IEP) is the cornerstone for the education of a child with ASD. It should identify the services a student needs so that he/she may grow and learn during the school year. Parents, teachers and support professionals play a key role in the development, implementation, and evaluation of the child’s IEP. All share the responsibility for monitoring the student’s progress toward meeting specific academic, social, and behavioral goals and objectives in the IEP. Although the type and intensity of services will vary, depending on the student’s age, cognitive and language levels, behavioral needs and family priorities, the IEP should address all areas in which a child needs educational assistance. These include academic and non-academic goals if the services will provide an educational benefit for the student. All areas of projected need are incorporated in the IEP, together with the specific setting in which the services will be provided and the professionals who will provide the service. School districts should ensure that the IEP process follows the procedural requirements of IDEA. This includes actively involving parents in the IEP process and adhering to the time frame requirements for assessment and developing and implementing the student’s IEP.  Moreover, parents must be notified of their due process rights. It’s important to recognize that parent-professional communication and collaboration are key components for making educational and program decisions.
The content of an IEP should include the following (Individuals with Disabilities Education Improvement Act, 2004):
  • The IEP should be based on the child’s unique pattern of strengths and weaknesses. Goals for a child with ASD commonly include the areas of communication, social behavior, adaptive skills, challenging behavior, and academic and functional skills. The IEP must address appropriate instructional and curricular accommodations and modifications, together with related services such as counseling, occupational therapy, speech/language therapy, physical therapy and transportation needs. Evidence-based instructional strategies should also be adopted to ensure that the IEP is implemented appropriately.
  • A statement of the child's present level of educational performance (both academic and nonacademic aspects of his or her performance). 
  • Specific goals and objectives designed to provide the appropriate educational services. This includes a statement of annual goals that the student may be expected to reasonably meet during the coming academic year, together with a series of measurable, intermediate objectives for each goal. 
  • Appropriate objective criteria, evaluation procedures and schedules for determining, at least annually, whether the child is achieving the specific objectives detailed in the IEP. 
  • A description of all specific special education and related services, including individualized instruction and related supports and services to be provided (e.g., counseling, occupational, physical, and speech/language therapy; transportation) and the extent to which the child will participate in regular educational programs with typical peers. 
  • Accommodations should be specifically documented in the IEP. Accommodations refer to the adjustments made to ensure that the student has equal access to educational programming by removing, to the extent, possible, barriers to successful classroom performance. Adjustments may be made to (a) instructional methods, teaching style, and curricular materials; (b) classroom and homework assignments; (c) assessment tools and ways of responding; (d) time requirements; and (e) environmental setting. Once accommodations are made, the student with special needs is expected to meet the standards of all students.
  • The initiation date and duration of each of the services to be provided (including extended school year services). 
  • If the student is 16 years of age or older, the IEP must include a description of transitional services (coordinated set of activities designed to assist the student in movement from school to post-school activities).
School districts should assure that progress monitoring of students with ASD is completed at specified intervals by an interdisciplinary team of professionals who have a knowledge base and experience in autism. This includes collecting evidence-based data to document progress towards achieving IEP goals and to assess program effectiveness. School districts should also provide on-going training and education in ASD for both parents and professionals. Professionals who are trained in specific methodology and techniques will be most effective in providing the appropriate services and in modifying curriculum based upon the unique needs of the individual child.
Information and tips on writing and developing measurable IEP goals for learners with ASD are available from the following:
Kabot, S., & Reeve, C. (2014). Curriculum and Program Structure. In L. A. Wilkinson (Ed.), Autism spectrum disorder in children and adolescents:  Evidence-based assessment and intervention in schools (pp. 195-218). Washington, DC: American Psychological Association.
Myles, B. S., Adreon, D. A., Hagen, K., Holverstott, J., Hubbard, A., Smith, S. M., et al. (2005). Life journey through autism: An educator’s guide to Asperger syndrome. Arlington, VA: Organization for Autism Research.
National Research Council (2001). Educating children with autism. Committee on Educational Interventions for Children with Autism. C. Lord & J. P. McGee (Eds). Division of Behavioral and Social Sciences and Education. Washington, DC: National Academy Press.
Twachtman-Cullen, D., & Twachtman-Bassett, J. (2011). The IEP from A to Z: How to create meaningful and measurable goals and objectives. San Francisco, CA: Jossey-Bass.
Wagner, S. (2014). Continuum of Services and Individualized Education Plan Process. In L. A. Wilkinson (Ed.). Autism spectrum disorder in children and adolescents:  Evidence-based assessment and intervention in schools (pp. 173-193). Washington, DC: American Psychological Association.
Wilkinson, L. A. (2010). A best practice guide to assessment and intervention for autism and Asperger syndrome in schools. London: Jessica Kingsley Publishers.
Wilkinson, L. A. (Ed.). (2014). Autism spectrum disorder in children and adolescents:  Evidence-based assessment and intervention in schools. Washington, DC: American Psychological Association.

Wilkinson, L. A. (2017). A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd edition). London: Jessica Kingsley Publishers.
Wilmshurst, L. & Brue, A. (2010). The complete guide to special education: Expert advice on evaluations, IEPs, and helping kids succeed (2nd edition). San Francisco, CA: Jossey-Bass.
Lee A. Wilkinson, PhD, CCBT, NCSP is a school psychologist and author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools, published by Jessica Kingsley Publishers. He is also the 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 and author of the book, Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT. His latest book is A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools, (2nd edition).

Tuesday, September 6, 2016

Pragmatic Language Skills and the Autism Spectrum

The DSM-5 diagnostic criteria for autism spectrum disorder (ASD) include persistent deficits in social communication and social interaction across multiple contexts. Poor pragmatic/social use of language or impairment in the ability to understand and use language in social-communicative contexts is a core feature of ASD. Pragmatic skills involve: (a) using language for different purposes; (b) changing language according to the needs of a listener or situation; (c) understanding non-literal language; and (d) following rules for conversations.  
There are many unwritten rules in society that govern our behavior. While most of us intuitively understand these rules, individuals with ASD have not automatically learned the conventions and nuances that make up their social environment. These unspoken or “hidden” social standards can make the world a confusing place and result in life-long challenges. For example, social expectations such as “it is not polite to interrupt others while they are talking,” “take turns in conversation” and “discuss other topics besides only those you are interested in” are not taught and are assumed to be known and understood. We seem to have an “unconscious” navigator that allows us to make intuitive sense of the unspoken rules in society and adjust to the social demands of our everyday lives.
The unspoken rules of social engagement involve the use of the pragmatic, social communicative functions of language (e.g., turn taking, understanding of inferences and figurative expressions) as well as nonverbal skills needed to communicate and regulate interaction (e.g., eye contact, gesture, facial expression). This includes body language and idioms, metaphors, or slang – phrases and meanings that we intuitively assimilate or learn through observation or subtle cues. Individuals with ASD tend to interpret language literally and may be puzzled by the common everyday expressions used by a typical peer or adult. Consider how idioms or figurative speech such as “how the cookie crumbles,” “curiosity killed the cat,” and “when it rains, it pours” might have a totally different meaning and result in confusion if taken literally. In order to understand language, we must understand what the idioms in that language mean. If you try to figure out the meaning of an idiom literally (word by word), you will be bewildered. While the typical individual might understand that the phrase “that’s the way the cookie crumbles,” and accompanying body language (e.g., voice, body) communicates to the listener that something unfortunate has happened, to someone with a pragmatic social-communication problem, this idiom will have a completely different meaning and be confusing. The following are but a few of well over 3,000 idioms in the English language.
  • Bite off More than you can chew  
  • Cross that bridge when you come it
  • Everything but the kitchen sink 
  • Get up on the wrong side of the bed 
  • Have a bone to pick with you 
  • Have your cake and eat it too 
  • Kill two birds with one stone  
  • Put all your eggs in one basket 
  • Raining cats and dogs 
  • Run circles around someone 
  • Till the cows come home
Because social communication deficits are among the core challenges of ASD, a best practice student assessment should include an evaluation of pragmatic competence and not be limited to the formal, structural aspects of language (i.e., articulation and receptive/ expressive language functioning). As a group, more capable students with ASD tend to demonstrate strength in formal language, but a weakness is pragmatic and social skills.  As a result, they often fail to qualify for speech-language services because they present strong verbal skills and large vocabularies, and score well on formal language assessments. Particular attention should be given to the pragmatic, social communicative functions of language (e.g., turn taking, understanding of inferences and figurative expressions) as well as to the nonverbal skills needed to communicate and regulate interaction (e.g., eye contact, gesture, facial expression, and body language). Significant and severe deficits in the ability to communicate and interact with others can limit their participation in mainstream academic settings and community activities. Moreover, pragmatic deficits tend to become even more obvious and problematic as social and educational demands increase with age. Because pragmatic language is a critical part of everyday social interaction, it is imperative that speech/language services for children with ASD include a focus on social communication skills. Students with pragmatic language deficits who do not meet the DSM-5 ASD criteria for restricted, repetitive patterns of behavior should be evaluated for social (pragmatic) communication disorder (SCD).  

Monday, September 5, 2016

Special Needs Students Bullied More than Others

Students with special needs face a number of challenges in our nations’ schools and communities. Although students in general and special education experience bullying, there is little research investigating bullying (i.e., as a bully, victim, or bully–victim) among students with disabilities. A study published in the Journal of School Psychology found that students receiving special education services for behavioral disorders and those with more noticeable disabilities are not only more likely to be bullied than their general education peers, but are more likely to engage in bullying behavior themselves.
Participants in the study were 816 students, 9 to 16 years of age, from nine Midwestern elementary and middle schools in one school district. From this total group, 686 were not receiving special education services (categorized as “no disability”), and 130 were receiving special education services (categorized as “observable disability,” “non-observable disability,” and “behavioral disability”). Data on students’ involvement in bullying, office referrals, and prosocial behavior were collected. Self-report measures were used to assess students’ experiences with bullying and victimization and how often students engaged in various aggressive and prosocial behaviors.
The results indicated that students with behavioral disorders reported the highest levels of bullying others and being bullied themselves. The study also found that students with observable disabilities (e.g.., language impairments, hearing impairments, and mild intellectual disability) were more likely to bully others and to be victimized compared with students in general education.  As the authors comment, “The observable nature of the disability makes it easy to identify those students as individuals with disabilities, which may place them at a greater risk for being the easy target of bullying. Being frustrated with the experience of victimization, those students might engage in bullying behavior as a form of revenge.”
The study also found that students with non-observable disabilities, such as a learning disability, reported similar levels of bullying and victimization as students without disabilities. They also reported significantly less victimization compared with students with more outward behavioral disabilities. While both boys and girls engaged in bullying, there was no significant gender difference in both general education and special education students when it came to the behavior. Although fifth grade students in general education reported much more victimization than sixth-, seventh-, eighth- and ninth-graders, there was no difference for students in special education.

What are the implications of this study? The authors offer several suggestions for school-based bullying prevention and intervention programming. For example, anti-bullying interventions emphasizing prosocial skills should be implemented for students, regardless of their ability. Students in general education could help the process by serving as prosocial role models for students with disabilities. Teachers may also provide reinforcement for prosocial behavior or assign students in general education with students in special education in small groups to work on class projects together to promote positive interaction. For students with both behavioral and observable disabilities, providing support and teaching strategies to cope with peer victimization are important. Helping students with observable disabilities become better integrated into general education classes may help prevent them from being bullied. "Programming should be consistently implemented across general and special education, should occur in each grade and should be part of an inclusive curriculum," the authors recommend. "A culture of respect, tolerance and acceptance is our only hope for reducing bullying among all school-aged youth."
© 2016 Lee A. Wilkinson, PhD

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