Wednesday, August 24, 2016

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

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

Students throughout the country will soon be making the transition to a new school year or a new grade. 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. 

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 following tips will help prepare a child with ASD for the new school year and make the transition back to school easier.
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. 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.
3. 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! A calm and collected parent is better able to help their child make a successful transition back to school.

Wednesday, August 10, 2016

Autistic Traits and Sensory Experiences in Adults

Autistic Traits and Sensory Experiences in Adults

Unusual sensory processing experiences are common among individuals with autism spectrum disorder (ASD), and are now part of the Diagnostic and Statistical Manual 5th Edition (DSM-5) diagnostic criteria. Although previous research indicates that ASD traits are associated with sensory scores in the general population, it is unclear whether they characterize the “broader phenotype” of ASD which includes individuals with mild impairments in social and communication skills that are similar to those shown by individuals with ASD, but exhibited to a lesser degree. 

Research

A study published in the
Journal of Autism and Developmental Disorders sought to replicate the reported relationship between ASD traits and sensory traits across the entire range of symptom severity, and to investigate its specificity in a large sample of adults both with and without ASD. Adults (n = 772) with and without an ASD were administered the Autism Spectrum Quotient (AQ) together with the Adult/Adolescent Sensory Profile (AASP), the Cardiff Anomalous Perceptions Scale (CAPS), and the Glasgow Sensory Questionnaire (GSQ), all questionnaire measures of abnormal sensory responsivity. Of the 772 participants, 23 reported having autism and 55 reported a first-degree relative with the disorder. Another 147 participants indicated having another psychiatric condition, such as depression, and 85 reported having migraine headaches on a regular basis.
The results indicated that self-reported atypical sensory experiences were positively correlated with ASD trait scores on all three sensory questionnaires. The more autistic traits, the more sensory problems he or she reported. Individuals with the most autism traits, such as narrow interests or social difficulties, showed high levels of atypical sensory behavior on all three questionnaires. Although the study’s sample was predominantly (72 %) female, the investigators found that the relationship between sensory symptoms and ASD traits was very similar for both genders. They also found that ASD traits were correlated with levels of anxiety symptoms. Participants who reported being anxious had both more autism traits and more unusual sensory responses than those who were not anxious. This suggests that  sensory processing issues and anxiety symptoms are related, yet separate, phenomena.
Implications

These results have implications for the integration of sensory processing issues into the diagnosis and assessment of ASD. For example, the study confirms the association between sensory experiences and autism across the entire autism spectrum, suggesting that sensory traits might serve as a dimensional measure of the severity of ASD. It should be noted, however, that unusual sensory experiences are not unique to ASD. The researchers found that trait anxiety, a history of psychiatric conditions, and a history of migraines were all associated with higher sensory scores, even after controlling for ASD traits. Thus, individuals with these conditions may report high levels of unusual sensory experiences, which could potentially lead to a misdiagnosis of ASD. It also appears unlikely that atypical sensory experiences underpin all ASD symptoms. Even so, it does appear that if sensory symptoms were treated successfully, then some core ASD symptoms, such as stereotypies, might also be reduced (or vice versa). Further research is needed to examine this issue. Finally, the cognitive/biological basis of the relationship between autistic traits and sensory problems is unknown, and further work is required to determine whether improving sensory processing could effectively reduce the severity of ASD symptoms.
Reference

Horder, J., Wilson, C. E., Mendez, M. A., & Murphy, D. J. (2014). Autistic traits and abnormal sensory experiences in adults. Journal of Autism and Developmental Disorders, 44, 1461-1469. doi:10.1007/s10803-013-2012-7
Lee A. Wilkinson, PhD, is a licensed and nationally certified school 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 CBTHe is also editor of a 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)