tag:blogger.com,1999:blog-20201630430399939522024-02-18T21:25:03.236-05:00Best Practice AutismYour Guide to the Autism Spectrum.bestpracticeautism.comhttp://www.blogger.com/profile/16482478063587857508noreply@blogger.comBlogger167125tag:blogger.com,1999:blog-2020163043039993952.post-46600126600572164742021-06-01T16:36:00.000-04:002021-06-05T06:09:20.553-04:00Triggers for Anxiety in Children with Autism<div dir="ltr" style="text-align: left;" trbidi="on">
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<b style="font-family: georgia;">What Triggers Anxiety for Autistic Children and Teens?</b></div>
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<span style="font-family: "georgia";"><b><br /></b></span></div>
<span style="font-family: "georgia";">Anxiety is a
frequent co-occurring (comorbid) problem for children and youth </span><span style="font-family: "georgia";">with autism spectrum disorder (ASD). Although
prevalence rates vary from 11% to 84%, most studies indicate that approximately
one-half of autistic children meet criteria for at </span><span style="font-family: "georgia";">least one anxiety disorder.
</span><span style="font-family: "georgia";">Despite promising advances in the research and practice
literature, our understanding of the phenomenology and treatment of
anxiety in ASD remains somewhat limited. Importantly, there is a paucity of
information on the difference between ASD and non-ASD populations in regards to
the manifestation of anxiety symptoms. Understanding more about the factors
triggering and maintaining anxiety in ASD, and how autistic children and their
families experience, think and speak about anxiety, will help inform the
development and implementation of autism-specific interventions for anxiety.</span></div>
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<span style="font-family: "georgia";">An exploratory study
published in the journal </span><i style="font-family: georgia;"><a href="http://aut.sagepub.com/content/16/2/107">Autism</a></i><span style="font-family: "georgia";">
reported on a series of 5 focus groups with parents of children and adolescents
with ASD and anxiety as a first step in identifying the triggers, behavioral
signs and cognitive processes associated with anxiety. Seventeen mothers of 19
children with a diagnosis of ASD participated in the focus groups. All children
(12 boys and 7 girls) had received ASD diagnoses from local clinical services
and were reported to experience significant levels of anxiety that had an
impact on their functioning.</span><br />
<span style="font-family: "georgia";"><br /></span>
<span style="font-family: "georgia";">The following is a summary
of key themes identified by parents in relation to triggers, symptoms and
impact of anxiety in their children with ASD.</span></div>
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<span style="font-family: "georgia";"></span><b><span style="font-family: "georgia";">Anxiety
triggers/Stressors</span></b></div>
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<span style="font-family: "georgia";">1. Change or disruption to
routine.</span></div>
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<span style="font-family: "georgia";">2. Confusion and worries
about social and communication situations.</span></div>
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<span style="font-family: "georgia";">3. Specific fears and
phobias.</span></div>
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<span style="font-family: "georgia";">4. Sensory oversensitivity
and overstimulation.</span></div>
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<span style="font-family: "georgia";">5. Being prevented from
preferred repetitive behaviors and interests.</span></div>
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<span style="font-family: "georgia";">6. Too many demands or
expectations.</span></div>
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<span style="font-family: "georgia";"></span><b><span style="font-family: "georgia";">Presentation of
anxiety</span></b></div>
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<span style="font-family: "georgia";">1. Increase in challenging
behavior.</span></div>
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<span style="font-family: "georgia";">2.
Avoidance/withdrawal/escape.</span></div>
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<span style="font-family: "georgia";">3. Increase in levels of
arousal.</span></div>
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<span style="font-family: "georgia";">4. Increase in sensory,
repetitive, and ritualistic behavior.</span></div>
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<span style="font-family: "georgia";">5. Physical sensations
associated with anxiety.</span></div>
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<span style="font-family: "georgia";">6. Cognitive distortions
and errors in thinking.</span></div>
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<b><span style="font-family: "georgia";">Impact of anxiety</span></b></div>
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<span style="font-family: "georgia";">1. Personal distress in
children, parents, and siblings.</span></div>
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<span style="font-family: "georgia";">2. Increase in challenging
behavior and stereotyped behaviors.</span></div>
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<span style="font-family: "georgia";">3. Restriction of
activities/opportunities.</span></div>
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<span style="font-family: "georgia";">4. Negative impact on
quality of life for child and family.</span></div>
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<span style="font-family: "georgia";"><b>Parent Perspectives</b></span></div>
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<span style="font-family: "georgia";">Across groups, parents
gave markedly similar descriptions of the triggers and behavioral signs
associated with anxiety. Parents’ perspectives on the anxieties of their children
indicate that there are many overlaps with anxiety as experienced in the
general population. Shared triggers included social worries, specific phobic
stimuli, and expectations that are, or are perceived to be, too demanding.
Common features of the presentation of anxiety include an increase in arousal
and avoidance/escape behaviors. </span></div>
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<span style="font-family: "georgia";">There were, however, a
number of autism-specific triggers and symptoms of anxiety identified in
children with ASD. Key features were the intensity, pervasiveness and
persistence of the anxiety. Changes and disruptions to routines, sensory
sensitivities and social difficulties associated with difficulties in perspective-taking
and social expectations appeared to be ASD-specific triggers. Situations that
were reported to trigger anxiety often reflected autism-related difficulties in
processing style or sensory sensitivity. </span><br />
<span style="font-family: "georgia";"><br /></span>
<span style="font-family: "georgia";">The majority of comments about the
presentation of anxiety fell into the categories of challenging behavior and
avoidance/withdrawal, indicating that behavioral manifestations are the major
expressions of anxiety in children with ASD. When asked about their anxious
thoughts, the most prominent theme that emerged was the difficulty that
children with ASD have in expressing their anxiety verbally, particularly at
times of severe distress. Although this is also occurs with many typically
developing children, it may be a particular difficulty for children and youth with ASD
given the challenges they face in understanding and expressing emotions and
pragmatic language difficulties. In addition to similar descriptions of the
triggers and behavioral signs associated with anxiety, the impact of anxiety
was reported to be often times more substantial than the impact of ASD itself.</span></div>
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<b><span style="font-family: "georgia";">Implications</span></b></div>
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<span style="font-family: "georgia";">Although this study did
not specifically address assessment and intervention/treatment issues, several
implications in these areas emerged. For example, when parents and children
with ASD are asked to describe their experiences in a semi-structured,
non-directed manner, they largely focus on features more specific to the ASD
population that are not typically measured on most standard anxiety measures.
Although there are broad-based measures that evaluate emotional/behavioral
difficulties in children with neurodevelopmental disabilities, a significant
gap remains in the resources available to clinicians and researchers for
measuring ASD-specific aspects of anxiety. This argues for the inclusion of
observational methods in the assessment of anxiety: using multiple informants,
multimodal assessment techniques, and methods.</span><br />
<span style="font-family: "georgia";"><br /></span><span style="font-family: "georgia";"></span>
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<span style="font-family: "georgia";">Identification of specific
triggers/stressors and presentation of anxiety in children with ASD can help
educators and interventionists improve programs and services for this group of
students. These findings may also be useful for clinicians working with
children and youth with ASD, particularly those utilizing CBT as a treatment
approach. Although recent randomized controlled trials suggest that enhanced
and adapted CBT can successfully treat anxiety disorders in high functioning
children with ASD, it is unclear which adaptations are critical or which
modifications are required for which anxiety disorder. </span><span style="font-family: "georgia";"> </span><span style="font-family: "georgia";">Nevertheless, the authors note that their
findings support the view that adaptations to CBT, such as adding ASD-specific
components to the treatment protocol, are important, relevant and acceptable to
parents of children with ASD.</span><span style="font-family: "georgia";"> </span><span style="font-family: "georgia";">They also
caution that even though CBT can be an effective means of treating anxiety in
youth with ASD, clinicians may need to consider whether CBT is the most
appropriate intervention or whether other approaches such as behavioral
strategies or environmental modifications may be more suitable, as accessing or
modifying cognitions may prove too challenging for some youth with ASD. Yet, CBT
is clearly an effective intervention for many autistic children and youth, and the
involvement of parents can further improve outcomes.</span></div>
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<span style="font-family: "georgia";">Recommendations for future
research include focusing on larger groups and control samples, and systematically
investigating the link between ASD cognitive processing styles and anxiety. The
authors propose that further exploration of the similarities and differences
between shared and ASD-specific triggers, manifestations, and effects of
anxiety using a variety of methodologies will contribute to the development of
more appropriate assessment measures and ASD-specific models of anxiety which
can then guide treatment for more effectively. </span></div>
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<span style="font-family: "georgia";">Ozsivadjian, A., Knott, F.,
& Magiati, I. (2012). Parent and child perspectives on the nature of
anxiety in children and young people with autism spectrum disorders: a focus
group study. <i>Autism</i>,
16, 107-121. DOI: 10.1177/1362361311431703</span></div>
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<span style="font-family: "georgia";"><b>Lee A. Wilkinson</b>, PhD, is a licensed and nationally certified school psychologist, and certified cognitive-behavioral therapist. He is author of the award-winning books, <i><a href="http://www.amazon.com/Practice-Assessment-Intervention-Asperger-Syndrome/dp/1849058113">A
Best Practice Guide to Assessment and Intervention for Autism and Asperger
Syndrome in Schools</a> </i>and<i> </i></span><i style="font-family: Georgia;"><a href="http://www.amazon.com/Overcoming-Anxiety-Depression-Autism-Spectrum/dp/1849059276/ref=sr_1_1?s=books&ie=UTF8&qid=1412370192&sr=1-1&keywords=overcoming+anxiety+and+depression+on+the+autism+spectrum">Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT</a></i><span style="font-family: "georgia";">. </span><span style="font-family: "georgia";">He is also the editor of a text in the APA School Psychology Book Series, </span><i style="font-family: Georgia;"><a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156">Autism
Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and
Intervention in Schools</a>. </i><span style="font-family: "georgia";">His latest book is </span><i style="font-family: georgia;"><a href="http://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8" target="_blank">A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd edition)</a></i><span style="font-family: "georgia";">.</span></div>
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bestpracticeautism.comhttp://www.blogger.com/profile/16482478063587857508noreply@blogger.com0tag:blogger.com,1999:blog-2020163043039993952.post-34571158909439862262021-05-01T16:21:00.000-04:002021-05-02T08:52:28.290-04:00Autism and Co-Occurring Conditions <div dir="ltr" style="text-align: left;" trbidi="on">
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<b>Psychiatric Comorbidity in Autism</b></div>
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<span style="font-family: "georgia";">Children with autism spectrum disorder (ASD) frequently have co-occurring (comorbid) psychiatric conditions, with estimates
as high as 70 to 84 percent. <span style="mso-spacerun: yes;"> </span>A Comorbid
disorder is defined as a disorder that co-exists or co-occurs with another
diagnosis so that both share a primary focus of clinical and educational
attention. Research indicates that autistic children and youth have a high risk for
meeting criteria for other disorders, such as </span><span style="font-family: "georgia";">mood and anxiety disorders, </span><span style="font-family: "georgia";">attention deficit/hyperactivity disorder (ADHD), and disruptive behavior disorders, all which contribute to overall impairment.</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "georgia";">I</span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "georgia";">nternalizing Problems</span></b></div>
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<span style="font-family: "georgia";">Studies have consistently reported an association between ASD and internalizing symptoms, in particular, anxiety and depression. A bidirectional association has been identified between internalizing disorders and autistic symptoms. For example, both a higher prevalence of anxiety disorders has been found in ASD and a higher rate of autistic traits has been reported in youth with mood and anxiety disorders. Autistic individuals also display more social anxiety symptoms compared to typical individuals, even if these symptoms were clinically overlapping with the characteristic social problems of ASD. In addition, there is some evidence to suggest that adolescents and young adults with ASD show a higher prevalence of bipolar disorders as compared to controls.</span></div>
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<span style="font-family: "georgia";">Depression is one of the most common comorbid conditions observed in individuals with ASD, particularly higher functioning youth. A study of psychiatric comorbidity in young autistic adults revealed that 70% had experienced at least one episode of major depression and 50% reported recurrent major depression. Although another documented association is with obsessive-compulsive disorder (OCD), it is difficult to determine whether observed obsessive-repetitive behaviors are an expression of a separate, comorbid OCD, or an integral part of the core diagnostic features of ASD (i. e., restricted, repetitive patterns of behavior, interests, or activities).</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "georgia";">Externalizing Problems</span></b></div>
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<span style="font-family: "georgia";">An association between ASD and attention-deficit/hyperactivity disorder (ADHD) and other externalizing problems (i. e., oppositional defiant disorder) have been reported. Studies have found that children with ASD in clinical settings present with co-occurring symptoms of ADHD with rates ranging between 37% and 85%. Although there continues to a debate about ADHD comorbidity in ASD, research, practice and theoretical models suggest that co-occurrence between these conditions is relevant and occurs frequently. For example, case studies suggest that ADHD is a relatively common initial diagnosis in young autistic children. It is also important to note that a significant change in the DSM-5 is removal of the DSM-IV-TR hierarchical rules prohibiting the concurrent diagnosis of ASD and ADHD. When the criteria are met for both disorders, both diagnoses are given.</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "georgia";">Other Comorbidities</span></b></div>
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<span style="font-family: "georgia";">Tourette Syndrome (TS) and other tic disorders have been found to be a comorbid condition in many children with ASD. A Swedish study showed that 20% of all school-age children with ASD met the full criteria for TS. There also appears to be a higher incidence of seizures in children with autism compared to the general population. The comorbidity of ASD and psychotic disorders has received some research attention. A study of children with ASD who were referred for psychotic behavior and given a diagnosis of schizophrenia showed that when psychotic behaviors were the presenting symptoms, depression and not schizophrenia, was the likely diagnosis. Thus, autistic individuals may present with characteristics that could lead to a misdiagnosis of schizophrenia and other psychotic disorders.</span></div>
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<span style="font-family: "georgia";"><b>Implications</b></span></div>
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<span style="font-family: "georgia";">Children and youth with ASD frequently have comorbid conditions, with rates significantly higher than would be expected from the general population. The most common co-occurring diagnoses are anxiety and depression, attention problems, and disruptive behavior disorders. The core symptoms of ASD can often mask the symptoms of a comorbid condition. The current challenge for practitioners is to determine if the symptoms observed in ASD are part of the same dimension (i. e, the autism spectrum) or whether they represent another condition. Although various psychometric instruments, such as clinical interviews, self-report questionnaires and checklists, are widely used to assist in diagnosis, these tools are designed and standardized to identify symptoms in the general population, and may not be appropriate and valid for use with ASD. Likewise, their administration may be problematic in that autistic individuals may have difficulties in sustaining a reciprocal conversation, reporting events, and perspective taking. Nevertheless, comorbid problems should be assessed whenever significant behavioral issues (e.g., inattention, impulsivity, mood instability, anxiety, sleep disturbance, <span style="background-color: white;">aggression) become evident or when major changes in behavior are reported. Co-occurring conditions should also be carefully investigated when severe or worsening symptoms are present that are not responding to intervention or treatment.</span></span></div>
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<b style="background-color: white; font-family: georgia;">Key References and Further Reading</b></div>
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<span style="background-color: white; color: #222222; font-family: "georgia" , serif;"><br /></span>
<span style="background-color: white; color: #222222; font-family: "georgia" , serif;">American
Psychiatric Association. (2013). </span><i style="color: #222222; font-family: Georgia, serif;">Diagnostic and statistical manual of
mental disorders </i><span style="background-color: white; color: #222222; font-family: "georgia" , serif;">(5th ed.) Washington, DC: Author.</span><br />
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<span style="background-color: white; color: #222222; font-family: "georgia" , serif;"><br /></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0in; mso-hyphenate: none;">
<span style="background-color: white; color: #222222; font-family: "georgia" , serif;">Colombi,
C., & Ghaziuddin, M. (2017). Neuropsychological Characteristics of
Children with Mixed Autism and ADHD. Autism Research and
Treatment, 2017, 1-5. doi:10.1155/2017/5781781<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0in; mso-hyphenate: none;">
<span style="background-color: white; color: #222222; font-family: "georgia" , serif;"><br /></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0in; mso-hyphenate: none;">
<span style="background-color: white; color: #222222; font-family: "georgia" , serif;">Doepke,
K. J., Banks, B. M., Mays, J. F., Toby, L. M., & Landau, S. (2014).
Co-occurring emotional and behavior problems in children with Autism Spectrum
Disorders. In L. </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0in; mso-hyphenate: none;">
<span style="background-color: white; color: #222222; font-family: "georgia" , serif;"><br /></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0in; mso-hyphenate: none;">
<span style="background-color: white; color: #222222; font-family: "georgia" , serif;">Wilkinson (Ed.), <i>Autism Spectrum Disorders in Children
and Adolescence: Evidence-based Assessment and Intervention in Schools</i> (pp.
125-148). Washington, DC: American Psychological Association.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0in; mso-hyphenate: none;">
<span style="background-color: white; color: #222222; font-family: "georgia" , serif;"><br /></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0in; mso-hyphenate: none;">
<span style="background-color: white; color: #222222; font-family: "georgia" , serif;">Duerden,
E. G., Oatley, H. K., Mak-Fan, K. M., McGrath, P. A., Taylor, M. J., Szatmari,
P., & Roberts, S. W. (2012). Risk factors associated with self-injurious
behaviors in children and adolescents with autism spectrum disorders. <i>Journal
of Autism and Developmental Disorders</i>, 42:2460–2470. DOI
10.1007/s10803-012-1497-9<o:p></o:p></span></div>
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<span style="background-color: white; color: #222222; font-family: "georgia" , serif;"><br /></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0in; mso-hyphenate: none;">
<span style="background-color: white; color: #222222; font-family: "georgia" , serif;">Maenner,
M. J., Arneson, C. L., Levy, S. E., Kirby, R. S., Nicholas, J. S., &
Durkin, M. S. (2012). Brief report: Association between behavioral
features and gastrointestinal problems among children with autism spectrum
disorder. J<i> Autism Dev Disord</i> 42:1520–1525. DOI
10.1007/s10803-011-1379-6<o:p></o:p></span></div>
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<span style="background-color: white; color: #222222; font-family: "georgia" , serif;"><br /></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0in; mso-hyphenate: none;">
<span style="background-color: white; color: #222222; font-family: "georgia" , serif;">Mayes,
S. D., Calhoun, S. L., Murray, M. J., & Zahid, J. (2011). Variables
associated with anxiety and depression in children with autism. <i>Journal
of Developmental and Physical Disabilities, 23</i>, 325–337.<o:p></o:p></span></div>
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<span style="background-color: white; color: #222222; font-family: "georgia" , serif;"><br /></span></div>
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<span style="background-color: white; color: #222222; font-family: "georgia" , serif;">Mazurek,
M. O., Vasa, R. A., Kalb, L. G., Kanne, S. M., Rosenberg, D., Keefer, A., et
al. (2013). Anxiety, sensory over-responsivity, and gastrointestinal problems
in children with autism spectrum disorders. <i>Journal of Abnormal Child
Psychology, 41</i>, 165–176.<o:p></o:p></span></div>
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<span style="background-color: white; color: #222222; font-family: "georgia" , serif;">Mazurek,
M. O., Kanne, S. M., & Wodka, E. L. (2013). Physical aggression
in children and adolescents with autism spectrum disorders. <i>Research in
Autism Spectrum Disorders, 7</i>, 455–465.<o:p></o:p></span></div>
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<span style="background-color: white; color: #222222; font-family: "georgia" , serif;">Mazzone,
L., Ruta, L., & Reale, L. (2012). Psychiatric comorbidities in Asperger
syndrome and high functioning autism: diagnostic challenges. <i>Annals of
General Psychiatry, </i>11:16. doi:10.1186/1744-859X-11-16<o:p></o:p></span></div>
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<span style="background-color: white; color: #222222; font-family: "georgia" , serif;">Sikora,
D. M., Vora, P., Coury, D. L., & Rosenberg, D. (2012).
Attention-Deficit/Hyperactivity Disorder Symptoms, Adaptive Functioning, and
Quality of Life in Children With Autism Spectrum Disorder. <i>Pediatrics</i>,
130, S91-97. DOI: 10.1542/peds.2012-0900G<o:p></o:p></span></div>
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<span style="background-color: white; color: #222222; font-family: "georgia" , serif;">Strang,
J. F., Kenworthy, L., Daniolos, P., Case, L., Wills, M. C., Martin, A., et al.
(2012). Depression and anxiety symptoms in children and adolescents with autism
spectrum disorders without intellectual disability. <i>Research in Autism
Spectrum Disorders, 6</i>(1), 406–412.<o:p></o:p></span></div>
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<span style="background-color: white; color: #222222; font-family: "georgia" , serif;">Tureck,
K., Matson, J. L., May, A., Whiting, S. E., & Davis, T. E., III. (2013).
Comorbid symptoms in children with anxiety disorders compared to children with
autism spectrum disorders. <i>Journal of Developmental and Physical
Disabilities</i>. doi: 10.1007/s10882-013<o:p></o:p></span></div>
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<span style="background-color: white; color: #222222; font-family: "georgia" , serif;">Wilkinson,
L. A. (2015). <i>Overcoming Anxiety on the Autism Spectrum: A Self-Help
Guide Using CBT. </i>London and Philadelphia: Jessica Kingsley Publishers<i>.</i><o:p></o:p></span></div>
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<span style="background-color: white; color: #222222; font-family: "georgia" , serif;">Wilkinson,
L. A. (2017). <i>A best practice guide to assessment and
intervention for autism spectrum disorder in schools (2nd ed.).</i> London
& Philadelphia : Jessica Kingsley Publishers.<o:p></o:p></span></div>
<span style="background-color: white; font-family: "georgia" , serif; font-size: 12pt;">
</span><br />
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<b><span style="background-color: white; color: #222222; font-family: "georgia" , serif;">Lee A. Wilkinson</span></b><span style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; color: #222222; font-family: "georgia" , serif;"><span style="background-color: white;">, PhD, is a licensed and nationally certified school
psychologist, and certified cognitive-behavioral
therapist. He is author of the award-winning books, <i><a href="http://www.amazon.com/Practice-Assessment-Intervention-Asperger-Syndrome/dp/1849058113">A
Best Practice Guide to Assessment and Intervention for Autism and Asperger
Syndrome in Schools</a> </i>and <i><a href="http://www.amazon.com/Overcoming-Anxiety-Depression-Autism-Spectrum/dp/1849059276/ref=sr_1_1?s=books&ie=UTF8&qid=1412370192&sr=1-1&keywords=overcoming+anxiety+and+depression+on+the+autism+spectrum">Overcoming
Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT</a></i>. He
is also editor of a text in the American Psychological Association
(APA) School Psychology Book Series, <i><a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156">Autism
Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and
Intervention in Schools</a>. </i>His latest book is <i><a href="https://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8">A
Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder
in Schools (2nd Edition)</a></i>.</span><span style="background-color: yellow;"><o:p></o:p></span></span></div>
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bestpracticeautism.comhttp://www.blogger.com/profile/16482478063587857508noreply@blogger.comtag:blogger.com,1999:blog-2020163043039993952.post-6490893144219270112021-04-02T12:51:00.000-04:002021-04-03T20:06:07.279-04:00Autism: Parent Acceptance and Empowerment<div dir="ltr" style="text-align: left;" trbidi="on">
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<b>Parent Acceptance and Empowerment</b></div>
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<span style="font-family: "georgia";"><br /></span>
<span style="font-family: "georgia";">Parents are often
overwhelmed by the challenges presented by a child with autism. Research has shown that
parents of children on the spectrum exhibit a characteristic stress profile which
includes anxiety related to the child's uneven intellectual profiles, deficits
in <span class="apple-style-span"><span style="font-family: "georgia";">social
relatedness, </span></span>disruptive and maladaptive behaviors (internalizing
and externalizing problems) and long-term care concerns. </span><span style="font-family: "georgia";">Among th</span><span style="font-family: "georgia";">ese stressors, the child’s maladaptive behavior profile is most reliably linked to parent stress.</span><span style="color: black; font-family: "georgia"; font-size: 10pt;"> </span><br />
<span style="font-family: "georgia";"><span style="font-family: "georgia";"><br /></span></span>
<span style="font-family: "georgia";"><span style="font-family: "georgia";">Studies i</span><span style="font-family: "georgia";">ndicate that raising children with autism is associated with higher levels of parenting stress and psychological
distress than parenting typically developing children, children with a
physical disability, or children with developmental delays without autism. Mothers,
in particular, appear to face unique challenges related to the characteristics
of autism. Because autism impairs social relatedness and adaptive functioning,
parent stress can </span><span style="color: black; font-family: "georgia";">decrease helpful psychological
processes and directly </span><span style="font-family: "georgia";">influence the parent or caregiver’s ability to
support the child with disabilities.</span></span></div>
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<span style="font-family: "georgia";"><b>Research</b></span></div>
<span style="font-family: "georgia";"><br /></span>
<span style="font-family: "georgia";">Increased attention is now
being given to the psychological well-being of parents of children and youth with autism.
<span style="color: black;">A number of studies have examined the factors that
can influence the impact of children’s problem behavior on parent mental
health. A study in the Journal <i>Autism</i> examined the
relationships between child problem behavior, parent mental health problems,
<i>psychological acceptance</i> (e.g., accepting and not being adversely influenced by
negative emotions and thoughts that a parent may have about their child), and
parent <i>empowerment</i> (e.g., actively attempting to change or eliminate
potentially stressful events through the application of knowledge and skills).</span></span></div>
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<i><span style="font-family: "georgia";">The
researchers found that the more positive parents’ psychological acceptance and
empowerment, the less they reported severe mental health problems. Although
greater parent empowerment was associated with fewer parent mental health
problems, </span><span style="font-family: "georgia";">psychological acceptance</span></i><span style="font-family: "georgia";"><i> had the greatest impact on parent
mental health problems, after controlling for ASD symptomatology, negative life
events, parent and child gender, and child age. </i></span><span style="font-family: "georgia"; font-size: 14pt;"></span></div>
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<b style="font-family: georgia;">Implications</b></div>
<span style="font-family: "georgia";"><br /></span>
<span style="font-family: "georgia";">This study has several
important implications. The relatively chronic nature of behavior problems in
children with autism may explain why acceptance is a more significant
psychological construct for explaining parent mental health than is
empowerment. If difficulties are manageable and support readily available,
then an active, problem-focused coping style would be related to improved parent
adjustment. However, for children with autism who exhibit more persistent behavior
problems, or for highly stressed and frustrated parents, a problem-focused
process may not be enough to ensure positive parent adjustment. If problems are
less controllable and/or support less accessible, it may be impossible for
parents to focus exclusively on trying to change or avoid their current
experience. The authors comment, “<i>In these situations, parents need a different
coping strategy, one that allows them to acknowledge their current experience
without trying to change it or avoid it.</i>”
Therefore, it may be critically important to understand and evaluate the
situation of the family, and offer parents both types of coping skills (acceptance
and empowerment) for use across different situations.<span style="color: black;"></span></span></div>
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<span style="font-family: "georgia"; font-size: 14pt;"></span><span style="font-family: "georgia";">This study supports
the exploration of acceptance and mindfulness-based interventions as effective
approaches for parents of children with autism and underscores the importance of
considering the parent psychological experience when developing interventions. The authors conclude, “<i>Child-focused therapy should not
focus exclusively on the child. At the same time that we provide parents with
skills and supports to improve their children’s experience, we must also invest
in helping parents to deal with their own emotions and coping strategies.</i>”</span><span style="font-family: "georgia"; font-size: 14pt;"> </span><span style="font-family: "georgia"; font-size: 14pt;"></span></div>
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<span style="font-family: "georgia";">Weiss, J. A., Cappadocia,
M. C., MacMullin, J. A., Viecili, M., & Lunsky, Y. (2012). The impact of child
problem behaviors of children with ASD on parent mental health: The mediating
role of acceptance and empowerment<i>. Autism, 16</i>, 261-274. DOI:
10.1177/1362361311422708</span></div>
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<b><span style="background: white; color: #1d2129; font-family: "georgia" , serif;">Lee
A. Wilkinson</span></b><span style="background: white; color: #1d2129; font-family: "georgia" , serif;">, PhD, is a licensed and nationally certified school
psychologist, and certified cognitive-behavioral
therapist. He is author of the award-winning books, <i><a href="http://www.amazon.com/Practice-Assessment-Intervention-Asperger-Syndrome/dp/1849058113">A Best Practice Guide to Assessment and
Intervention for Autism and Asperger Syndrome in Schools</a> </i>and <i><a href="http://www.amazon.com/Overcoming-Anxiety-Depression-Autism-Spectrum/dp/1849059276/ref=sr_1_1?s=books&ie=UTF8&qid=1412370192&sr=1-1&keywords=overcoming+anxiety+and+depression+on+the+autism+spectrum">Overcoming Anxiety and Depression on the
Autism Spectrum: A Self-Help Guide Using CBT</a>. </i>He is also
editor of a text in the APA School Psychology Book
Series, <i><a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156">Autism Spectrum Disorder in Children and
Adolescents: Evidence-Based Assessment and Intervention in Schools</a></i><i>.</i> His latest book is<i> <a href="http://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8">A Best Practice Guide to Assessment and
Intervention for Autism Spectrum Disorder in Schools (2nd Edition)</a></i><i>.</i></span></div>
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bestpracticeautism.comhttp://www.blogger.com/profile/16482478063587857508noreply@blogger.com3tag:blogger.com,1999:blog-2020163043039993952.post-68625130610508071522021-03-02T19:56:00.007-05:002021-03-03T15:05:22.536-05:00Autistic Girls, Boys Differ in Social Communication<p><span style="font-family: georgia;"></span></p><div class="separator" style="clear: both; text-align: center;"><span style="font-family: georgia;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEix2gjalKArKh7iNJNP2G74RO8gYOe8cSKE5xalp46aKnpfZg2Si0LYNY118z_msT56uN9SzR_ZObbQueHSNIjxjSITr90mEq8r2cawKNqhe2H9nfZ-lkoTG5mgHcW-nzNLqgG3SilalcWS/s2048/GirlsSocialGroup3.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1308" data-original-width="2048" height="255" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEix2gjalKArKh7iNJNP2G74RO8gYOe8cSKE5xalp46aKnpfZg2Si0LYNY118z_msT56uN9SzR_ZObbQueHSNIjxjSITr90mEq8r2cawKNqhe2H9nfZ-lkoTG5mgHcW-nzNLqgG3SilalcWS/w400-h255/GirlsSocialGroup3.jpg" width="400" /></a></span></div><span><br /><div style="text-align: center;"><div style="-webkit-font-smoothing: antialiased; border: 0px; box-sizing: border-box; font-stretch: inherit; font-variant-east-asian: inherit; font-variant-numeric: inherit; line-height: 1; margin: 0px 0px 24px; outline: 0px; padding: 0px; text-align: center; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;"><b><span style="font-family: verdana; font-size: medium;">Autistic girls, boys differ in how they talk about social groups</span></b></div></div></span><p></p><div style="text-align: center;"><span style="font-family: courier;"><span class="author-header-authors" style="-webkit-font-smoothing: antialiased; border: 0px; box-sizing: border-box; color: #777777; font-stretch: inherit; font-variant-east-asian: inherit; font-variant-numeric: inherit; letter-spacing: 1px; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; text-rendering: optimizelegibility; text-transform: uppercase; vertical-align: baseline; word-break: normal;"><span class="author-header-names" style="-webkit-font-smoothing: antialiased; border: 0px; box-sizing: border-box; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;"><a class="author url fn" href="https://www.spectrumnews.org/author/charlesqchoi/" rel="author" style="-webkit-font-smoothing: antialiased; border: 0px; box-sizing: border-box; color: black; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;" title="Posts by Charles Q. Choi"><span><b>CHARLES Q.CHOI</b></span></a></span></span><span face="azo-sans-web, "Azo Sans", Azo-Sans, Azo, sans-serif" style="color: #777777; font-weight: bold; letter-spacing: 1px; text-transform: uppercase;"> </span></span></div><p><span style="font-family: georgia;"><span style="font-style: inherit; font-variant-caps: inherit; font-variant-ligatures: inherit; font-weight: inherit;">During conversations, girls with autism use “we,” “they” and other</span><span style="font-style: inherit; font-variant-caps: inherit; font-variant-ligatures: inherit; font-weight: inherit;"> </span>words related to social </span>groups<span style="font-family: georgia; font-style: inherit; font-variant-caps: inherit; font-variant-ligatures: inherit; font-weight: inherit;"> </span><span style="font-family: georgia; font-style: inherit; font-variant-caps: inherit; font-variant-ligatures: inherit; font-weight: inherit;">differently than autistic boys do, according to a new study.</span></p><article style="-webkit-font-smoothing: antialiased; border: 0px; box-sizing: border-box; font-stretch: inherit; font-variant-east-asian: inherit; font-variant-numeric: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;"><p style="-webkit-font-smoothing: antialiased; border: 0px; box-sizing: border-box; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.6842; margin: 0px 0px 30px; outline: 0px; padding: 0px; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;"><span style="font-family: georgia;">The findings could help parents and clinicians identify autism in girls, who tend to be diagnosed less often and later than boys, researchers say.</span></p><p style="-webkit-font-smoothing: antialiased; border: 0px; box-sizing: border-box; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: 1.6842; margin: 0px 0px 30px; outline: 0px; padding: 0px; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;"><span style="font-family: georgia;"><span style="font-weight: inherit;">The failure to recognize autism in girls can put them at an </span><span style="border-color: initial; border-image: initial; border-style: initial; box-sizing: border-box; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; outline-color: initial; outline-style: initial; transition-duration: 0.15s; transition-property: color; transition-timing-function: ease-out;">increased risk of mental health problems</span><span style="font-weight: inherit;"> such as anxiety, depression and suicidality.</span></span></p><p style="-webkit-font-smoothing: antialiased; border: 0px; box-sizing: border-box; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.6842; margin: 0px 0px 30px; outline: 0px; padding: 0px; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;"><span style="font-family: georgia; font-style: inherit; font-variant-caps: inherit; font-variant-ligatures: inherit; font-weight: inherit;">“If girls with autism are not properly understood, then these girls may not get access to the proper resources they need early in life to get the support they need to flourish and reach their full potential,” says lead investigator</span><span style="font-family: georgia; font-style: inherit; font-variant-caps: inherit; font-variant-ligatures: inherit; font-weight: inherit;"> </span><span style="font-family: georgia;">Julia Parish-Morris</span><span style="font-family: georgia; font-style: inherit; font-variant-caps: inherit; font-variant-ligatures: inherit; font-weight: inherit;">, assistant professor of psychiatry at the University of Pennsylvania.</span></p><p style="-webkit-font-smoothing: antialiased; border: 0px; box-sizing: border-box; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.6842; margin: 0px 0px 30px; outline: 0px; padding: 0px; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;"><span style="font-family: georgia;">To gain insight into gender differences in problems with social communication — a core trait of autism — Parish-Morris and her colleagues analyzed how girls and boys with and without autism talk about other people during unscripted conversations.</span></p><p style="-webkit-font-smoothing: antialiased; border: 0px; box-sizing: border-box; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.6842; margin: 0px 0px 30px; outline: 0px; padding: 0px; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;"><span style="font-family: georgia;">“This is one of the few studies that have used natural language samples and not just responses to standardized tests to examine the difference in social interest between boys and girls with autism and typically developing boys and girls,” says Jenny Burton, a speech-language pathologist who was not involved with the study. It is also one of few studies to support the idea that, compared with autistic boys, girls with the condition have strengths in social interaction and motivation, she says.</span></p><div style="border: 0px; box-sizing: border-box; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.6842; margin: 0px 0px 30px; outline: 0px; padding: 0px; text-align: left; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;"><b style="-webkit-font-smoothing: antialiased; border: 0px; box-sizing: border-box; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;"><span style="font-family: georgia; font-size: medium;">Word search:</span></b></div><p style="-webkit-font-smoothing: antialiased; border: 0px; box-sizing: border-box; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.6842; margin: 0px 0px 30px; outline: 0px; padding: 0px; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;"><span style="font-family: georgia;">The scientists recorded audio and video as each participant took part in an informal five-minute ‘get to know you’ conversation with an undergraduate student or research assistant. The sample included 17 girls and 33 boys with autism, and 15 girls and 22 boys without the condition, all aged 8 to 17 and matched for age and intelligence quotient. They also matched the autistic children for levels of social impairment.</span></p><p style="-webkit-font-smoothing: antialiased; border: 0px; box-sizing: border-box; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.6842; margin: 0px 0px 30px; outline: 0px; padding: 0px; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;"><span style="font-family: georgia;">Computer programs transcribed the conversations and counted the number of plural personal pronouns — those that refer to groups of people, such as “we,” “us,” “they” and “them” — as well as words with social connotations, such as “family” and “friends.” The researchers then calculated how often a child used these words relative to the total number of words he or she said overall.</span></p><p style="-webkit-font-smoothing: antialiased; border: 0px; box-sizing: border-box; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.6842; margin: 0px 0px 30px; outline: 0px; padding: 0px; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;"><span style="font-family: georgia;">Autistic girls use plural personal pronouns almost twice as often as autistic boys do, and they use social words more often as well, the researchers found. The study was published in November in the <i style="-webkit-font-smoothing: antialiased; border: 0px; box-sizing: border-box; font-stretch: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;">Journal of Child Psychology and Psychiatry</i>.</span></p><p style="-webkit-font-smoothing: antialiased; border: 0px; box-sizing: border-box; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.6842; margin: 0px 0px 30px; outline: 0px; padding: 0px; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;"><span style="font-family: georgia;">The findings may indicate that girls are “pressured to conform socially,” Parish-Morris says. “Pronouns can give hints about social embeddedness or the sense of social belonging, which matters with conditions with social challenges such as autism.”</span></p><p style="-webkit-font-smoothing: antialiased; border: 0px; box-sizing: border-box; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: 1.6842; margin: 0px 0px 30px; outline: 0px; padding: 0px; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;"><span style="font-family: georgia;"><span style="font-weight: inherit;">The findings agree with previous research suggesting that autistic girls are more motivated to socialize than autistic boys — for instance, autistic girls tend to </span><span style="color: black;"><a href="https://doi.org/10.1177/1362361316671845" rel="noopener noreferrer" style="-webkit-font-smoothing: antialiased; border: 0px; box-sizing: border-box; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration-line: none; text-rendering: optimizelegibility; transition: color 0.15s ease-out 0s; vertical-align: baseline; word-break: normal;" target="_blank"><span style="color: black;">hover near other children</span></a> </span><span style="font-weight: inherit;">on playgrounds, whereas autistic boys tend to play alone.</span></span></p><p style="-webkit-font-smoothing: antialiased; border: 0px; box-sizing: border-box; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.6842; margin: 0px 0px 30px; outline: 0px; padding: 0px; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;"><span style="font-family: georgia;">Autistic girls also use “they” and “them” more often than non-autistic girls do, the study found. Such heightened discussion of groups autistic girls are not members of may indicate they are aware of their social exclusion, the scientists note. “Saying ‘we did this and that’ is a very different frame of reference from saying ‘they did this or that,’” Parish-Morris says.</span></p><div style="border: 0px; box-sizing: border-box; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.6842; margin: 0px 0px 30px; outline: 0px; padding: 0px; text-align: left; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;"><b style="-webkit-font-smoothing: antialiased; border: 0px; box-sizing: border-box; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;"><span style="font-family: georgia; font-size: medium;">Not a monolith:</span></b></div><p style="-webkit-font-smoothing: antialiased; border: 0px; box-sizing: border-box; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.6842; margin: 0px 0px 30px; outline: 0px; padding: 0px; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;"><span style="font-family: georgia;">Overall, the study shows that autistic children and adolescents use significantly fewer plural personal pronouns than their non-autistic peers do. If the same pattern holds true for even younger children, diminished or atypical use of personal pronouns might prove useful to flag children for diagnosis, the researchers suggest.</span></p><p style="-webkit-font-smoothing: antialiased; border: 0px; box-sizing: border-box; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.6842; margin: 0px 0px 30px; outline: 0px; padding: 0px; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;"><span style="font-family: georgia;">The findings underscore the idea that “autism is not a monolith — it manifests differently across sexes and genders and ages and cultures,” Parish-Morris says.</span></p><p style="-webkit-font-smoothing: antialiased; border: 0px; box-sizing: border-box; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.6842; margin: 0px 0px 30px; outline: 0px; padding: 0px; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;"><span style="font-family: georgia;">As a next step, researchers could explore how autistic girls and boys differ when talking with other children instead of with adults.</span></p><p style="-webkit-font-smoothing: antialiased; border: 0px; box-sizing: border-box; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.6842; margin: 0px 0px 30px; outline: 0px; padding: 0px; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;"><span style="font-family: georgia;">Future studies could also analyze the specific socially connoted words autistic girls and boys use.</span></p><p style="-webkit-font-smoothing: antialiased; border: 0px; box-sizing: border-box; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.6842; margin: 0px 0px 30px; outline: 0px; padding: 0px; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;"><span style="font-family: georgia;">“It would be interesting knowing whether they are referencing family versus peers, due to potentially fewer social activities with peers and more time with family,” says Rene Jamison, associate professor of pediatrics at the University of Kansas in Kansas City, who did not take part in the new research. “In my research, we have found that when girls are in the 8 to 12 age range, both girls with and without autism would reference their family more than their peers, but as they grow older, we would expect girls without autism to shift to more external social groups, but girls with autism would not shift as much.”</span></p><div style="border: 0px; box-sizing: border-box; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.6842; margin: 0px 0px 30px; outline: 0px; padding: 0px; text-align: left; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;"> <span style="font-family: georgia; font-style: inherit; font-variant-caps: inherit; font-variant-ligatures: inherit; font-weight: inherit; text-align: center;">This article
was published on </span><a href="https://www.spectrumnews.org/">Spectrum</a><span style="font-family: georgia; font-style: inherit; font-variant-caps: inherit; font-variant-ligatures: inherit; font-weight: inherit; text-align: center;">, the
leading site for autism research news.</span></div><div style="border: 0px; box-sizing: border-box; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.6842; margin: 0px 0px 30px; outline: 0px; padding: 0px; text-align: left; text-rendering: optimizelegibility; vertical-align: baseline; word-break: normal;"><span style="font-family: georgia; margin-left: 1em; margin-right: 1em; text-align: center; text-indent: -0.25in;"> <img border="0" data-original-height="80" data-original-width="72" height="50" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjGY6s2Vy9xv5Az3zdbcpv_4ZN2lHRpeArHoFjwe87uOs7EJUY3QEtIhkBsTaFirEDJe0qp4-ApYP8pHLMgNeIxKnfqNFSBcQ-i4sq2QLZVqGomBFbzY1yuj_O78g1JVx8TQU7v14ZL1qe-/w45-h50/spectrum-mark-orange.png" width="45" /></span> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjGY6s2Vy9xv5Az3zdbcpv_4ZN2lHRpeArHoFjwe87uOs7EJUY3QEtIhkBsTaFirEDJe0qp4-ApYP8pHLMgNeIxKnfqNFSBcQ-i4sq2QLZVqGomBFbzY1yuj_O78g1JVx8TQU7v14ZL1qe-/s80/spectrum-mark-orange.png" style="font-family: georgia; font-size: 16px; margin-left: 1em; margin-right: 1em; text-align: center; text-indent: -0.25in;"><br /></a><div style="font-family: georgia; font-size: 16px; margin-left: 1em; margin-right: 1em; text-align: center; text-indent: -0.25in;"><a href="https://www.spectrumnews.org/news/autistic-girls-boys-differ-in-how-they-talk-about-social-groups/" style="font-style: inherit; font-variant-caps: inherit; font-variant-ligatures: inherit; font-weight: inherit; text-align: left;">https://www.spectrumnews.org/news/autistic-girls-boys-differ-in-how-they-talk-about-social-groups/</a></div></div><div><p class="MsoNormal" style="line-height: normal; margin-bottom: 0in;"><span style="font-family: georgia;">Lee A.
Wilkinson, PhD, is author of the award-winning books, </span><i style="font-family: georgia;"> <a href="https://www.amazon.com/Practice-Assessment-Intervention-Asperger-Syndrome/dp/1849058113">A Best Practice Guide to Assessment and Intervention for Autism and Asperger in Schools</a> </i><span style="font-family: georgia;">and </span><i style="font-family: georgia;"><a href="https://www.amazon.com/Overcoming-Anxiety-Depression-Autism-Spectrum/dp/1849059276/ref=sr_1_1?s=books&ie=UTF8&qid=1412370192&sr=1-1&keywords=overcoming+anxiety+and+depression+on+the+autism+spectrum">Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT</a>. </i><span style="font-family: georgia;">He
is also editor of a text in the APA School Psychology Book Series, </span><i style="font-family: georgia;"><a href="https://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156">Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools</a></i><span style="font-family: georgia;">. His latest book is</span><i style="font-family: georgia;"> <a href="https://www.amazon.com/dp/1785927043/ref=sm_n_ma_dka_US_pr_ran_0_1?adId=1785927043&creativeASIN=1785927043&linkId=254e5b67d2b38ae6ecf36501006e98a8&tag=ncsp1046-20&linkCode=w43&ref-refURL=https%3A%2F%2Fbestpracticeautism.blogspot.com%2F&slotNum=0&imprToken=VXhspEa5l.ZTb-VGAR01wA&adType=smart&adMode=manual&adFormat=grid&impressionTimestamp=1614779441433">A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition)</a></i></p><br /></div></article>bestpracticeautism.comhttp://www.blogger.com/profile/16482478063587857508noreply@blogger.com0tag:blogger.com,1999:blog-2020163043039993952.post-2001191976265601972021-03-01T18:43:00.002-05:002021-03-02T19:55:10.225-05:00Co-Occurring ADHD in Autistic Children <div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "georgia";">Interest in the
co-occurrence of autism spectrum disorder (ASD) and
attention-deficit/hyperactivity disorder (ADHD) has grown in the last decade.
Both are neurodevelopmental disorders with onset of symptoms in early
childhood. Research, practice and theoretical models indicate that these
disorders frequently overlap and co-occur. For example, studies conducted in
the US and Europe indicate that children with ASD in clinical settings present
with comorbid (co-occurring) symptoms of ADHD with rates ranging between 37%
and 85%. In fact, </span><span style="font-family: "georgia" , serif;">ADHD is a relatively common initial diagnosis in
young children with ASD. Some researchers suggest that there are sub-groups of
children with ASD with and without ADHD symptoms.</span><br />
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<span style="font-family: "georgia" , serif;"><o:p></o:p></span></div>
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<span style="font-family: "georgia";">More severe externalizing, internalizing and social problems, as well
as more impaired adaptive functioning, and more autistic traits and maladaptive
behaviors have been reported in children with both ASD and ADHD than children
identified with only ASD. For example, school-age
children with co-occurrence of ASD and ADHD were significantly more impaired
than children with only ASD on measures of cognitive and social functioning, as
well as in the ability to function in everyday situations. </span><span style="font-family: "georgia" , serif;">Symptoms included inattention, impulsivity, hyperactivity
and other features such as low frustration tolerance, poor self-monitoring,
temper and anger management problems, and mood changes in the classroom. </span><span style="font-family: "georgia";">They were also more
likely to have significant cognitive delays and display more severe autism
mannerisms, such as stereotypic and repetitive behaviors in comparison with
children identified with only ASD.</span></div>
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<span style="font-family: "georgia";"><i>It is imperative that
practitioners recognize the high co-occurrence rates of these two disorders as
well as the potential increased risk for social and adaptive impairment
associated with comorbidity of ASD and ADHD. Children with the combined
presence of ASD and ADHD may need different treatment methods or intensities
than those with ASD only in order to achieve better outcomes.</i></span></div>
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<span style="font-family: "georgia";">If clinically significant
ADHD symptoms are identified, and social development does not appear to be
responding to intervention, changes in the intervention program (e.g.
intensity, strategies, and goals) may be required. It is also important to note
that a significant change in the DSM-5 is removal of the DSM-IV-TR hierarchical
rules prohibiting the concurrent diagnosis of ASD and ADHD. When the criteria
are met for both disorders, both diagnoses are given. Thus, an assessment of
ADHD characteristics should be included whenever inattention and/or impulsivity
are indicated as presenting problems. </span><br />
<span style="font-family: "georgia" , serif;"><br /></span>
<span style="font-family: "georgia" , serif;">Although the social deficits of autism are
typically described as being “reciprocal” in nature and those of ADHD are
considered to be the result of inattention and disinhibition, the distinction
is not always easy to make in real-world practice. In addition to rating scales,
an examination of the child’s neuropsychological characteristics and profile
may be helpful in identifying the comorbidity of ASD and ADHD. For example, a comprehensive
developmental assessment may include measures of neuropsychological functions
such as working memory, planning and strategy formation, cognitive
flexibility, response inhibition, and self-regulation. </span><span style="font-family: "georgia";">More research is needed to further
clarify the behavioral characteristics of children with co-occurring ASD and
ADHD so that specialized treatments and interventions may be designed to
improve outcomes and quality of life for this group of children. </span><span style="font-family: "georgia" , serif;">Further
information on best practice guidelines for assessment of ASD is available
from </span><i style="font-family: Georgia, serif;"><a href="http://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8">A
Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder
in Schools (2nd Edition)</a></i><br />
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<span style="font-family: "georgia";"><b>Key References and Further Reading</b></span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;"><br /></span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;">American Psychiatric Association. (2013). </span><i style="font-family: Georgia, "Times New Roman", serif;">Diagnostic and statistical
manual of mental disorders </i><span style="font-family: "georgia" , "times new roman" , serif;">(5th ed.) Washington, DC: Author.</span></div>
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<o:p></o:p></div>
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<span style="font-family: "georgia" , serif;">Colombi, C., & Ghaziuddin, M. (2017).
Neuropsychological Characteristics of Children with Mixed Autism and
ADHD. </span><i style="font-family: Georgia, serif;">Autism Research and Treatment</i><span style="font-family: "georgia" , serif;">, 1-5. </span></div>
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<span style="background-color: white; font-family: "georgia" , serif;"><br /></span></div>
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<span style="background-color: white; font-family: "georgia" , serif;">Doepke, K. J., </span><strong style="box-sizing: border-box; font-family: Georgia, serif;"><span style="font-weight: normal;">Banks, B. M.</span></strong><span style="background-color: white; font-family: "georgia" , serif;">,
Mays, J. F., Toby, L. M., & Landau, S. (2014). Co-occurring emotional and
behavior problems in children with Autism Spectrum Disorders. In L. Wilkinson
(Ed.), </span><em style="box-sizing: border-box; font-family: Georgia, serif;">Autism Spectrum Disorders in Children and
Adolescence: Evidence-based Assessment and Intervention in Schools</em><em style="font-family: Georgia, serif;"><span style="font-style: normal;"> </span></em><span style="background-color: white; font-family: "georgia" , serif;">(pp.
125-148). Washington, DC: American Psychological Association.</span></div>
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<span style="font-family: "georgia" , serif;"><br /></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0in;">
<span style="font-family: "georgia" , serif;">Kuhlthau K.,
Orlich F., Hall T.A., et al. (2010). Health- Related Quality of Life in
children with autism spectrum disorders: results from the autism treatment
network. </span><i><span style="font-family: "georgia" , serif;">Journal of
Autism and Developmental Disorders</span></i><span style="font-family: "georgia" , serif;">, 40(6), 721–729.<o:p></o:p></span></div>
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<span style="font-family: "georgia" , serif; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;"><br /></span></div>
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<span style="font-family: "georgia" , serif; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;">Loveland
K. A., Tunali-Kotoski, B. (2005), The school age child with autism. In F. R.
Volkmar, R. Paul, A. Klin, & D. Cohen (Eds.), <i>Handbook of autism and
pervasive developmental</i> <i>disorders: Vol. 1. Diagnosis, development,
neurobiology, and behavior </i>(3rd ed., pp. 247-287). New York: Wiley.<o:p></o:p></span></div>
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<span style="font-family: "georgia" , serif;"><br /></span></div>
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<span style="font-family: "georgia" , serif;">Murray M.J.,
(2010). Attention-deficit/hyperactivity disorder in the context of autism
spectrum disorders. </span><i><span style="font-family: "georgia" , serif;">Current<u>
</u>Psychiatry<u> </u>Reports</span></i><span style="font-family: "georgia" , serif;">, 12(5), 382–388.<o:p></o:p></span></div>
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<span style="font-family: "georgia";"><br /></span></div>
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<span style="font-family: "georgia";">Rao, P. A., & and
Landa, R. J. (2014). Association between severity of behavioral phenotype and
comorbid attention deficit hyperactivity symptoms in children with autism
spectrum disorders. </span><i style="font-family: georgia;">Autism, 18</i><span style="font-family: "georgia";">, 272-280.</span></div>
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<span style="font-family: "georgia" , serif;"><br /></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0in; mso-layout-grid-align: none; text-autospace: none;">
<span style="font-family: georgia;"><span>Sikora, D. M., Vora, P., Coury, D. L., &
Rosenberg, D. (2012). Attention-Deficit/Hyperactivity Disorder Symptoms,
Adaptive Functioning, and Quality of Life in Children With Autism Spectrum
Disorder. </span><i>Pediatrics</i>, 130, S91-97. DOI:
10.1542/peds.2012-0900G</span></div>
</div>
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<span style="background: white; color: #1d2129; font-family: georgia;">Wilkinson, L. A. (2017). A best practice guide to assessment and intervention for autism spectrum disorder in schools. London & Philadelphia: Jessica Kingsley Publishers.</span><br />
<span style="background: white; color: #1d2129; font-family: "georgia" , serif;"><b><br /></b></span>
<span style="background: white; color: #1d2129; font-family: "georgia" , serif;"><b>Lee A. Wilkinson</b>, PhD, is
a licensed and nationally certified school psychologist, and certified cognitive-behavioral therapist. He is author of the
award-winning books, <i><a href="http://www.amazon.com/Practice-Assessment-Intervention-Asperger-Syndrome/dp/1849058113">A Best Practice Guide to Assessment and
Intervention for Autism and Asperger Syndrome in Schools</a> </i>and <i><a href="http://www.amazon.com/Overcoming-Anxiety-Depression-Autism-Spectrum/dp/1849059276/ref=sr_1_1?s=books&ie=UTF8&qid=1412370192&sr=1-1&keywords=overcoming+anxiety+and+depression+on+the+autism+spectrum">Overcoming Anxiety and Depression on the
Autism Spectrum: A Self-Help Guide Using CBT</a>. </i>He is also
editor of a text in the APA School Psychology Book
Series, <i><a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156">Autism Spectrum Disorder in Children and
Adolescents: Evidence-Based Assessment and Intervention in Schools</a></i><i>.</i> His latest book is<i> <a href="http://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8">A Best Practice Guide to Assessment and
Intervention for Autism Spectrum Disorder in Schools (2nd Edition)</a></i><i>.</i></span></div>
</div>
</div>
bestpracticeautism.comhttp://www.blogger.com/profile/16482478063587857508noreply@blogger.com0tag:blogger.com,1999:blog-2020163043039993952.post-62330419228830567212021-02-02T09:53:00.003-05:002021-03-02T19:53:25.609-05:00The Empathy Myth in Autism<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "georgia" , serif; text-align: left;">One of the most
common myths about autistic individuals is that they don’t feel empathy
towards others. There are two interrelated types of empathy: </span><i style="font-family: georgia, serif; text-align: left;">affective</i><span style="font-family: "georgia" , serif; text-align: left;"> or </span><i style="font-family: georgia, serif; text-align: left;">emotional</i><span style="font-family: "georgia" , serif; text-align: left;"> </span><i style="font-family: georgia, serif; text-align: left;">empathy</i><span style="font-family: "georgia" , serif; text-align: left;">, which
involves feeling an appropriate emotional response to another person’s emotion,
and </span><i style="font-family: georgia, serif; text-align: left;">cognitive</i><span style="font-family: "georgia" , serif; text-align: left;"> </span><i style="font-family: georgia, serif; text-align: left;">empathy</i><span style="font-family: "georgia" , serif; text-align: left;">, or </span><i style="font-family: georgia, serif; text-align: left;">Theory of Mind</i><span style="font-family: "georgia" , serif; text-align: left;">
(ToM), which involves understanding or predicting another person’s perspective.
The affective component of empathizing involves feeling an appropriate emotion
triggered by seeing/learning of another’s emotion. When engaged in affective
empathy, we vicariously experience the emotional states of others,
understanding that our feelings are not ours, but rather those of the other person.
Sympathy is also considered an affective component of empathy. It is the
feeling or emotion triggered by seeing or learning of someone else’s distress
which moves you to want to take an action that will help ease their suffering.</span></div>
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<span style="font-family: "georgia" , serif; text-align: justify;">The </span><i style="font-family: georgia, serif; text-align: justify;">cognitive </i><span style="font-family: "georgia" , serif; text-align: justify;">or ToM component of empathy
involves the understanding and/or predicting what someone else might think,
feel, or do. It is the ability to identify cues that indicate the thoughts and
feelings of others and “to put oneself into another person’s shoes.” It is also
referred to as “mentalizing,” “mindreading,” and “perspective taking.” The
ability to reflect on one’s own and other people’s minds (beliefs, desires,
intentions, imagination and emotions) allows us to interact effectively with
others in the social world. ToM may also be thought of existing on a continuum
with some individuals able to “mindread” relatively easily and intuitively,
while others experience varying degrees of problems interpreting and predicting
another person’s behavior. Most (but not all) typical individuals are able to
mindread relatively easily and intuitively. They can read another person’s
facial expression and body language, and tone of voice and recognize his or her
thoughts and feelings, and the likely course of their behavior. In other words,
they interpret, predict, and participate in </span><span style="font-family: "georgia" , serif; text-align: justify;">social
interaction</span><span style="font-family: "georgia" , serif; text-align: justify;"> automatically, and for the most part, intuitively. Often referred to as "mindblindness," it is this cognitive component of empathy that is delayed in autism.</span></div>
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<span style="font-family: "georgia" , serif; text-align: left;"><span style="font-family: "georgia" , serif; font-size: 12pt; line-height: 107%; text-align: justify;">Unfortunately, the failure to understand the difference
between affective (emotional) empathy and cognitive empathy has led to a persistent myth
and stereotype that people with autism lack empathy and
cannot understand emotion. It’s critically important to recognize that</span><span style="background: white; color: #1d2129; font-family: "georgia" , serif; font-size: 9pt; line-height: 107%; text-align: justify;"> </span><span style="font-family: "georgia" , serif; font-size: 12pt; line-height: 107%; text-align: justify;">autism
is characterized by challenges associated with cognitive empathy (ToM), not emotional empathy which is intact. </span></span><span style="font-family: "georgia" , serif; text-align: left;">Although autistic individuals may have difficulty with social cues and understanding and predicting another’s
thoughts, motives and intentions, they <span style="background: white;">have the ability
to care and be concerned about other people’s feelings. </span></span><br />
<i><span style="font-family: "georgia" , serif; text-align: left;"><br /></span></i>
<i><span style="font-family: "georgia" , serif; text-align: left;">Autism
does not deprive someone of emotional empathy! Autistic people can and do experience feelings and
emotions intensely as everyone else, even though it may not always be obvious to others in a "typical" way.</span><span style="text-align: center;"><span style="font-family: "georgia" , serif;"><o:p><b> - </b>Dr. Lee A. Wilkinson</o:p></span></span></i></div><div style="text-align: left;"><i><span style="text-align: center;"><span style="font-family: "georgia" , serif;"><o:p><br /></o:p></span></span></i></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "georgia" , serif;">Key References and Further
Reading<o:p></o:p></span></b></div>
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<span style="font-family: "georgia" , serif;">Baron-Cohen, S.
(1991). The theory of mind deficit in autism: how specific is it? British
Journal of Developmental Psychology, 9. 301-314. <o:p></o:p></span></div>
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<span style="font-family: "georgia" , serif;">Baron-Cohen, S.,
Jolliffe, T., Mortimore, C., & Robertson, M. (1997). Another advanced test
of theory of mind: evidence from very high functioning adults with autism or
Asperger Syndrome. Journal of Child Psychology and Psychiatry, 38. 813-822. <o:p></o:p></span></div>
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<span style="font-family: "georgia" , serif;">Baron-Cohen, S.,
Ring, H. A., Bullmore, E. T., Wheelwright, S., Ashwin, C., & Williams, S.
C. R. (2000). The amygdala theory of autism. Neuroscience & Biobehavioral
Reviews, 24(3), 355-364. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Baron-Cohen, S.,
& Swettenham, J. (1997). Theory of mind in autism: Its relationship to
executive function and central coherence. Handbook of autism and pervasive
developmental disorders, 880-893.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Baron-Cohen, S.
(2000). Theory of mind in autism: A fifteen year review. In S. Baron-Cohen, H.
TagerFlusberg, & D. J. Cohen (Eds.), Understanding other minds:
Perspectives from developmental cognitive neuroscience (pp. 3–20). New York:
Oxford University Press<o:p></o:p></span></div>
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<span style="font-family: "georgia" , serif;">Fletcher-Watson,
S, McConnell, F, Manola, E & McConachie, H 2014, 'Interventions based on
the Theory of Mind cognitive model for autism spectrum disorder (ASD)' Cochrane
database of systematic reviews. DOI: 10.1002/14651858.CD008785.p<o:p></o:p></span></div>
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<span style="font-family: "georgia" , serif;">Begeer S. Theory
of mind interventions can be effective in treating autism, although long-term
success remains unproven <i>Evidence-Based Mental Health </i>2014;<b>17:</b>120.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Fletcher-Watson S,
McConnell F, Manola E, McConachie H. Interventions based on the Theory of Mind
cognitive model for autism spectrum disorder (ASD). Cochrane Database of
Systematic Reviews 2014, Issue 3. Art. No.: CD008785. DOI:
10.1002/14651858.CD008785.pub2<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Gray, C. A.
(1998). Social stories and comic strip conversations with students with
Asperger Syndrome and high-functioning Autism. In E. Schopler, G. B. Mesibov,
& L. J. Kunce (Eds.), Asperger syndrome or high functioning autism? (pp.
167-194). NY: Plenum Press.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Hutchins, T.,
& Prelock, P. A. (2008). Supporting theory of mind development:
Considerations and recommendations for professionals providing services to
individuals with ASD. Topics in Language Disorders, 28 (4), 340-364.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">O’Brien, K.,
Slaughter, V. & Peterson, C.C. (2011). Sibling influences on theory of mind
development for children with ASD. J Child Psychology & Psychiatry, 52(6),
713-719. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">O’Hare, A.E.,
Bremner, L., Nash, M., Happe, F., Pettigrew, L.M. (2009). A clinical assessment
tool for advanced theory of mind performance in 5 to 12 year olds. JADD, 39(6),
916-928.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Sprung, M. (2010).
Clinically relevant measures of children’s theory of mind and knowledge about
thinking: Non-standard and advanced measures. Child and Adolescent Mental
Health, 15(4), 204-216.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Tager-Flusberg, H.
(2001). A reexamination of the theory of mind hypothesis of Autism. In J. A.
Burack, T. Charman., N. Yirmiya., & P. R. Zelazo (Eds.), The development of
autism: Perspectives from theory and research (pp.173-193). Mahwah, NJ:
Lawrence Erlbaum.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Wellman, H. M.,
Baron-Cohen, S., Caswell, R., Gomez, J. C., Swettenham, J., Toye, E., &
Lagattuta, K. (2002). Thought-bubbles help children with autism acquire an
alternative to a theory of mind. Autism, 6(4), 343-363.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Wilkinson, L. A.
(2011). Mindblindness in <i>Encyclopedia of Child Behavior and
Development</i>, Part 13, 955-956, DOI: 10.1007/978-0-387-79061-9_1795<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Wilkinson, L. A. (2015). <i>Overcoming
Anxiety on the Autism Spectrum: A Self-Help Guide Using CBT</i><i>. </i><span style="mso-bidi-font-style: italic;">London and Philadelphia: Jessica Kingsley
Publishers<i>.</i></span><o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Wilkinson, L. A.
(2017<i style="mso-bidi-font-style: normal;">). A best practice guide to
assessment and intervention for autism spectrum disorder in schools</i>.
Jessica Kingsley Publishers. London and Philadelphia.<o:p></o:p></span></div>
<div class="MsoNormal">
<b><span style="font-family: "georgia" , serif;">Lee A.
Wilkinson</span></b><span style="font-family: "georgia" , serif;">, PhD, is a
licensed and nationally certified school psychologist, and certified cognitive-behavioral therapist. He is author of the
award-winning books, <a href="http://www.amazon.com/Practice-Assessment-Intervention-Asperger-Syndrome/dp/1849058113"><i>A
Best Practice Guide to Assessment and Intervention for Autism and Asperger
Syndrome in Schools</i></a><i> </i>and <a href="http://www.amazon.com/Overcoming-Anxiety-Depression-Autism-Spectrum/dp/1849059276/ref=sr_1_1?s=books&ie=UTF8&qid=1412370192&sr=1-1&keywords=overcoming+anxiety+and+depression+on+the+autism+spectrum"><i>Overcoming
Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT</i></a><i>. </i>He
is also editor of a text in the APA School Psychology Book
Series, <a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156"><i>Autism
Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and
Intervention in Schools</i></a>. His latest book is<i> </i><a href="http://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8"><i>A
Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder
in Schools (2nd Edition)</i></a>.</span></div>
</div>
bestpracticeautism.comhttp://www.blogger.com/profile/16482478063587857508noreply@blogger.com0tag:blogger.com,1999:blog-2020163043039993952.post-59016209555126367552021-01-05T09:11:00.003-05:002021-01-05T11:26:16.530-05:00Genes’ Influence On Social Behaviors Shifts With Age<p></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjzfCkBjaNo0gDtJ2EPEZD8yaJ5jNfCe1doPu0vO3lWsQyTucktYJX-NwiF5dw9PYKpitwwIdSPgT3S8c7raAZvh7nw6GS-giLg3T_0Mx8LzYXHuCFA0-maDD0FOHyXlTFljIsqozGYjWjI/s450/Identicaltwins2.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="300" data-original-width="450" height="266" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjzfCkBjaNo0gDtJ2EPEZD8yaJ5jNfCe1doPu0vO3lWsQyTucktYJX-NwiF5dw9PYKpitwwIdSPgT3S8c7raAZvh7nw6GS-giLg3T_0Mx8LzYXHuCFA0-maDD0FOHyXlTFljIsqozGYjWjI/w400-h266/Identicaltwins2.jpg" width="400" /></a></div><br /><div style="text-align: center;"> <span style="font-size: large;">Genes’ Influence On Social Behaviors Shifts With Age</span></div><div style="text-align: center;"><i style="text-align: left;"><span style="font-size: 14.5pt; line-height: 107%;"><br /></span></i></div><div style="text-align: center;"><i style="text-align: left;"><span style="font-family: georgia; line-height: 107%;">Reciprocal
social behavior — the give and take of information or objects during
interactions with others — is strongly heritable, according to an analysis of
twins.</span></i></div><div><p></p><p class="Default"><i><span style="font-size: 14.5pt; line-height: 107%;"><o:p></o:p></span></i></p>
<p class="Default"><span style="line-height: 107%;"><span style="font-family: georgia;">Some social
behaviors associated with autism are heritable, according to a new study. But
the extent to which genes and the environment influence these behaviors changes
as a child grows, the results show.</span><o:p style="font-size: 14.5pt;"></o:p></span></p>
<p class="Default"><span style="line-height: 107%;"><span style="font-family: georgia;">The
researchers examined toddlers’ so-called reciprocal
social behavior, or the ability to engage in interactions such as
sharing toys or conversing. Reciprocity skills vary in the general population,
and prominent difficulties in this area can be a sign of autism. To estimate
the heritability of these behaviors, the team measured them in a group of twins
— including identical twins, who share nearly all of their DNA, and fraternal
twins, who share about half.</span><o:p style="font-size: 14.5pt;"></o:p></span></p>
<p class="Default"><span style="line-height: 107%;"><span style="font-family: georgia;">Identical
twins tend to have more similar scores on measures of their social behaviors
than fraternal twins do, the researchers found, suggesting a strong genetic
component. But the degree of heritability changed as the twins developed,
suggesting that the influence of genetics and the environment on behavior is
not stable, says lead investigator Natasha Marrus, assistant professor of psychiatry at
Washington University in St. Louis, Missouri.</span><o:p style="font-size: 14.5pt;"></o:p></span></p>
<p class="Default"><span style="line-height: 107%;"><span style="font-family: georgia;">“Development
doesn’t look static when we watch it, and I don’t think the biology underneath
it is static either,” she says.</span><o:p style="font-size: 14.5pt;"></o:p></span></p>
<p class="Default"><span style="line-height: 107%;"><span style="font-family: georgia;">Because
differences in social reciprocity are observable before the age at which autism
is usually diagnosed, understanding how it develops could help researchers
chart the condition’s early trajectory, Marrus says.</span><o:p style="font-size: 14.5pt;"></o:p></span></p>
<p class="Default"><span style="line-height: 107%;"><span style="font-family: georgia;">The paper is
an important first step toward creating measures of behavioral dimensions that
appear in early development in autistic children, says Peter
Mundy, professor of education at the University of California, Davis,
who was not involved in the work. And it solidifies the idea that genetics
influences these behaviors.</span><o:p style="font-size: 14.5pt;"></o:p></span></p>
<p class="Default"><span style="line-height: 107%;"><span style="font-family: georgia;">“That’s
unassailable,” Mundy says. “It’s a good contribution.”</span><o:p style="font-size: 14.5pt;"></o:p></span></p>
<p class="Default"><b><span style="line-height: 107%;"><span style="font-family: georgia;">Social factors:</span><o:p style="font-size: 14.5pt;"></o:p></span></b></p>
<p class="Default"><span style="line-height: 107%;"><span style="font-family: georgia;">The
researchers analyzed data from the parents of 1,563 18-month-olds. The
parents watched a video of a typically developing
19-month-old interacting with an adult, rated how their child compared with the
girl in the video on 13 items, and answered 31 additional questions about their
child’s social behaviors, such as whether the child understands verbal requests
or tries to play with other people. They repeated both tests when the children
were 24 months old.</span><o:p style="font-size: 14.5pt;"></o:p></span></p>
<p class="Default"><span style="line-height: 107%;"><span style="font-family: georgia;">An analysis
revealed that the children’s scores on some survey items tended to be
correlated. A child who responds to her name, for example, is also likely to be
interested in what others are doing, the researchers found. Based on these
correlations, they identified five ‘dimensions’ of reciprocal social behavior:
social motivation; functional communication; restricted interests and repetitive behaviors; social avoidance; and social
orienting.</span><o:p style="font-size: 14.5pt;"></o:p></span></p>
<p class="Default"><span style="line-height: 107%;"><span style="font-family: georgia;">The team
repeated the tests in a group of 134 identical twin pairs and 205 fraternal
pairs, also at 18 and 24 months of age, and measured how similarly the twins
scored on each of the five dimensions. They did additional modeling to
differentiate the effects of genetics and shared and unshared environmental
factors.</span><o:p style="font-size: 14.5pt;"></o:p></span></p>
<p class="Default"><span style="line-height: 107%;"><span style="font-family: georgia;">At both ages
and for all five dimensions, identical twins had stronger similarities than
fraternal twins, indicating that reciprocal behaviors are strongly heritable.</span><o:p style="font-size: 14.5pt;"></o:p></span></p>
<p class="Default"><span style="line-height: 107%;"><span style="font-family: georgia;">But the
heritability of each dimension changed as the children grew. The influence of
genetics on social motivation and functional communication waned from 18 to 24
months. By contrast, its influence on social orienting nearly doubled between
screenings; it also increased, although to a lesser extent, for social
avoidance and repetitive behaviors.</span><o:p style="font-size: 14.5pt;"></o:p></span></p>
<p class="Default"><span style="line-height: 107%;"><span style="font-family: georgia;">The results
suggest that the interplay between genetics and environmental factors changes
over time, Marrus says, with the environment playing a stronger role at some
points than at others.</span><o:p style="font-size: 14.5pt;"></o:p></span></p>
<p class="Default"><span style="line-height: 107%;"><span style="font-family: georgia;">“Just because
something is heritable, it doesn’t mean that exact same level of genetic
influence operates over the entire course of your life,” Marrus says.</span><o:p style="font-size: 14.5pt;"></o:p></span></p>
<p class="Default"><b><span style="line-height: 107%;"><span style="font-family: georgia;">New
measures:</span><o:p style="font-size: 14.5pt;"></o:p></span></b></p>
<p class="Default"><span style="line-height: 107%;"><span style="font-family: georgia;">The apparent
change in genetic influence may actually reflect decreasing errors in the
measures used, Mundy says. A child’s language abilities, for example, would
play a key part in the parent’s assessment of the child’s social skills, and
language development is more varied in 18-month-olds than in 24-month-olds.</span><o:p style="font-size: 14.5pt;"></o:p></span></p>
<p class="Default"><span style="line-height: 107%;"><span style="font-family: georgia;">“I interpret
this as consolidation of true score over time,” Mundy says. “I would think it’s
not reflecting a major biological change.”</span><o:p style="font-size: 14.5pt;"></o:p></span></p>
<p class="Default"><span style="line-height: 107%;"><span style="font-family: georgia;">Dividing the broad
category of ‘social behavior’ into specific dimensions could ultimately help
researchers assess which interventions are effective, when and for whom,
says Giacomo Vivanti, associate professor in the Early
Detection and Intervention program at the Drexel Autism Institute in
Philadelphia, Pennsylvania, who was not involved in the work.</span><o:p style="font-size: 14.5pt;"></o:p></span></p>
<p class="Default"><span style="line-height: 107%;"><span style="font-family: georgia;">“The
boundaries between these constructs are really fuzzy,” Vivanti says. “We need a
more fine-grained understanding of, ‘What are we talking about when we talk
about social behavior?’</span><o:p style="font-size: 14.5pt;"></o:p></span></p>
<p class="Default"><span style="line-height: 107%;"><span style="font-family: georgia;">The findings
could help clinicians identify behaviors that may indicate autism in children
too young to be diagnosed, Marrus says. A child with difficulties in several
categories of reciprocal social behavior, for example, may have more underlying
genetics linked to autism and be more likely to have the condition than a child
with difficulties in only one category.</span><o:p style="font-size: 14.5pt;"></o:p></span></p>
<p class="Default"><span style="line-height: 107%;"><span style="font-family: georgia;">“Being able to
understand how to weigh all of those dimensions within an individual could be
very important, especially early in life, to figuring out what is this child’s
level of risk,” Marrus says.</span><o:p style="font-size: 14.5pt;"></o:p></span></p>
<p class="Default"><span style="font-family: georgia; line-height: 107%;">That approach
could also help researchers tease apart the heritable dimensions of other
autism traits, such as motor skills development, Marrus says. Marrus and others
have shown that eye-contact patterns, another indicator of social
behavior, are heritable.</span></p><p class="Default"><span style="font-size: 19.3333px;"> </span><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjGY6s2Vy9xv5Az3zdbcpv_4ZN2lHRpeArHoFjwe87uOs7EJUY3QEtIhkBsTaFirEDJe0qp4-ApYP8pHLMgNeIxKnfqNFSBcQ-i4sq2QLZVqGomBFbzY1yuj_O78g1JVx8TQU7v14ZL1qe-/s80/spectrum-mark-orange.png" style="font-family: georgia; font-size: 16px; margin-left: 1em; margin-right: 1em; text-align: center; text-indent: -0.25in;"><img border="0" data-original-height="80" data-original-width="72" height="50" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjGY6s2Vy9xv5Az3zdbcpv_4ZN2lHRpeArHoFjwe87uOs7EJUY3QEtIhkBsTaFirEDJe0qp4-ApYP8pHLMgNeIxKnfqNFSBcQ-i4sq2QLZVqGomBFbzY1yuj_O78g1JVx8TQU7v14ZL1qe-/w45-h50/spectrum-mark-orange.png" width="45" /></a></p><p class="Default"><span style="font-family: georgia; font-size: 14.5pt; line-height: 107%; text-align: center; text-indent: -0.25in;"><span style="font-family: georgia; font-size: 16px; text-indent: -0.25in;"><span face="azo-sans-web, "Azo Sans", Azo-Sans, Azo, sans-serif" style="background-color: white; text-indent: 0px;"> This article was published on <a href="https://www.spectrumnews.org/"><span style="color: #990000;">Spectrum</span></a>, </span></span></span><span style="font-family: georgia; font-size: 16px; text-align: center; text-indent: -0.25in;"><span face="azo-sans-web, "Azo Sans", Azo-Sans, Azo, sans-serif" style="background-color: white; text-indent: 0px;">the leading site for autism </span></span><span style="font-family: georgia; font-size: 16px; text-align: center; text-indent: -0.25in;"><span face="azo-sans-web, "Azo Sans", Azo-Sans, Azo, sans-serif" style="background-color: white; text-indent: 0px;">research </span></span><span style="font-family: georgia; font-size: 16px; text-align: center; text-indent: -0.25in;"><span face="azo-sans-web, "Azo Sans", Azo-Sans, Azo, sans-serif" style="background-color: white; text-indent: 0px;">new</span></span><span style="font-family: georgia; font-size: 16px; text-align: center; text-indent: -0.25in;"><span face="azo-sans-web, "Azo Sans", Azo-Sans, Azo, sans-serif" style="background-color: white; text-indent: 0px;">s.</span></span></p><p></p><p class="Default" style="text-align: center;"><span style="background-color: #eefbff; font-family: georgia; font-size: 16px; text-indent: -0.25in;"></span></p><div class="separator" style="clear: both; text-align: center;"><span style="background-color: #eefbff; font-family: georgia; font-size: 16px; text-indent: -0.25in;"><div class="separator" style="clear: both; text-align: left;"><span style="background-color: white; text-indent: -0.25in;"><p class="Default" style="text-align: center;"><span style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; font-family: Georgia, serif;"><a href="https://www.spectrumnews.org/news/genes-influence-on-social-behaviors-shifts-with-age/">https://www.spectrumnews.org/news/genes-influence-on-social-behaviors-shifts-with-age/</a></span></p></span></div></span></div></div><div><div class="separator" style="clear: both; text-align: center;"><span style="background-color: #eefbff; font-family: georgia; font-size: 16px; text-indent: -0.25in;"><div class="separator" style="clear: both; text-align: left;"><span style="background-color: white; text-indent: -0.25in;"><p class="Default" style="text-align: left;"><b><span style="font-family: "Georgia",serif;"> Lee A. Wilkinson</span></b><span style="font-family: "Georgia",serif;">, PhD, is author of the award-winning
books, <i> </i></span><span style="font-family: Georgia, serif; text-indent: -0.25in;"><i><a href="https://www.amazon.com/Practice-Assessment-Intervention-Asperger-Syndrome/dp/1849058113">A Best Practice Guide to Assessment and Intervention for Autism and Asperger in Schools</a> </i>and <i><a href="https://www.amazon.com/Overcoming-Anxiety-Depression-Autism-Spectrum/dp/1849059276/ref=sr_1_1?s=books&ie=UTF8&qid=1412370192&sr=1-1&keywords=overcoming+anxiety+and+depression+on+the+autism+spectrum">Overcoming </a></i></span><i style="font-family: Georgia, serif; text-indent: -0.25in;"><a href="https://www.amazon.com/Overcoming-Anxiety-Depression-Autism-Spectrum/dp/1849059276/ref=sr_1_1?s=books&ie=UTF8&qid=1412370192&sr=1-1&keywords=overcoming+anxiety+and+depression+on+the+autism+spectrum">Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT</a>. </i><span style="font-family: Georgia, serif; text-indent: -0.25in;">He
is also editor of a text in the APA School Psychology Book
Series, </span><i style="font-family: Georgia, serif; text-indent: -0.25in;"><a href="https://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156">Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools</a></i><span style="font-family: Georgia, serif; text-indent: -0.25in;">. His latest book is</span><i style="font-family: Georgia, serif; text-indent: -0.25in;"> <a href="https://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8">A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition)</a></i></p></span></div></span></div></div>bestpracticeautism.comhttp://www.blogger.com/profile/16482478063587857508noreply@blogger.com0tag:blogger.com,1999:blog-2020163043039993952.post-64587467752614490452021-01-04T17:30:00.003-05:002021-01-05T09:30:17.277-05:00Autism and Improvisational Music Therapy<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "georgia";"><b><br /></b></span></div>
<div style="text-align: center;">
<span style="font-family: "georgia";"><b>Autism and Music Therapy</b></span></div>
<span style="font-family: "georgia";"><br /></span>
<span style="font-family: "georgia";">Music therapy has become
an integral part of many programs for children with autism. The broad category
of music therapy is generally described as interventions that seek to teach
individual skills or goals through music. Music therapists use their training
as musicians, clinicians, and researchers to effect changes in cognitive,
physical, communication, social, and emotional skills. <span style="mso-spacerun: yes;"> </span>According to the <i>National Autistic Society</i>, “Music therapy
aims to encourage increased self-awareness/self-other awareness, leading to
more overt social interactions. The therapy stimulates and develops the
communicative use of voice and pre-verbal dialogue with another, establishing
meaning and relationship to underpin language development. The client may also
benefit from increased tolerance of sound, tolerance of and capacity for
two-way communication.”<span style="mso-spacerun: yes;"> </span></span></div>
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<span style="font-family: "georgia";"><i>Research
Autism</i> reports strong positive evidence from peer-reviewed journals that
support the effectiveness of music therapy for individuals with autism. Based on the literature to date, music therapy has shown good
effects in influencing joint attention, social interaction, verbal and gestural
communication and behavior. It is considered to be a useful intervention,
particularly with young children, and where language acquisition is either
delayed or disordered to a severe degree. </span><span style="font-family: "georgia";"><span style="font-family: "georgia";">Currently, music therapy
is identified as an emerging intervention by the National Autism Center (2015)
and incorporates many of the identified autism-specific evidence-based practices. </span></span><span style="font-family: "georgia";"><span style="font-family: "georgia";">Supporters of music therapy emphasize
that it can be used to develop social engagement, joint attention, communication
abilities, while also addressing emotional needs and quality of life.</span></span><span style="font-family: "georgia";"><!--[if gte mso 9]><xml>
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<span style="font-family: "georgia";"></span><span style="font-family: "georgia";"><span style="font-family: "georgia";">A study published in the
journal <i><a href="https://www.semanticscholar.org/paper/Emotional%2C-motivational-and-interpersonal-of-with-Kim-Wigram/c7c91c2af69156495a31d6afc305ad0a34224faa">Autism</a></i>
provides further support for the effectiveness of music therapy with autistic children. </span></span><span style="font-family: "georgia";">This randomized controlled exploratory study employed a single subject comparison design in two diff</span><span style="font-family: "georgia";">erent conditions (improvisational music therapy versus toy play sessions) and two different parts of a session (an undirected/child-led part versus a more directed/therapist-led part) in each condition.</span><br />
<span style="font-family: "georgia";"><br /></span>
<span style="font-family: "georgia";">Improvisational music therapy is
an individualized intervention that facilitates moment-by-moment motivational
and interpersonal responses in children with autism. Compared with other
therapeutic interventions utilizing music as a background or contingent
stimulus, improvisational music therapy involves the interactive use of live
music for engaging clients to meet their therapeutic needs. It is gaining
growing recognition as an effective intervention addressing fundamental levels
of spontaneous self-expression, emotional communication and social engagement
for individuals with a wide range of developmental disorders.</span></div>
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<span style="font-family: "georgia";"></span><b><span style="font-family: "georgia";">Results and Discussion</span></b>
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<span style="font-family: "georgia";"></span><span style="font-family: "georgia";">Improvisational music
therapy produced markedly more and longer events of joy, emotional synchronicity
and initiation of engagement behaviors in the children than toy play sessions.
In response to the therapist’s interpersonal demands, ‘compliant (positive)
responses’ were observed more in music therapy than in toy play sessions, and
‘no responses’ were twice as frequent in toy play
sessions as in music therapy. In the music therapy condition, there were more joy,
emotional synchronicity and initiation of engagement events in the undirected
part than the directed part, suggesting that children were happier, more able
to express their happy emotions and more able to share their affects with the
therapist when leading. These results suggest that musical attunement enhances
musical-emotional communication together with joy and emotional synchronicity,
which results in children’s spontaneous willingness to respond, initiate and
engage further.</span></div>
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<span style="font-family: "georgia";"></span><span style="font-family: "georgia";">According to the authors,
“The temporal structure of music and the specific use of musical attunement in
improvisational music therapy suggests that we can help children with autism
experience and develop affective skills in a social context.” <span style="mso-spacerun: yes;"> </span>Creating music relates to the child’s
expression, interest and focus of attention may evoke responses from the child
to a therapist creating such relational music for them. Moreover, improvising
music together is an emotionally engaging process. Music can be an attractive
medium, allowing the child his/her own space and the choice of objects, at the
same time engaging the child with different objects of the therapist’s choice. </span></div>
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<span style="font-family: "georgia";"></span><span style="font-family: "georgia";">Of course, this
“exploratory” study has limitations.<span style="mso-spacerun: yes;"> </span>For
example, the small sample makes any generalizable conclusion premature. The
test power is low and should be considered when interpreting the results.
Likewise, the small sample limits the relevance of subgroup analyses (language,
age, severity) as well as therapists’ effects which would be helpful to
understanding how children with different developmental needs respond to this
type of intervention different therapists. </span>
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<span style="font-family: "georgia";"></span><b><span style="font-family: "georgia";">Conclusion</span></b>
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<span style="font-family: "georgia";"></span><span style="font-family: "georgia";">The results
of this exploratory study found significant evidence supporting the value of
music therapy in promoting social, emotional and motivational development in autistic children. The findings highlight the importance of social-motivational
aspects of musical interaction between the child and the therapist, the
therapeutic potential of such aspects in improvisational music therapy, and the
relative value of less directed and more child centered approaches for children
with autism. The authors conclude, “Both previous and the current study
indicate that we should use music within the child’s focus of attention,
behavioral cue and interests, whether it is improvised or precomposed. A future
study should perhaps look at the differential effect on response of improvised
and precomposed music with young children with autism.” </span>
</div>
<div class="MsoNormal">
<b><span style="background: white; color: #1d2129; font-family: "georgia" , serif; font-size: 12pt; line-height: 107%;">Lee A. Wilkinson</span></b><span style="background: white; color: #1d2129; font-family: "georgia" , serif; font-size: 12pt; line-height: 107%;">, PhD, is author of the award-winning
books, <i><a href="http://www.amazon.com/Practice-Assessment-Intervention-Asperger-Syndrome/dp/1849058113">A Best Practice Guide to Assessment and
Intervention for Autism and Asperger Syndrome in Schools</a> </i>and <i><a href="http://www.amazon.com/Overcoming-Anxiety-Depression-Autism-Spectrum/dp/1849059276/ref=sr_1_1?s=books&ie=UTF8&qid=1412370192&sr=1-1&keywords=overcoming+anxiety+and+depression+on+the+autism+spectrum">Overcoming Anxiety and Depression on the
Autism Spectrum: A Self-Help Guide Using CBT</a>. </i>He is also
editor of a text in the APA School Psychology Book Series, <i><a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156">Autism Spectrum Disorder in Children and
Adolescents: Evidence-Based Assessment and Intervention in Schools</a></i><i>.</i> His latest book is<i> <a href="http://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8">A Best Practice Guide to Assessment and
Intervention for Autism Spectrum Disorder in Schools (2nd Edition)</a></i></span></div>
<div class="MsoNormal">
<span style="font-family: "georgia";"><a href="http://bestpracticeautism.com/"></a></span></div>
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bestpracticeautism.comhttp://www.blogger.com/profile/16482478063587857508noreply@blogger.com0tag:blogger.com,1999:blog-2020163043039993952.post-87525415118454957312020-12-13T09:06:00.002-05:002021-01-05T09:27:30.068-05:00Autism Traits in Childhood Linked to Eating Disorders in Adolescence<p class="Default"></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjoSCKiDUNZhnxfW8eNzgX6h8ed6gbulZgLtNCknEcg-ydS_4znQJLnzgGqnfyTU7ypDkSTOJ574tXMSSDjWt7OO4XVUAI9y1X2e_T6y5h8GHzaVATdZxyZYIh9sbrSbClof9TjQaeUiA5f/s2048/anorexianervosa1.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1365" data-original-width="2048" height="266" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjoSCKiDUNZhnxfW8eNzgX6h8ed6gbulZgLtNCknEcg-ydS_4znQJLnzgGqnfyTU7ypDkSTOJ574tXMSSDjWt7OO4XVUAI9y1X2e_T6y5h8GHzaVATdZxyZYIh9sbrSbClof9TjQaeUiA5f/w400-h266/anorexianervosa1.jpg" width="400" /></a></div><p></p><p class="Default"><span style="font-size: 16pt; line-height: 107%;"><span style="font-family: georgia;">Autism Traits in Childhood Linked to Eating Disorders in Adolescence</span><span style="font-family: Georgia, serif;"><o:p></o:p></span></span></p>
<p class="Default"><b><span style="font-family: georgia; font-size: x-small;">BY <a href="https://www.spectrumnews.org/author/lauradattaro/" title="Posts by Laura Dattaro">LAURA DATTARO</a> / 4 JUNE
2020</span></b></p><p class="Default"><span style="font-family: "Georgia",serif;"><o:p></o:p></span></p>
<p class="Default"><span style="font-family: "Georgia",serif;">Children with social
difficulties are more likely than those without to develop disordered eating by
age 14, according to a recent study. The researchers analyzed data from a
longitudinal study to understand the relationship between autism and eating
disorders over time. <o:p></o:p></span></p>
<p class="Default"><span style="font-family: "Georgia",serif;">At least 20 percent
of adults and 3 percent of children with eating disorders also have autism. But
much of what researchers know about link between the two conditions has come
from studies of people seeking treatment for eating disorders, which makes it
difficult to understand whether one condition sets the stage for the other or
something else explains the overlap. <o:p></o:p></span></p>
<p class="Default"><span style="font-family: "Georgia",serif;">It is possible that
eating disorders can cause traits that look like autism, says lead investigator
Francesca Solmi, senior research fellow at University College London in the
United Kingdom. Research suggests, for example, that the starvation associated
with anorexia nervosa can cause problems with emotional processing. <o:p></o:p></span></p>
<p class="Default"><span style="font-family: "Georgia",serif;">“From all the
research we had so far, we cannot see really well whether autism comes first
and eating disorders second, or whether people with eating disorders have high
levels of autistic traits because it’s somehow a manifestation of the eating
disorder,” Solmi says. <o:p></o:p></span></p>
<p class="Default"><b><span style="font-family: "Georgia",serif;">Mapping Trajectories:
<o:p></o:p></span></b></p>
<p class="Default"><span style="font-family: "Georgia",serif;">To investigate
whether autism traits precede disordered eating, Solmi and her colleagues
analyzed data from the Avon Longitudinal Study of Parents and Children, which
tracks nearly 14,000 people born in Bristol, England, in 1991 and 1992. <o:p></o:p></span></p>
<p class="Default"><span style="font-family: "Georgia",serif;">Mothers of individuals
in the cohort filled out a questionnaire about social behaviors associated with
autism, such as persistent interrupting or being unaware of others’ feelings,
when their children were 7, 11, 14 and 16 years old. At age 14, the children
answered questions about their eating habits, such as whether and how often
they fasted, purged, or used diet pills to lose weight. They were also asked
about the frequency of binging behavior. <o:p></o:p></span></p>
<p class="Default"><span style="font-family: "Georgia",serif;">Of the 5,381
adolescents included in the new study, 421 — nearly 8 percent — engaged in some
type of disordered eating at least monthly. Almost 3 percent, or 148 children,
did so every week. Girls were roughly three times as likely to report such
behaviors as boys were. <o:p></o:p></span></p>
<p class="Default"><span style="font-family: "Georgia",serif;">The Avon study does
not include data on food habits before age 14, but other work shows that
disordered eating rarely occurs before puberty. <o:p></o:p></span></p>
<p class="Default"><span style="font-family: "Georgia",serif;">The researchers found that adolescents with disordered eating habits had more autism traits at
ages 7, 11 and 14, suggesting that these traits raise the odds of developing an
eating disorder. The more autism traits a teenager had, the more frequent
her disordered eating behaviors. <o:p></o:p></span></p>
<p class="Default"><span style="font-family: "Georgia",serif;">Those patterns held
true for both boys and girls, which was surprising, Solmi says. Autism tends to
be underdiagnosed in girls, and eating disorders are underdiagnosed in boys,
making it difficult to study both conditions in people seeking treatment. <o:p></o:p></span></p>
<p class="Default"><span style="font-family: "Georgia",serif;">The work was
published 3 May in the Journal of Child Psychology and Psychiatry. <o:p></o:p></span></p>
<p class="Default"><b><span style="font-family: "Georgia",serif;">Common Biology:</span></b><span style="font-family: "Georgia",serif;"> </span></p><p class="Default"><span style="font-family: "Georgia",serif;">The study could help researchers better
understand early childhood behaviors that lead to eating disorders, says
Susanne Koch, associate professor of clinical medicine at the University of
Copenhagen in Denmark, who was not involved in the research. <o:p></o:p></span></p>
<p class="Default"><span style="font-family: "Georgia",serif;">“It’s not enough
just to look at persons when they have had an eating disorder,” Koch says. “We
need to look at the development of the eating disorder.” <o:p></o:p></span></p>
<p class="Default"><span style="font-family: "Georgia",serif;">The emergence of
disordered eating may be related to the social stresses of adolescence, Solmi
says, and that stress can be particularly intense for people with autism
traits. <o:p></o:p></span></p>
<p class="Default"><span style="font-family: "Georgia",serif;">“If you have
difficulties relating to your peers, this might result in feelings of anxiety
or depression,” Solmi says. “In the case of eating disorders, it could be that
eating then becomes one way in which people cope.” <o:p></o:p></span></p>
<p class="Default"><span style="font-family: "Georgia",serif;">Other experts say
further work is needed to understand the mechanisms underlying both social
difficulties and eating disorders. It is likely that they share common biology,
rather than one condition causing the other, says Walter Kaye, executive
director of the Eating Disorders Program at the University of California, San
Diego, who was not involved in the work. <o:p></o:p></span></p>
<p class="Default"><span style="font-family: "Georgia",serif;">“Until we understand
more about mechanisms and neurobiology, it’s going to be hard to come up with
better treatments,” Kaye says. <o:p></o:p></span></p>
<p class="Default"><span style="font-family: "Georgia",serif;">Regardless, the
study may hold a valuable message for clinicians who work with autistic people
and those who treat eating disorders, says Jennifer Wildes, associate professor
of psychiatry and behavioral neuroscience at the University of Chicago in
Illinois, who was not involved in the research. They can be on the lookout for
eating disorders in autistic people as adolescence approaches and watch for
social difficulties in people struggling with eating disorders, including
typically developing individuals. <o:p></o:p></span></p>
<p class="Default"><span><span style="font-family: georgia;">“That may inform how
they work with those people in treatment and how they work with their families
as well,” Wildes says. </span><span style="font-family: Georgia, serif;"><o:p></o:p></span></span></p>
<p class="Default"><b><span style="font-family: "Georgia",serif;">References: <o:p></o:p></span></b></p>
<p class="Default" style="margin-left: 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;"><!--[if !supportLists]--><span style="font-family: "Georgia",serif; mso-bidi-font-family: Georgia; mso-fareast-font-family: Georgia;">1.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "Georgia",serif;">Solmi
F. et al. J. Child Psychol. Psychiatry Epub ahead of print (2020) PubMed <o:p></o:p></span></p>
<p class="Default" style="margin-left: 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;"><!--[if !supportLists]--><span style="font-family: "Georgia",serif; mso-bidi-font-family: Georgia; mso-fareast-font-family: Georgia;">2.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "Georgia",serif;">Oldershaw
A. et al. Eur. Eat. Disord. Rev. 20, 502-509 (2012) PubMed <o:p></o:p></span></p>
<p class="Default" style="margin-left: 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;"><!--[if !supportLists]--><span style="font-family: "Georgia",serif; mso-bidi-font-family: Georgia; mso-fareast-font-family: Georgia;">3.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "Georgia",serif;">Hudson
J.I. et al. Biol. Psychiatry 61, 348-358 (2007) PubMed <o:p></o:p></span></p>
<p class="Default" style="margin-left: 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;"><!--[if !supportLists]--><span style="font-family: "Georgia",serif; mso-bidi-font-family: Georgia; mso-fareast-font-family: Georgia;">4.<span style="font-family: "Times New Roman"; font-size: 7pt; font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "Georgia",serif;">Sonneville
K.R. and S.K. Lipson Int. J. Eat. Disord. 51, 518-526 (2018) PubMed</span></p><p class="Default" style="margin-left: 0.5in; mso-list: l0 level1 lfo1; text-align: center; text-indent: -0.25in;"></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhGw6tEZNF_bJi4j8HO48zM5xksF9iV1ILQ3vgrNLIYcWR49bdiLz7_Q4UjltHM5I8iPgI2J-xxk7FfoVZhg1-J99rdxRWsvz3SPl9_NCUgi0m-wOX8QJiW2do64y_m9imNzuRkGeu0rKPY/s50/spectrum6.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="50" data-original-width="45" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhGw6tEZNF_bJi4j8HO48zM5xksF9iV1ILQ3vgrNLIYcWR49bdiLz7_Q4UjltHM5I8iPgI2J-xxk7FfoVZhg1-J99rdxRWsvz3SPl9_NCUgi0m-wOX8QJiW2do64y_m9imNzuRkGeu0rKPY/s0/spectrum6.png" /></a></div><div class="separator" style="clear: both; text-align: center;"><span style="font-family: georgia; text-align: left; text-indent: -0.25in;"><span face="azo-sans-web, "Azo Sans", Azo-Sans, Azo, sans-serif" style="background-color: white; text-indent: 0px;">This article was published on </span><a href="https://www.spectrumnews.org/" style="text-indent: 0px;" target="_blank"><span>Spectrum</span></a><span face="azo-sans-web, "Azo Sans", Azo-Sans, Azo, sans-serif" style="background-color: white; text-indent: 0px;">, the leading site for autism </span></span><span style="font-family: georgia; text-align: left; text-indent: -0.25in;"><span face="azo-sans-web, "Azo Sans", Azo-Sans, Azo, sans-serif" style="background-color: white; text-indent: 0px;">research </span></span><span style="font-family: georgia; text-align: left; text-indent: -0.25in;"><span face="azo-sans-web, "Azo Sans", Azo-Sans, Azo, sans-serif" style="background-color: white; text-indent: 0px;">new</span></span><span style="font-family: georgia; text-align: left; text-indent: -0.25in;"><span face="azo-sans-web, "Azo Sans", Azo-Sans, Azo, sans-serif" style="background-color: white; text-indent: 0px;">s. </span></span></div><p></p><div style="margin-left: 0.5in; text-align: center; text-indent: -0.25in;"><a href="https://www.spectrumnews.org/news/autism-traits-in-childhood-linked-to-eating-disorders-in-adolescence/" style="font-family: Georgia, serif; text-indent: 0px;">https://www.spectrumnews.org/news/autism-traits-in-childhood-linked-</a><a href="https://www.spectrumnews.org/news/autism-traits-in-childhood-linked-to-eating-disorders-in-adolescence/" style="font-family: Georgia, serif; text-indent: 0px;">to</a></div><div style="margin-left: 0.5in; text-align: center; text-indent: -0.25in;"><a href="https://www.spectrumnews.org/news/autism-traits-in-childhood-linked-to-eating-disorders-in-adolescence/" style="font-family: Georgia, serif; text-indent: 0px;">eating</a><span style="text-indent: -0.25in;"> </span><a href="https://www.spectrumnews.org/news/autism-traits-in-childhood-linked-to-eating-disorders-in-adolescence/" style="font-family: Georgia, serif; text-indent: 0px;">disorders-in-adolescence/</a></div><div style="margin-left: 0.5in; text-align: left; text-indent: -0.25in;"><b style="background-color: white; font-family: georgia; text-indent: -0.25in;"><span style="color: #0f1111;"><br /></span></b></div><div style="margin-left: 0.5in; text-align: left; text-indent: -0.25in;"><span style="font-family: georgia;"><b><span style="line-height: 107%;">Lee A. Wilkinson</span></b><span style="line-height: 107%;">,
PhD, is author of the award-winning books, <i> <a href="https://www.blogger.com/blog/post/edit/2020163043039993952/4055012375140587996">A
Best Practice Guide to</a></i></span></span></div><div style="margin-left: 0.5in; text-align: left; text-indent: -0.25in;"><span style="font-family: georgia;"><span style="line-height: 107%;"><i><a href="https://www.blogger.com/blog/post/edit/2020163043039993952/4055012375140587996">Assessment and Intervention for Autism and Asperger
Syndrome in</a></i></span></span></div><div style="margin-left: 0.5in; text-align: left; text-indent: -0.25in;"><span style="font-family: georgia;"><span style="line-height: 107%;"><i><a href="https://www.blogger.com/blog/post/edit/2020163043039993952/4055012375140587996">Schools</a> </i>and <i><a href="https://www.blogger.com/blog/post/edit/2020163043039993952/4055012375140587996">Overcoming
Anxiety and Depression on the Autism Spectrum: A Self-Help</a></i></span></span></div><div style="margin-left: 0.5in; text-align: left; text-indent: -0.25in;"><span style="font-family: georgia;"><span style="line-height: 107%;"><i><a href="https://www.blogger.com/blog/post/edit/2020163043039993952/4055012375140587996">Guide Using CBT</a>. </i>He
is also editor of a text in the APA School Psychology Book</span></span></div><div style="margin-left: 0.5in; text-align: left; text-indent: -0.25in;"><span style="font-family: georgia;"><span style="line-height: 107%;">Series, <i><a href="https://www.blogger.com/blog/post/edit/2020163043039993952/4055012375140587996">Autism
Spectrum Disorder in Children and Adolescents: Evidence-Based</a></i></span></span></div><div style="margin-left: 0.5in; text-align: left; text-indent: -0.25in;"><span style="font-family: georgia;"><span style="line-height: 107%;"><i><a href="https://www.blogger.com/blog/post/edit/2020163043039993952/4055012375140587996">Assessment and
Intervention in Schools</a></i>. His latest book is<i> <a href="https://www.blogger.com/blog/post/edit/2020163043039993952/4055012375140587996">A
Best Practice Guide to</a></i></span></span></div><div style="margin-left: 0.5in; text-align: left; text-indent: -0.25in;"><span style="font-family: georgia;"><span style="line-height: 107%;"><i><a href="https://www.blogger.com/blog/post/edit/2020163043039993952/4055012375140587996">Assessment and Intervention for Autism Spectrum Disorder
in Schools (2nd Edition)</a></i></span></span></div>bestpracticeautism.comhttp://www.blogger.com/profile/16482478063587857508noreply@blogger.com0tag:blogger.com,1999:blog-2020163043039993952.post-15152946569524735452020-12-05T13:30:00.017-05:002021-01-06T13:02:57.714-05:00Autism: Empathizing-Systemizing Cognitive Styles<p style="text-align: center;"></p>
<p style="text-align: center;"> </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg-TXqbO-_gDCzEUjq14xWRBIubQmvUts_VaErQKwOX9W6X5tcwnMrS9cgLDlBwrTz4KfVvmdghPQS1jRn9inEK8-6PiIPfKdQjdKkikgiL29bSAfJtEUk_U6m0Y7ObUBYHUHITPvuXRVBF/s800/E-S+Theory+men-women.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="479" data-original-width="800" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg-TXqbO-_gDCzEUjq14xWRBIubQmvUts_VaErQKwOX9W6X5tcwnMrS9cgLDlBwrTz4KfVvmdghPQS1jRn9inEK8-6PiIPfKdQjdKkikgiL29bSAfJtEUk_U6m0Y7ObUBYHUHITPvuXRVBF/w400-h240/E-S+Theory+men-women.jpg" width="400" /></a></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;"><span style="font-family: georgia;">The
empathizing-systemizing (E-S) theory describes a distinct cognitive style or way
of thinking. The E-S theory attempts to explain many of the
social-communication problems experienced by autistic individuals by
focusing on two factors or psychological dimensions, empathizing (E) and
systemizing (S). Empathizing (E) is defined as the drive to identify emotions
and thoughts in others and to respond to these appropriately. In contrast,
Systemizing (S) is defined as the drive to analyze and construct systems, with
the goal of identifying and understanding rules in order to predict systemic
behavioral events. </span><span style="font-family: georgia;">The Systemizing
Mechanism theory seeks out<i> If-and-then </i>patterns.</span></div><p class="Default"><span style="font-size: 14.5pt; line-height: 107%;"><i><o:p></o:p></i></span></p><div class="separator" style="clear: both; text-align: center;"><span style="font-family: georgia;"><b>Five Cognitive Styles</b></span></div><div class="separator" style="clear: both; text-align: left;"><span style="font-family: georgia;"><br /></span></div><div class="separator" style="clear: both; text-align: left;"><span style="font-family: georgia;">The E-S model assumes that we all have both systemizing and
empathizing skills and that they are normally distributed across the population
and independent of each other. According to Baron-Cohen, about one-third of all
people (</span><span style="font-family: georgia;">40 percent of women and 24 percent of men) </span><span style="font-family: georgia;">are Type E — strong on empathy and somewhat weaker on systemizing,
another third of all people (</span><span style="font-family: georgia;">40 percent of men and 26 percent of women) </span><span style="font-family: georgia;">are Type S — strong on systemizing and weaker on
empathy, and a final third are Type B — with balanced abilities. </span><span style="font-family: georgia;"> People who are Extreme Type E have very strong empathy (hyper-empathizers) but are below average on systemizing. In contrast, Extreme Type S individuals are very strong at systemizing (hyper-systemizers) but below average on empathy. </span><span style="font-family: georgia;">These five
brain types are defined by where individuals fall on the empathy and systemizing
dimensions and is consistent with the viewpoint of “neurodiversity.” Autistic
individuals and hyper-systemizers should be seen as just one of many types of
brains and that add to human neurodiversity. </span></div><p class="Default"><span style="font-size: 14.5pt; line-height: 107%;"><o:p></o:p></span></p><div class="separator" style="clear: both; text-align: left;"><span style="font-family: georgia;">Baron-Cohen posits that autistic people have a more "masculinized" profile. that is they show the Type S or Extreme Type S brain types that are more common in the male population and where their systemizing is higher than their empathy. </span><span style="background: white; color: #212121; font-family: georgia; line-height: 17.12px;">A</span><span style="font-family: georgia;">n extension of the E-S theory, the Extreme Male Brain (EMB) theory suggests </span><span style="background: white; color: #212121; font-family: georgia; line-height: 17.12px;">that autistic people, on average, will score lower than the typical population on tests of empathy (E) and will score the same as if not higher than the typical population on tests of systemizing (S).</span></div><div class="separator" style="clear: both; text-align: left;"><span style="line-height: 107%;"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi-zQsbQ09HFO1MOxJEzgVp10mceIBhWE8OQr9yetc9PHNxcbeetpbim39h5w5_ss1PaWMacrnXDOtKRo_Pw08IsA3wasJ4DBp6D2KuxwgivzdibmoGt_SGy7qvlz7SZFaQzDJ61aX4vdjI/s928/E-S+Theory5.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="928" data-original-width="792" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi-zQsbQ09HFO1MOxJEzgVp10mceIBhWE8OQr9yetc9PHNxcbeetpbim39h5w5_ss1PaWMacrnXDOtKRo_Pw08IsA3wasJ4DBp6D2KuxwgivzdibmoGt_SGy7qvlz7SZFaQzDJ61aX4vdjI/w546-h640/E-S+Theory5.png" width="546" /></a></div><div class="separator" style="clear: both; text-align: left;"><span style="font-family: georgia;">The E-S theory seeks to explain the following strengths and weaknesses in autism by referring</span></div></span></div><blockquote style="border: none; margin: 0px 0px 0px 40px; padding: 0px; text-align: left;"></blockquote><span style="font-family: georgia;">to delays and deficits in empathy (E), and </span><span style="font-family: georgia;">intact or even superior skill in systemizing (S).</span><div class="separator" style="clear: both; text-align: left;"><span style="line-height: 107%;"><span style="line-height: 107%;"><ul style="text-align: left;"><li><span style="font-family: georgia;">talented in mathematics or music</span></li><li><span style="font-family: georgia;">superior attention to detail</span></li></ul><div><span style="font-family: georgia;"> • excellent understanding of a whole system</span></div><p></p><p class="Default"><span style="font-family: georgia;"> • preference
for repetition </span></p>
<p class="Default"><span style="font-family: georgia;"> • difficulty
reading emotions<o:p></o:p></span></p>
<p class="Default"><span style="font-family: georgia;"> • difficulty
coping in social groups<o:p></o:p></span></p>
<p class="Default"><span style="font-family: georgia;"> • difficulty
seeing another person’s perspective<o:p></o:p></span></p>
<p class="Default"><span style="font-family: georgia;"> • a tendency
for black and white thinking</span></p>
<p class="Default"><span style="font-family: georgia;"> • sensory hypersensitivity.</span></p>
<div style="line-height: normal; text-align: left;"><span style="font-family: georgia;"><p style="text-align: left;">A final comment
regarding the E-S theory of autism. Theories are used to provide a model for
understanding human thoughts, emotions, and behaviors. By definition, a theory
is an idea or set of ideas that is intended to explain facts or events, but is
not known or proven to be true. It is important to remember that the E-S theory
is among several that seek to explain the behavior and psychological profile of
individuals with autism. Likewise, it may not explain all of the
characteristics or features associated with being on the autism spectrum or
account for the whole range of autistic traits.</p></span></div><div style="line-height: normal; text-align: center;"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh6OIjx4GmboPJuGPbZ2qHfmtQsXlvedzVi-TJTV9R3BH9RgH3rJbNz6PPpgXfMtQktcQO_xKlqYvDdMkz-ptmhlNMVEA1pWtEYpC8mfptd8fIP0wkKz5k_5sxznSM3QyNSU8wx118ClFsE/s50/spectrumblue2.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="50" data-original-width="44" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh6OIjx4GmboPJuGPbZ2qHfmtQsXlvedzVi-TJTV9R3BH9RgH3rJbNz6PPpgXfMtQktcQO_xKlqYvDdMkz-ptmhlNMVEA1pWtEYpC8mfptd8fIP0wkKz5k_5sxznSM3QyNSU8wx118ClFsE/s0/spectrumblue2.png" /></a></div><span style="font-family: georgia; text-align: left;">Adapted from Wilkinson, L. A. (2015). </span><i style="font-family: georgia; text-align: left;"><a href="https://www.amazon.com/Overcoming-Anxiety-Depression-Autism-Spectrum/dp/1849059276/ref=sr_1_1?s=books&ie=UTF8&qid=1412370192&sr=1-1&keywords=overcoming+anxiety+and+depression+on+the+autism+spectrum">Overcoming
anxiety and depression on the autism spectrum: A self-help guide using CBT<span style="font-style: normal;">.</span></a></i><span style="font-family: georgia; text-align: left;"> London: Jessica Kingsley Publishers.</span></div>
<p class="Default"><b><span style="font-family: georgia;"> </span></b><b style="text-align: center;"><span style="font-family: georgia;">References and Further Reading</span></b></p>
<div style="text-align: left;"><span style="font-family: georgia;">Baron-Cohen, S. (2004) <i>The Essential Difference: Male and Female
Brains and the Truth about Autism</i>. New York, NY: Basic Books.</span></div>
<p class="Default"><span style="font-family: georgia;">Baron-Cohen, S. (2008) <i>Autism and Asperger Syndrome: The Facts</i>.
New York, NY: Oxford University Press.<o:p></o:p></span></p>
<div style="text-align: left;"><span style="font-family: georgia;">Baron-Cohen, S., Richler, J., Bisarya, D., Gurunathan, N., and
Wheelwright, S. (2004) ‘The Systemizing Quotient: An Investigation of Adults
with Asperger Syndrome or High-Functioning Autism, and Normal Sex Differences.’
In U. Frith and E. Hill (eds) <i>Autism: Mind and Brain. </i>New York, NY:
Oxford University Press.</span></div>
<p class="Default"><span style="font-family: georgia;">Baron-Cohen, S., and Wheelwright, S. (2004) ‘The Empathy Quotient (EQ
): An investigation of adults with Asperger Syndrome and high-functioning
autism, and normal sex differences.’ <i>Journal of Autism and Developmental
Disorders, 34</i>, 163–175.<o:p></o:p></span></p>
<div style="text-align: left;"><span style="font-family: georgia;">Baron-Cohen, S., Wheelwright, S., Lawson, J., Griffin, R., Ashwin, C.,
Billington, J., and Chakrabarti, B. (2005) ‘Empathizing and Systemizing in
Autism Spectrum Conditions.’ In F. R. Volkmar, R. Paul, A. Klin, and D. Cohen
(eds.) <i>Handbook of Autism and Pervasive Developmental Disorders, Volume 1:
Diagnosis,</i> <i>Development,
Neurobiology, and Behavior </i>(third
edition). Hoboken, NJ: Wiley.</span></div><div style="text-align: left;"><span style="font-family: georgia;"><br /></span></div>
<div style="background: white; line-height: normal; text-align: left;"><span style="color: #0f1111;"><span style="font-family: georgia;">Baron-Cohen S,
Auyeung B, Nørgaard-Pedersen B, Hougaard DM, Abdallah MW, Melgaard L, Cohen AS,
Chakrabarti B, Ruta L, Lombardo MV. <i>Elevated fetal steroidogenic activity in
autism</i>. Mol Psychiatry. 2015 Mar;20(3):369-76. doi: 10.1038/mp.2014.48.
Epub 2014 Jun 3. PMID: 24888361; PMCID: PMC4184868.</span></span></div><div style="background: white; line-height: normal; text-align: left;"><span style="color: #0f1111;"><span style="font-family: georgia;"><br /></span></span></div>
<div style="background: white; line-height: normal; text-align: left;"><span style="color: #0f1111;"><span style="font-family: georgia;">Baron-Cohen S (2020). <i>The Pattern
Seekers: How Autism Drives Human Invention</i>. New York, NY: Basic Books.</span></span></div><div style="background: white; line-height: normal; text-align: left;"><span style="color: #0f1111;"><span style="font-family: georgia;"><br /></span></span></div>
<div style="background: white; line-height: normal; text-align: left;"><span style="color: #0f1111;"><span style="font-family: georgia;">Wilkinson, L. A.
(2015). <i>Overcoming anxiety and depression on the autism spectrum: A
self-help guide using CBT</i>. London: Jessica Kingsley Publishers.</span></span></div><div style="background: white; line-height: normal; text-align: left;"><span style="color: #0f1111;"><span style="font-family: georgia;"><br /></span></span></div>
<p class="MsoNormal" style="background: white; line-height: normal;"><span style="font-family: georgia;"><b><span style="color: #0f1111;">Lee
A. Wilkinson</span></b><span style="color: #0f1111;">, PhD, is a licensed and nationally
certified school psychologist, and certified
cognitive-behavioral therapist. He is author of the award-winning
books, <i> </i><a href="http://www.amazon.com/Practice-Assessment-Intervention-Asperger-Syndrome/dp/1849058113"><i>A
Best Practice Guide to Assessment and Intervention for Autism and Asperger
Syndrome in Schools</i></a><i> </i>and <a href="http://www.amazon.com/Overcoming-Anxiety-Depression-Autism-Spectrum/dp/1849059276/ref=sr_1_1?s=books&ie=UTF8&qid=1412370192&sr=1-1&keywords=overcoming+anxiety+and+depression+on+the+autism+spectrum"><i>Overcoming
Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT</i></a><i>. </i>He
is also editor of a text in the APA School Psychology Book
Series, <a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156"><i>Autism
Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and
Intervention in Schools</i></a>. His latest book is<i> </i><a href="http://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8"><i>A
Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder
in Schools (2nd Edition)</i></a>.</span></span></p><!--[endif]--></span><!--[endif]--></span></div><p></p><p class="MsoNormal" style="background: white; line-height: normal; mso-margin-bottom-alt: auto; mso-outline-level: 1;"><span style="font-family: georgia;"><span style="color: #0f1111;"></span></span>
</p>
<p></p>
bestpracticeautism.comhttp://www.blogger.com/profile/16482478063587857508noreply@blogger.com0tag:blogger.com,1999:blog-2020163043039993952.post-88302091120471424592020-12-01T09:33:00.001-05:002021-01-06T12:25:19.549-05:00Holiday Tips for Families of Children with Autism<div dir="ltr" style="text-align: left;" trbidi="on">
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</o:shapelayout></xml><![endif]--><span style="font-family: "georgia";"> The holiday season can be
a stressful time of year for everyone, especially for parents of children on the autism spectrum. The sights and sounds of the holidays can be
stressful and over-stimulating. There are many changes in routine, family events,
parties, and vacations that need to be planned. Sometimes the stress of these
changes can become overwhelming and the joy and happiness of the holidays might
be lost. Here are some helpful tips to lessen your child’s anxiety and increase
your family’s enjoyment of the holiday season:</span><b style="mso-bidi-font-weight: normal;"><span style="font-family: "georgia";"> </span></b><br />
<br />
<div style="text-align: center;">
<div style="text-align: left;">
<div style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "georgia";"> Decorating and Shopping</span></b><span style="font-family: "georgia";"> </span><span style="font-family: "georgia";"> </span><span style="font-family: "georgia";"><br /></span></div>
</div>
</div>
<ul style="text-align: left;">
<li><span style="font-family: "georgia";">If your child has difficulty with change, you may want to gradually
decorate the</span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;"> </span>house. Decorate in stages, rather than all
at once. It may also be helpful to develop </span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;">a </span><span style="mso-spacerun: yes;"></span><span style="mso-spacerun: yes;"></span>visual <span style="mso-spacerun: yes;"> </span>schedule
or calendar that shows what will be done on each day.</span></li>
</ul>
<ul style="text-align: left;">
<li><span style="font-family: "georgia";">Allow your child to interact with the decorations and help put them in
place.</span></li>
<li><span style="font-family: "georgia";">Flashing lights or musical decorations can disturb some children. To
see how your</span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;"> </span>child will respond, provide an opportunity
experience these items in a store or at</span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;"> </span>elsewhere first.</span><span style="font-family: "georgia";"> </span></li>
<li><span style="font-family: "georgia";">Last minute holiday shopping can be stressful for children who rely on
routines. If</span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;"> </span>you do take your child shopping, allow enough
time to gradually adapt to the intense</span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;"> </span>holiday stimuli that stores exhibit this
time of year.</span></li>
</ul>
<div class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "georgia";">Family Routines and Travel</span></b>
</div>
<ul style="text-align: left;">
<li><span style="font-family: "ms mincho"; mso-ascii-font-family: Georgia; mso-bidi-font-family: "MS Mincho";"></span><span style="font-family: "georgia"; mso-fareast-font-family: TTE5590800t00;"></span><span style="font-family: "georgia";">Meet as a family to discuss how to minimize disruptions to established
routines and</span><span style="font-family: "georgia";"> how
to <span style="mso-spacerun: yes;"> </span>support positive behavior when disruptions
are inevitable.</span><span style="font-family: "georgia";"> </span></li>
<li><span style="font-family: "georgia";">Continue using behavior support strategies during the holidays. For
example, use</span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;"></span> social stories to help your child cope
with changes in routine and visual supports to </span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;"></span>help prepare for more complicated days.</span></li>
<li><span style="font-family: "georgia";"> </span><span style="font-family: "georgia";">Use a visual schedule if you are celebrating the holidays on more than
one day to</span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;"> </span>show when there will be parties/gifts and when
there will not.</span><span style="font-family: "georgia";"> </span></li>
<li><span style="font-family: "georgia";">Use rehearsal and role play to give children practice ahead of time in
dealing with</span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;"> </span>new social situations, or work together to
prepare a social story that incorporates all</span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;"> </span>the elements of an upcoming event or visit
to better prepare them for that situation</span><span style="font-family: "georgia";"> </span></li>
<li><span style="font-family: "georgia";">If you are traveling for the holidays, make sure you have child’s
favorite foods, books</span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;"> </span>or toys available. Having familiar items readily
available can help to calm stressful</span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;"> </span>situations.</span><span style="font-family: "georgia";"> </span></li>
<li><span style="font-family: "georgia";">If you are going to visit family or friends, make sure there is a quiet,
calm place to go</span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;"></span><span style="mso-spacerun: yes;"> </span>to
if needed. Teach your child to leave a situation and/or how to access support
when</span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;"> </span>a situation becomes overwhelming. For
example, if you are having visitors, have a</span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;"> </span>space set aside for the child as their calm space. They should be taught</span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;"> </span>ahead of time to go to this space when feeling overwhelmed. This self-</span><span style="font-family: "georgia";">management strategy will also be helpful in
future situations.</span>
</li>
</ul>
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<span style="font-family: "georgia";"> </span><b style="mso-bidi-font-weight: normal;"><span style="font-family: "georgia";">Gifts and Play Time</span></b>
</div>
<ul style="text-align: left;">
<li><span style="font-family: "ms mincho"; mso-ascii-font-family: Georgia; mso-bidi-font-family: "MS Mincho";"></span><span style="font-family: "georgia"; mso-fareast-font-family: TTE5590800t00;"></span><span style="font-family: "georgia";">If you put gifts under the Christmas tree, prepare well ahead of time
by teaching tha</span><span style="font-family: "georgia";">t gifts are not to be opened without the family
there. Give your child a wrapped</span><span style="font-family: "georgia";"> gift and
a reward for keeping it intact.</span><span style="font-family: "georgia";"> </span></li>
<li><span style="font-family: "georgia";">Practice unwrapping gifts, taking turns and waiting for others, and
giving gifts. Role</span><span style="font-family: "georgia";"> play
scenarios with your child in preparation for him/her getting a gift they may
not</span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;"> </span>want</span><span style="font-family: "georgia";"> </span></li>
<li><span style="font-family: "georgia";">Take toys and other gifts out of the box before wrapping them. It can
be more fun and</span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;"> </span>less frustrating if your child can open
the gift and play with it immediately.</span><span style="font-family: "georgia";"> </span></li>
<li><span style="font-family: "georgia";">When opening gifts as a family, try passing around an ornament to
signal whose turn</span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;"> </span>it is to open the next gift. This helps alleviate
disorganization and the frustration of</span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;"> </span>waiting.</span><span style="font-family: "georgia";"> </span></li>
<li><span style="font-family: "georgia";">Prepare siblings and young relatives to share their new gifts with
others.</span><span style="font-family: "georgia";"> </span></li>
<li><span style="font-family: "georgia";">If necessary, consider giving your child a quiet space to play with their own gifts,</span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;"> </span>away from the temptation of grabbing at other
children’s toys</span><span style="font-family: "georgia";"> </span></li>
<li><span style="font-family: "georgia";">Prepare family members for strategies to use to minimize anxiety or
behavioral</span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;"> </span>incidents, and to enhance participation. Provide
suggestions ahead of time that will</span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;"> </span>make for a less stressful holiday season.</span><span style="font-family: "georgia";"> </span></li>
<li><span style="font-family: "georgia";">Keep an eye out for signs of anxiety or distress, including an
increase in behavior</span><span style="font-family: "georgia";"> such
as humming or rocking - this may indicate it's time to take a break from the</span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;"> </span>activity.</span></li>
<li><span style="font-family: "georgia";"> </span><span style="font-family: "georgia";">Understand how much noise and other sensory input your child can
manage. Know</span><span style="font-family: "georgia";"> their level of anxiety and the amount of preparation
it may require.</span><span style="font-family: "georgia";"> </span></li>
<li><span style="font-family: "georgia";">Try to relax and have a good time. Do everything possible to help
reduce the stress</span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;"> </span>level for your child and family during the
holidays. If you are tense your child may</span><span style="font-family: "georgia";"><span style="mso-spacerun: yes;"> </span>sense that something is wrong. Don’t
forget to prepare yourself! A calm and collected</span><span style="font-family: "georgia";"> parent
is better able to help their family enjoy this wonderful time of year.</span></li>
</ul>
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<br />
<span style="font-family: "georgia";"><b>Lee A. Wilkinson</b>, PhD, is a licensed and nationally certified school psychologist, and certified cognitive-behavioral therapist. </span><span style="background-color: white; color: #1d2129; font-family: "georgia" , serif;">He is author of the
award-winning books, </span><i style="color: #1d2129; font-family: Georgia, serif;"><a href="http://www.amazon.com/Practice-Assessment-Intervention-Asperger-Syndrome/dp/1849058113">A Best Practice Guide to Assessment and
Intervention for Autism and Asperger Syndrome in Schools</a> </i><span style="background-color: white; color: #1d2129; font-family: "georgia" , serif;">and </span><i style="color: #1d2129; font-family: Georgia, serif;"><a href="http://www.amazon.com/Overcoming-Anxiety-Depression-Autism-Spectrum/dp/1849059276/ref=sr_1_1?s=books&ie=UTF8&qid=1412370192&sr=1-1&keywords=overcoming+anxiety+and+depression+on+the+autism+spectrum">Overcoming Anxiety and Depression on the
Autism Spectrum: A Self-Help Guide Using CBT</a>. </i><span style="background-color: white; color: #1d2129; font-family: "georgia" , serif;">He is also
editor of a text in the APA School Psychology Book
Series, </span><i style="color: #1d2129; font-family: Georgia, serif;"><a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156">Autism Spectrum Disorder in Children and
Adolescents: Evidence-Based Assessment and Intervention in Schools</a></i><i style="color: #1d2129; font-family: Georgia, serif;">.</i><span style="background-color: white; color: #1d2129; font-family: "georgia" , serif;"> His latest book is</span><i style="color: #1d2129; font-family: Georgia, serif;"> <a href="http://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8">A Best Practice Guide to Assessment and
Intervention for Autism Spectrum Disorder in Schools (2nd Edition)</a></i><i style="color: #1d2129; font-family: Georgia, serif;">.</i></div>
</div>
bestpracticeautism.comhttp://www.blogger.com/profile/16482478063587857508noreply@blogger.com0tag:blogger.com,1999:blog-2020163043039993952.post-84422192053642728312020-11-02T13:58:00.003-05:002021-01-06T13:11:50.276-05:00Social (Pragmatic) Communication Skills and Autism <div dir="ltr" style="text-align: left;" trbidi="on">
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<b>Social (Pragmatic) Communication Skills and the Autism Spectrum</b></div>
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<span style="font-family: "georgia" , serif;"><br /></span></div>
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<span style="font-family: "georgia" , serif;">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. </span><span style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; color: #1d2129; font-family: "georgia" , serif;"><o:p></o:p></span><br />
<span style="font-family: "georgia" , serif;"></span><br />
<div class="MsoNormal" style="line-height: normal;">
<span style="font-family: "georgia" , serif;">There are many unwritten rules in society that govern our
behavior. While most of us intuitively understand these rules, many autistic individuals 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.</span><span style="background: yellow;"><o:p></o:p></span></div>
</div>
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<div style="text-align: center;">
<span style="font-family: "georgia";"><b>Figurative Language</b></span></div>
<span style="font-family: "georgia";"><br /></span>
<span style="font-family: "georgia";">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, sarcasm, or slang – phrases and meanings
that we intuitively assimilate or learn through observation or subtle cues.
Individuals with autism tend to interpret language literally and may be puzzled by
the common everyday expressions used by a typical peer or adult. Consider how
idioms 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.</span><span class="apple-style-span"><span lang="EN-GB" style="font-family: "georgia";"> </span></span><br />
<ul style="text-align: left;">
<li><span dir="LTR"><span style="font-family: "georgia";">Bite
off More than you can chew </span></span><span dir="LTR"><span style="font-family: "georgia";"> </span></span></li>
<li><span dir="LTR"><span style="font-family: "georgia";">Cross
that bridge when you come it</span></span><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;"></span></span></li>
<li><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;"><span style="font: 7pt "Times New Roman";"></span></span></span><span dir="LTR"><span style="font-family: "georgia";">Everything
but the kitchen sink</span></span><span dir="LTR"><span style="font-family: "georgia";"> </span></span></li>
<li><span dir="LTR"><span style="font-family: "georgia";">Get
up on the wrong side of the bed</span></span><span dir="LTR"><span style="font-family: "georgia";"> </span></span></li>
<li><span dir="LTR"><span style="font-family: "georgia";">Have
a bone to pick with you</span></span><span dir="LTR"><span style="font-family: "georgia";"> </span></span></li>
<li><span dir="LTR"><span style="font-family: "georgia";">Have
your cake and eat it too</span></span><span dir="LTR"><span style="font-family: "georgia";"> </span></span></li>
<li><span dir="LTR"><span style="font-family: "georgia";">Kill
two birds with one stone </span></span><span dir="LTR"><span style="font-family: "georgia";"> </span></span></li>
<li><span dir="LTR"><span style="font-family: "georgia";">Put
all your eggs in one basket</span></span><span dir="LTR"><span style="font-family: "georgia";"> </span></span></li>
<li><span dir="LTR"><span style="font-family: "georgia";">Raining
cats and dogs</span></span><span dir="LTR"><span style="font-family: "georgia";"> </span></span></li>
<li><span dir="LTR"><span style="font-family: "georgia";">Run
circles around someone</span></span><span dir="LTR"><span style="font-family: "georgia";"> </span></span></li>
<li><span dir="LTR"><span style="font-family: "georgia";">Till
the cows come hom</span></span><span dir="LTR"><span style="font-family: "georgia";">e </span></span><span dir="LTR"><span style="font-family: "georgia";"></span></span><span style="font-family: "georgia";"></span></li>
</ul>
<div style="text-align: center;">
<span style="font-family: "georgia" , "times new roman" , serif;"><b>Assessment</b></span></div>
<span style="font-family: "georgia";"><br /></span>
<span style="font-family: "georgia";">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 autistic students 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). </span><br />
<span style="font-family: "georgia" , serif;"><br /></span>
<span style="font-family: "georgia" , serif;">Assessments
to identify pragmatic language deficits tend to be less well developed than
tests of language fundamentals. There are fewer standard measures available to
assess these skills in children with autism. Valid norms for pragmatic development
and objective criteria for pragmatic performance are also limited. Among the
standardized instruments that focus on the social communicative functions of
language are the Comprehensive Assessment of Spoken Language (CASL;
Carrow-Woolfolk, 1999), Test of Pragmatic Language, 2nd Edition (TOPL-2;
Phelps-Terasaki & Phelps-Gunn, 2007), Social Language Development
Test-Elementary (SLDT-E; Bowers, Huisingh, & LoGiudice, 2008), Children's
Communication Checklist, Second Edition (CCC-2; Bishop, 2006) and Pragmatic
Language Skills Inventory (PLSI; Gilliam & Miller, 2006). </span><br />
<div class="MsoNormal" style="line-height: normal;">
<span style="font-family: "georgia" , serif;"><o:p></o:p></span></div>
<span style="font-family: "georgia";">Significant and severe deficits in the ability to communicate and
interact with others can limit students' 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).<span style="mso-spacerun: yes;"> </span></span><br />
<span style="font-family: "georgia";"><span style="mso-spacerun: yes;"></span></span><br />
<div class="MsoNormal" style="background: white; line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 4; vertical-align: baseline;">
<span style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; font-family: "georgia" , serif;">Best practice assessment
and intervention guidelines are available from: </span><span style="font-family: "georgia" , serif;"><a href="http://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=sr_1_2?s=books&ie=UTF8&qid=1479742377&sr=1-2&keywords=wilkinson+autism" target="_blank"><em><span style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 1pt none windowtext; padding: 0in; text-decoration-line: none;"><span style="color: #990000;">A Best Practice
Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools
(2nd ed.)</span></span></em></a><span style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial;"> and </span><a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156" target="_blank"><span style="color: #990000;"><em><span style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 1pt none windowtext; padding: 0in; text-decoration-line: none;">Autism Spectrum
Disorder in Children and Adolescents: Evidence-Based Assessment and
Intervention in Schools</span></em><em><span style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 1pt none windowtext; font-style: normal; padding: 0in; text-decoration-line: none;">.</span></em></span><em><span style="border: 1pt none; color: #665ed0; padding: 0in;"> </span></em></a><span style="color: #505050;"><o:p></o:p></span></span></div>
<span style="font-family: "georgia";"><br /></span>
<span style="font-family: "georgia";"><b>Lee A. Wilkinson</b>, PhD, is a licensed and nationally certified school psychologist, and certified cognitive-behavioral therapist. He is author of the award-winning books, <i><a href="http://www.amazon.com/Practice-Assessment-Intervention-Asperger-Syndrome/dp/1849058113">A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools</a> </i>and<i> </i></span><i style="font-family: Georgia;"><a href="http://www.amazon.com/Overcoming-Anxiety-Depression-Autism-Spectrum/dp/1849059276/ref=sr_1_1?s=books&ie=UTF8&qid=1412370192&sr=1-1&keywords=overcoming+anxiety+and+depression+on+the+autism+spectrum">Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT</a></i><span style="font-family: "georgia";">. </span><span style="font-family: "georgia";">He is also the editor of a text in the APA School Psychology Book Series, </span><i style="font-family: Georgia;"><a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156">Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools</a>. </i><span style="font-family: "georgia";">Hi</span><span style="font-family: "georgia";">s</span><i style="font-family: Georgia;"> </i><span style="font-family: "georgia";">latest book is </span><i style="font-family: georgia;"><a href="http://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8" target="_blank">A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition)</a></i><span style="font-family: "georgia";">.</span><span style="font-family: "georgia";"> </span></div>
<div class="MsoNormal">
<span style="font-family: "georgia";">© Lee A. Wilkinson,
PhD</span></div>
</div>
bestpracticeautism.comhttp://www.blogger.com/profile/16482478063587857508noreply@blogger.com0tag:blogger.com,1999:blog-2020163043039993952.post-60664893881583014562020-10-11T12:09:00.001-04:002021-01-06T13:11:07.668-05:00Self-Injurious Behavior (SIB) in Autistic Children <div dir="ltr" style="text-align: left;" trbidi="on">
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<b>Predic</b><b>tors of Self-Injurious behavior in Autism</b></div>
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<span style="font-family: "georgia";">Children with autism spectrum disorder (ASD)
frequently engage in maladaptive behaviors such as aggression and rituals. The
most distressing to caregivers and challenging for health care providers are
self-injurious behaviors (SIB). Although self-injury is not a symptom of autism, certain symptoms, situations, and comorbidities related to ASD can
lead some autistic individuals people to engage in self-injurious
behavior. </span><span style="font-family: "georgia" , serif;">The most
common types of SIB in children and adults with ASD include hand biting, head banging and scratching. This might include head banging
on floors, walls or other surfaces, hand or arm biting, hair pulling, eye gouging,
face or head slapping, skin picking, scratching or pinching, forceful head shaking. </span><span style="font-family: "georgia" , serif; font-size: 12pt;">SIB varies from case to case can be understood as
existing on a continuum in relation to frequency and intensity, ranging from
mild and infrequent to severe and chronic. </span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhqvkcojCddLdazJxiN0y68OJovZ4HVgRuJtGlDwPXehRaV2p_iHoYK-NtKuNsJfoZLsaI8doGksJMLXoXwvc6Nyp7b2S9RyIcrC-I_kcdk14I33ITgTM89QNT3CAiPHY_K8-eDDpalG1q5/s1600/Self-Injury+%25282%2529.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="342" data-original-width="492" height="222" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhqvkcojCddLdazJxiN0y68OJovZ4HVgRuJtGlDwPXehRaV2p_iHoYK-NtKuNsJfoZLsaI8doGksJMLXoXwvc6Nyp7b2S9RyIcrC-I_kcdk14I33ITgTM89QNT3CAiPHY_K8-eDDpalG1q5/s320/Self-Injury+%25282%2529.jpg" width="320" /></a></div>
<span style="font-family: "georgia";"><p class="Default"><span style="line-height: 107%;">In many cases, self-injury begins as a means of communication.
Often a child is trying to convey a feeling or idea they may not be able to
express in words. Biting, headbanging or other self-injury behaviors may be
attempts to express pain, fear, displeasure, or anxiety. Self-injury can
also be a form of sensory stimulation. An individual with autism may
self-injure as a way to increase or decrease their level of arousal. An
increased understanding of the incidence and risk factors associated with SIB
in autism is needed to develop treatment options.<o:p></o:p></span></p></span></div><div class="MsoNormal" style="text-align: center;"><span style="font-family: "georgia";"><b>Research</b></span></div><div class="MsoNormal"><span style="font-family: "georgia";">A study in the <i>Journal of Autism
and Developmental Disorders</i> assessed 7 factors that may influence self
injury in a large group of 250 children and adolescents with ASD: (a) atypical
sensory processing; (b) impaired cognitive ability; (c) impaired functional
communication; (d) deficits in social interaction; (e) age; (f) the need for
sameness; and (g) ) compulsive or ritualistic behavior. Other factors that may
influence SIB incidence such as gender and ASD severity were also assessed. A
series of diagnostic tests were administered either directly to the children
and adolescents or to their parents to assess: (a) autism severity; (b)
cognitive and adaptive ability; (c) and receptive and expressive language; (d)
repetitive behaviors; and (e) self-injury.</span></div>
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<span style="font-family: "georgia";"><i>The results indicated that
half of the children and adolescents demonstrated SIB. Atypical sensory
processing was the strongest single predictor of self-injury followed by
sameness, impaired cognitive ability and social functioning. Age, impaired
functional communication, and ritualized behavior did not contribute
significantly to self-injury. No significant effects of gender or severity of
autistic symptoms were found in the study.</i></span></div>
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<span style="font-family: "georgia";"><b>Implications</b></span></div>
<span style="font-family: "georgia";"><br /></span>
<span style="font-family: "georgia";"><span style="font-family: "georgia" , serif; font-size: 12pt;">Self-injurious behavior is an important public health problem in
individuals with autism spectrum disorder (ASD). SIB</span></span><span style="font-family: "georgia";"> </span><span style="font-family: "georgia" , serif; font-size: 12pt;">is a debilitating behavior
that occurs in a significant proportion of children, teens, and adults with ASD</span><span style="font-family: "georgia";">. Atypical
sensory processing and the need for sameness were contributors to SIB in this
study. </span><span style="font-family: "georgia" , "times new roman" , serif;"><span style="background: white; font-size: 12pt; line-height: 107%;">Research has also</span><span style="font-size: 12pt; line-height: 107%;"> </span></span><span style="font-family: "georgia" , serif; font-size: 12pt; line-height: 107%;">found significant associations between SIB
and behavioral (aggression, hyperactivity, anxiety) developmental (adaptive behaviors, nonverbal IQ), and somatic (sleep and GI problems ) factors. </span><span style="font-family: "georgia";"><span style="font-family: "georgia" , serif; font-size: 12pt; line-height: 107%;">Current and previous research findings support
the need for a comprehensive and multidisciplinary approach for assessing and managing
SIB in ASD. </span></span><span style="font-family: "georgia";">It is critical
that interventions that target the risk factors associated SIB be identified
and implemented in clinical practice. Providing empirically supported
behavioral interventions to autistic individuals with self-aggressive behavior will not
only impact directly on the problem behavior, but will their enhance social,
educational, and adaptive functioning as well. Further research is clearly
needed to better understand additional contributing factors that may influence
these complex behaviors in children with ASD. For exam</span><span style="font-family: "georgia";">ple, temperament, ability
to self-regulate emotions, and medication usage might contribute to increased
self injury.</span></div>
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<b><span style="font-family: "georgia" , serif;">Key References </span></b></div>
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<p class="Default"><span style="font-family: Georgia, serif; line-height: 107%;"><a href="https://www.spectrumnews.org/news/long-term-study-tracks-persistence-of-self-harm-in-autistic-people/">https://www.spectrumnews.org/news/long-term-study-tracks-persistence-of-self-harm-in-autistic-people/</a><o:p></o:p></span></p>
<p class="Default" style="line-height: normal;"><span style="font-family: Georgia, serif;"><a href="https://www.autism.org/causes-and-interventions-for-self-injury-in-autism/">https://www.autism.org/causes-and-interventions-for-self-injury-in-autism/</a><span style="font-size: 14pt;"><o:p></o:p></span></span></p></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0in; margin-left: .25in; margin-right: 0in; margin-top: 0in; margin: 0in 0in 0in 0.25in; mso-outline-level: 4; vertical-align: baseline;"><span style="font-family: georgia, serif;">Christensen
T, Ringdahl J, Bosch J, et al. (2009). Constipation associated with self-injurious and
aggressive behavior exhibited by a child diagnosed with autism. </span><i style="font-family: georgia, serif;">Education
& Treatment of Children, </i><span style="font-family: georgia, serif;">32, 89–103.</span></div>
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<span style="font-family: "georgia" , serif;">Devine D. (2014). Self-injurious behaviors in autistic children: a neuro-developmental theory of
social and environment isolation. <i>Psychopharmacology, </i>231, 979–997. <o:p></o:p></span></div>
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<span style="font-family: "georgia" , serif;">Duerden,
E. G., Oatley, H. K., Mak-Fan, K. M., McGrath, P. A., Taylor, M. J., Szatmari,
P., & Roberts, S. W. (2012). Risk factors associated with self-injurious
behaviors in children and adolescents with autism spectrum disorders. <i>Journal
of Autism and Developmental Disorders</i>, 42:2460–2470. DOI
10.1007/s10803-012-1497-9<o:p></o:p></span></div>
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<br /></div>
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<span style="font-family: "georgia" , serif;">Mahatmya,
D., Zobel, A., & Valdovinos, M. G. (2008). Treatment approaches for
self-injurious behavior in individuals with autism: Behavioral and
pharmacological methods. Journal of Early and Intensive Behavior Intervention,
5, 106-118.<o:p></o:p></span></div>
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<span style="font-family: "georgia" , serif;">Moseley,
R. L., Gregory, N. J., Smith, P., Allison, C., & Baron-Cohen, S. (2019). A
'choice', an 'addiction', a way 'out of the lost': exploring self-injury in
autistic people without intellectual disability. <i>Molecular autism</i>, <i>10</i>,
18. doi:10.1186/s13229-019-0267-3<o:p></o:p></span></div>
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<span style="font-family: "georgia" , serif;">Soke, G.
N., Rosenberg, S. A., Hamman, R. F., Fingerlin, T., Rosenberg, C. R.,
Carpenter, L., … DiGuiseppi, C. (2017). Factors associated with self-injurious behaviors in children with autism spectrum disorder: Findings from two large national samples. <i>Journal of autism and developmental disorders</i>, <i>47</i>(2),
285–296. doi:10.1007/s10803-016-2951-x<o:p></o:p></span></div>
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<span style="font-family: "georgia" , serif;">Summers,
J., Shahrami, A., Cali, S., D'Mello, C., Kako, M., Palikucin-Reljin, A., …
Lunsky, Y. (2017). Self-Injury in autism spectrum disorder and intellectual disability: Exploring the role of reactivity to pain and sensory input. <i>Brain
sciences</i>, <i>7</i>(11), 140. doi:10.3390/brainsci7110140<o:p></o:p></span></div>
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<span style="font-family: "georgia" , serif;">Waters,
P., & Healy, O. (2012). Investigating the relationship between self-injurious behavior, social Deficits, and co-occurring behaviors in children
and adolescents with autism spectrum disorder. <i>Autism research and
treatment</i>, <i>2012</i>, 156481. doi:10.1155/2012/156481<o:p></o:p></span></div>
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<span style="font-family: "georgia"; font-size: 16px;"><br /></span>
<span style="font-family: "georgia"; font-size: 16px;">Wilkinson, L. A. (2017). Best practice in special education. In L. A. Wilkinson,<a href="https://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=sr_1_2?s=books&ie=UTF8&qid=1479742377&sr=1-2&keywords=wilkinson+autism"> <i>A best practice guide to assessment and intervention for autism spectrum disorder in schools</i></a> (pp. 157-200). </span><span style="font-family: "georgia"; font-size: 16px;">London and Philadelphia</span><span style="font-family: "georgia"; font-size: 16px;">: Jessica Kingsley Publishers.</span></div>
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<b><span style="background: white; color: #1d2129; font-family: "georgia" , serif; font-size: 12pt; line-height: 107%;"><br /></span></b>
<b><span style="background: white; color: #1d2129; font-family: "georgia" , serif; font-size: 12pt; line-height: 107%;">Lee A. Wilkinson</span></b><span style="background: white; color: #1d2129; font-family: "georgia" , serif; font-size: 12pt; line-height: 107%;">, PhD, NCSP is a licensed and nationally
certified school psychologist, and certified
cognitive-behavioral therapist. He is author of the award-winning
books, <i><a href="http://www.amazon.com/Practice-Assessment-Intervention-Asperger-Syndrome/dp/1849058113">A Best Practice Guide to Assessment and
Intervention for Autism and Asperger Syndrome in Schools</a> </i>and <i><a href="http://www.amazon.com/Overcoming-Anxiety-Depression-Autism-Spectrum/dp/1849059276/ref=sr_1_1?s=books&ie=UTF8&qid=1412370192&sr=1-1&keywords=overcoming+anxiety+and+depression+on+the+autism+spectrum">Overcoming Anxiety and Depression on the
Autism Spectrum: A Self-Help Guide Using CBT</a>. </i>He is also
editor of a text in the APA School Psychology Book Series, <i><a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156">Autism Spectrum Disorder in Children and
Adolescents: Evidence-Based Assessment and Intervention in Schools</a></i><i>.</i> His latest book is<i> <a href="http://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8">A Best Practice Guide to Assessment and
Intervention for Autism Spectrum Disorder in Schools (2nd Edition)</a>.</i></span></div>
</div>
</div>
bestpracticeautism.comhttp://www.blogger.com/profile/16482478063587857508noreply@blogger.com0tag:blogger.com,1999:blog-2020163043039993952.post-41008246525283257532020-09-02T13:06:00.002-04:002021-01-06T12:20:37.813-05:00Transition Planning for Students with Autism <div dir="ltr" style="text-align: left;" trbidi="on">
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<b><span style="font-family: "georgia" , serif;">Transition</span></b><span style="font-family: "georgia" , serif;"> <b>Planning for Students with Autism</b></span></div>
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<span style="font-family: "georgia" , serif;">Once
the young person with autism leaves the school system, the educational
entitlements of the Individuals with Disabilities Education Improvement Act
of 2004 (IDEA 2004) are no longer
available. The need for supports and services to help adolescents
transition to greater independence has become a critical issue as a growing
number of youth face significant challenges, with many on the spectrum
unemployed, isolated, and lacking services (Orsmond, Shattuck, Cooper,
Sterzing, & Anderson, 2013). Research indicates that outcomes are almost
universally lower for youth on the autism spectrum compared to their peers. </span><br />
<span style="font-family: "georgia" , serif;"><br /></span>
<span style="font-family: "georgia" , serif;">According to the National Autism Indicators Report: Transition into Young
Adulthood (Roux, Shattuck, Rast, Rava, & Anderson, 2015): (a) only about
one in five lived independently (without parental supervision) in the period
between high school and their early 20s; (b) approximately 26 percent of young adults and 28 percent of those unemployed
and not in school received no services which could help them with employment,
continue their education, or live more independently; (c) Over one-third (37
percent) of young adults were disconnected during their early 20s, meaning they
never got a job or continued education after high school; and (d) transition
planning, a key process for helping youth build skills and access services as
they enter adulthood, was frequently delayed. Just 58 percent of youth had a
transition plan by the federally required age.<o:p></o:p></span></div>
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<b><span style="font-family: "georgia" , serif;"><br /></span></b>
<b><span style="font-family: "georgia" , serif;">The
Transition Plan<i><o:p></o:p></i></span></b></div>
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<span style="font-family: "georgia" , serif;">The
transition from school to adulthood is a process that begins when students and
their parents begin planning for their post high school life. A transition plan
is critical for young people with
autism to be successful and participate to the fullest extent possible in
society. The focus of intervention planning must shift from addressing
the core deficits in childhood to promoting adaptive behaviors that can facilitate
and enhance functional independence and quality of life in adulthood. This
includes new developmental challenges such as independent living, self-advocacy,
vocational engagement, postsecondary education, and family support. <o:p></o:p></span></div>
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<span style="font-family: "georgia" , serif;">IDEA
requires that transition plan activities for students with disabilities begin no
later than the first IEP to be in effect when the child turns 16, or younger if
determined appropriate by the IEP team or state education agency. Transition
services are a coordinated set of activities that focus on improving the
academic and functional achievement of the student with a disability to
facilitate the movement from school to post-school activities, including
postsecondary education, vocational education, integrated employment (as well
as supported employment); continuing and adult education, adult services,
independent living, or community participation. Responsibilities of the IEP
team include coordinating communication and services between school and
community-based service providers; addressing environmental, sensory,
behavioral and/or mental health concerns; identifying potential careers and
employers; and teaching work behaviors, job skills, and community living skills
(Virginia Department of Education, 2010). Just as with other educational
services in a student’s IEP, schools must provide the services necessary for
the student to achieve the transition goals stated in the IEP. </span><br />
<span style="font-family: "georgia" , serif;"><br /></span>
<span style="font-family: "georgia" , serif;">The IEP
must include: (a) appropriate measurable postsecondary goals based upon
age-appropriate transition assessments related to training, education, employment
and, where appropriate, independent living skills; (b) the transition services
(including courses of study) needed to assist the child in reaching those
goals; and (c) beginning not later than one year before the child reaches the
age of majority under state law, a statement that the child has been informed
of the child’s rights under Part B, if any, that will transfer to the child on
reaching the age of majority. The school must also invite the student to his or
her IEP meeting if a purpose of the meeting will be the consideration of the
postsecondary goals for the child and the transition services needed to assist
the child in reaching these goals (IDEA, 2004). <o:p></o:p></span></div>
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<span style="font-family: "georgia" , serif;"><b>Implications</b></span></div>
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<span style="font-family: "georgia" , serif;">Students
with autism face significant challenges as they transition to adulthood. Postsecondary
outcome studies reveal poor long-term outcomes in living arrangements,
employment, and community integration when compared to their peers with other
types of challenges. Research indicates that many are socially isolated and
that the vast majority of young autistic adults will be residing in the
parental or guardian home during the period of emerging adulthood (Anderson,
Shattuck, Cooper, Roux, & Wagner, 2014; Orsmond, Shattuck, Cooper,
Sterzing, & Anderson, 2013). A consistent theme for parents of adolescents
with autism is the fear that their child will “fall through the cracks” when
transitioning from child to adult services. Unfortunately, </span><span lang="EN" style="font-family: "georgia" , serif; mso-ansi-language: EN;">access to
needed supports and services drops off dramatically after high school - with many
receiving little or no assistance. <o:p></o:p></span></div>
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<span lang="EN" style="font-family: "georgia" , serif; mso-ansi-language: EN;">As we know, </span><span style="font-family: "georgia" , serif;">no two people with autism are
alike. The characteristics, strengths, and challenges vary widely across individuals. Support and service needs also
differ and continually change as individuals with autism age. Comprehensive
transition planning and support for students leaving high school and exiting
special educational programming, each with unique strengths, interests, and
challenges, is an urgent task confronting our communities and schools (Roux,
Shattuck, Rast, Rava, & Anderson, 2015). Greater emphasis must be placed on
transition planning as a key process for helping autistic youth build skills and access
services as they leave school and enter adulthood. This includes a focus on
independent living skills, self-advocacy, vocational engagement, postsecondary
education, family support, and a continuum of mental health services for those
experiencing comorbid (co-occurring) mental health issues (Lake, Perry, &
Lunsky, 2014). </span><br />
<span style="background-color: white; color: #1d2129; font-family: "georgia" , serif;"><br /></span>
<span style="font-family: "georgia" , serif;"><o:p></o:p></span><span style="background-color: white; color: #1d2129; font-family: "georgia" , serif;">Image courtesy of </span><a href="http://advocacyinaction.net/autism-preparing-your-child-for/" style="font-family: Georgia, serif;">http://advocacyinaction.net/autism-preparing-your-child-for/</a></div>
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<span style="font-family: "georgia" , serif;">Adapted
from Wilkinson, L. A. (2017<i>). </i><a href="https://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8"><i><span style="color: #990000;">A best practice guide to assessment and
intervention for autism spectrum disorder in schools</span></i></a>. London and Philadelphia:
Jessica Kingsley Publishers.<o:p></o:p></span></div>
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<span style="background: white; font-family: "georgia" , serif;"><span style="color: #990000; font-size: large;">👉 <a href="https://read.amazon.com/kp/embed?asin=B01M7NO6Y1&preview=newtab&linkCode=kpe&ref_=cm_sw_r_kb_dp_a.j.zb4ZZEJ36&reshareId=3AW31VTAXG8SQJH909XQ&reshareChannel=system" target="_blank">Click here to read a free preview of “A Best Practice Guide…”</a></span></span></div>
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<b><span style="font-family: "georgia" , serif;">Key References
and Further Reading<o:p></o:p></span></b></div>
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<span style="font-family: "georgia" , serif;">Anderson,
K. A., Shattuck, P. T., Cooper, B. P., Roux, A. M., & Wagner, M. (2014).
Prevalence and correlates of postsecondary residential status among young
adults with an autism spectrum disorder. <i>Autism, 18</i>, 562-570. doi: 10.1177/1362361313481860<o:p></o:p></span></div>
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<i><span lang="EN-GB" style="font-family: "georgia" , serif; mso-ansi-language: EN-GB;">Individuals with Disabilities Education Improvement Act of 2004</span></i><span lang="EN-GB" style="font-family: "georgia" , serif; mso-ansi-language: EN-GB;">. Pub.
L. No. 108-446, 108th Congress, 2nd Session. (2004).<o:p></o:p></span></div>
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<span style="font-family: "georgia" , serif;">Lake, J.
K., Perry, A., & Lunsky, Y. (2014). Mental health services for
individuals with high functioning autism spectrum disorder. <i>Autism Research
and Treatment</i>, Volume 2014, Article ID 502420.
doi:10.1155/2014/502420<o:p></o:p></span></div>
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<span style="font-family: "georgia" , serif;">Orsmond,
G. I., Shattuck, P. T., Cooper, B. P., Sterzing, P. R., & Anderson, K. A.
(2013). Social participation among young adults with an autism spectrum
disorder<b><u>.</u></b> <i>Journal of Autism and Developmental Disorders, 43</i>,
270-2719. doi 10.1007/s10803-013-1833-8<o:p></o:p></span></div>
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<span style="font-family: "georgia" , serif;">Roux,
A. M., Shattuck, P. T., Rast, J. E., Rava, J. A., & Anderson, K. A. (2015).
<i>National Autism Indicators Report: Transition into Young Adulthood</i>.
Philadelphia, PA: Life Course Outcomes Research Program, A.J. Drexel Autism
Institute, Drexel University. Available from <a href="http://drexe.lu/autismindicators"><span style="color: #990000;">http://drexe.lu/autismindicators</span></a><span class="MsoHyperlink"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: normal;">
<span style="font-family: "georgia" , serif; mso-bidi-font-weight: bold;"><span style="font-family: "georgia" , serif;">Ohio Center for Autism and Low Incidence (OCALI). </span><i style="font-family: georgia, serif;">Transition to Adulthood Guidelines.</i></span><br />
<span style="color: #990000; font-family: "georgia" , serif;">http://www.ocali.org/project/transition_to_adulthood_guidelines</span></div>
<div class="MsoNormal" style="line-height: normal;">
<span style="font-family: "georgia" , serif;">Virginia
Department of Education, Office of Special Education and Student Services
(October, 2010). <i>Autism Spectrum Disorders and the Transition to Adulthood</i>.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal;">
<span style="font-family: "georgia" , serif;">Wagner,
S. (2014). Continuum of services and individualized education plan process. In
L. A. Wilkinson (Ed.). <i>Autism spectrum disorder in children and
adolescents: Evidence-based assessment and intervention in schools</i>
(pp. 173-193). Washington, DC: American Psychological Association.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal;">
<span style="font-family: "georgia" , serif;">Wilkinson,
L. A. (2017). <i>A best practice guide to assessment and intervention for
autism spectrum disorder in schools.</i> Philadelphia & London:
Jessica Kingsley Publishers.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal;">
<span style="font-family: "georgia" , serif; mso-bidi-font-weight: bold;">Wrightslaw. <i>Transition
Planning.<span style="color: #cc0000;"> </span></i></span><span style="font-family: "georgia" , serif;"><a href="http://www.wrightslaw.com/info/trans.index.htm"><span style="color: #990000; font-family: "georgia" , "times new roman" , serif;">http://www.wrightslaw.com/info/trans.index.htm</span></a><span style="font-family: "georgia" , serif;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: normal;">
<span style="font-family: "georgia" , serif;"><b>Lee
A. Wilkinson</b>, PhD, is a licensed and nationally certified school
psychologist, and certified cognitive-behavioral
therapist. He is author of the award-winning books, </span><span style="color: #990000;"><a href="http://www.amazon.com/Practice-Assessment-Intervention-Asperger-Syndrome/dp/1849058113" style="font-family: Georgia, serif;"><i><span style="color: #990000;">A Best Practice Guide to Assessment and
Intervention for Autism and Asperger Syndrome in Schools</span></i></a><i style="font-family: georgia, serif;"> </i></span><span style="font-family: "georgia" , serif;">and </span><a href="http://www.amazon.com/Overcoming-Anxiety-Depression-Autism-Spectrum/dp/1849059276/ref=sr_1_1?s=books&ie=UTF8&qid=1412370192&sr=1-1&keywords=overcoming+anxiety+and+depression+on+the+autism+spectrum" style="font-family: Georgia, serif;"><i><span style="color: #990000;">Overcoming Anxiety and Depression on the
Autism Spectrum: A Self-Help Guide Using CBT</span></i></a><i style="font-family: Georgia, serif;">. </i><span style="font-family: "georgia" , serif;">He is also
editor of a text in the APA School Psychology Book Series, </span><a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156" style="font-family: Georgia, serif;"><i><span style="color: #990000;">Autism Spectrum Disorder in Children and
Adolescents: Evidence-Based Assessment and Intervention in Schools</span></i></a><span style="font-family: "georgia" , serif;">. His
latest book is</span><i style="font-family: Georgia, serif;"> </i><a href="http://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8" style="font-family: Georgia, serif;"><i><span style="color: #990000;">A Best Practice Guide to Assessment and
Intervention for Autism Spectrum Disorder in Schools (2nd Edition)</span></i></a><i style="font-family: Georgia, serif;">.</i></div>
</div>
bestpracticeautism.comhttp://www.blogger.com/profile/16482478063587857508noreply@blogger.com0tag:blogger.com,1999:blog-2020163043039993952.post-75746651175701603302020-08-03T09:34:00.001-04:002021-01-06T12:19:06.113-05:00Autism and Assistive Technology (AT) <div dir="ltr" style="text-align: left;" trbidi="on">
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<b><span style="font-family: "georgia" , serif; font-size: 12pt;">Assistive Technology</span></b></div>
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<span style="font-family: "georgia" , serif; text-align: left;">Assistive
technology (AT) refers to a number of accommodations and adaptations which
enable individuals with disabilities to function more independently.</span><span style="font-family: "georgia" , serif; font-size: 11.5pt; text-align: left;"> </span><span style="font-family: "georgia" , serif; text-align: left;">This includes
any type of technology that provides students with disabilities greater access
to the general education curriculum and increases the potential to master
academic content, interact with others, and enhance functional independence and
quality of life. While AT is not necessary or required for every student
receiving special education services, schools are required to provide the
appropriate assistive technology system when it supports the child’s access to
a free and appropriate public education (FAPE). There are various types of
technology ranging from "low" to "high" tech that might be
incorporated into the educational setting to increase children’s independent
functioning skills and reduce barriers that may prevent them from performing at
a similar level as their peers. For example, students may use software with
word prediction capabilities that allow them to have more success with written
composition. Hardware such as portable keyboards, laptop computers, and tablets
may lessen the physical demand of writing for students with weak fine motor
skills or difficulty coordinating ideas with writing. Similarly, a
speech-generating device or voice output communication aids may meet the needs
of children with limited expressive language, by providing an effective means
of verbal communication.</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "georgia" , serif;"><o:p> </o:p></span></b><b><span style="font-family: "georgia" , serif;">Augmentative and Alternative
Communication (AAC)</span></b></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "georgia" , serif;"><o:p> </o:p></span></b><span style="font-family: "georgia" , serif; text-align: left;">Communication
impairments can impact an individual’s ability to communicate with others
(expressive communication) and/or receive communication from others (receptive
communication). Augmentative and Alternative Communication (AAC) is a type of
assistive technology that can help assist children with communication
impairments to increase skills in this area and to become more competent
communicators. Some autistic students who have
difficulty with expressive communication may be successful in social
interaction and expressing their wants and needs with a low technology AAC
system such as the Picture Exchange Communication System (</span><span style="background: white; color: #1d2129; font-family: "georgia" , serif; font-size: 12pt;">PECS</span><span style="background: white; color: #1d2129; font-family: "georgia" , serif; font-size: 8pt;">©</span><span style="font-family: "georgia" , serif; text-align: left;">). PECS is
considered an evidence-based practice that incorporates both behavioral and
developmental-pragmatic principles to teach functional communication to
children with limited verbal and/or communication skills. </span><span style="background-color: white; color: #1d2129; font-family: "georgia" , serif; font-size: 12pt;">There are six phases
of PECS instruction, with each phase building on the last. The phases are: (1)
Teaching the physically assisted exchange, (2) Expanding spontaneity, (3)
Simultaneous discrimination of pictures, (4) Building sentence structure, (5)
Responding to, “What do you want?” and (6) Commenting in response to a
question. </span><span style="background-color: white; color: #1d2129; font-family: "georgia" , serif; font-size: 12pt;">PECS relies on the
principles of applied behavior analysis (ABA) so that distinct prompting,
reinforcement, and error correction strategies are specified at each training
phase in order to teach spontaneous, functional communication. </span><span style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; color: #1d2129; font-family: "georgia" , serif;">The research evidence suggests that PECS can
be used in multiple settings, including schools, homes, and therapy settings </span><span style="font-family: "georgia" , serif;">to successfully improve functional communication, play, and
behavioral skills.</span></div>
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<span style="font-family: "georgia" , serif;">It is important
for educational teams to consider AAC for any student with autism. For some autistic students, AAC may act as the primary mode of communication. For others, it may
be a secondary form. A referral to an assistive technology specialist or
speech-language pathologist for an evaluation should be made for a student who
may benefit from assistive technology and/or an augmentative communication
system. As with all assessment and intervention
procedures, a team approach is necessary to determine the child’s strengths and
limitations, and the range and scope of potential assistive technology options
to address their specific needs.</span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Adapted from Wilkinson, L. A. (2017). </span><span class="MsoHyperlink"><i><span style="font-family: "georgia" , serif;"><a href="https://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8">A
best practice guide to assessment and intervention for autism spectrum disorder
in schools<span style="font-style: normal;">.</span></a></span></i></span><span style="font-family: "georgia" , serif;"> London and Philadelphia: Jessica Kingsley Publishers.</span></div>
<div align="center" class="MsoNormal" style="line-height: 200%; text-align: center;">
<span face=""segoe ui emoji" , sans-serif" style="mso-bidi-font-family: "Segoe UI Emoji";">👉</span><span style="font-family: "georgia" , serif;"><span style="font-size: large;"> <span class="MsoHyperlink"><a href="https://read.amazon.com/kp/embed?asin=B01M7NO6Y1&preview=newtab&linkCode=kpe&ref_=cm_sw_r_kb_dp_a.j.zb4ZZEJ36&reshareId=3AW31VTAXG8SQJH909XQ&reshareChannel=system">Click
here to read a free preview of “A Best Practice Guide…”</a></span></span><o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="line-height: 200%; text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "georgia" , serif;">Key
References and Further Reading<o:p></o:p></span></b></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Charlop-Christy,
M. H., Carpenter, M., H., LeBlanc, L. A., & Kellet, K. (2002). Using the
Picture Exchange Communication System (PECS) with children with autism:
Assessment of PECS acquisition, speech, social-communicative behavior, and
problem behavior. <i>Journal of Applied Behavior Analysis, 35, </i>213–231.<o:p></o:p></span></div>
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<span style="font-family: "georgia" , serif;">Frost, L., &
Bondy, A. (2002). The Picture Exchange Communication System Training Manual
(2nd ed.). Cherry Hill, NJ: Pyramid Educational Consultants.</span></div>
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<span style="font-family: "georgia" , serif;">Ganz, J. B.,
Davis, J. L., Lund, E. M., Goodwyn, F. D</span><b style="font-family: Georgia, serif;">., </b><span style="font-family: "georgia" , serif;">& Simpson, R. L. (2012).
Meta-analysis of PECS with individuals with ASD: Investigation of targeted
versus non-targeted outcomes, participant characteristics, and implementation
phase.</span><i style="font-family: Georgia, serif;"> Research in Developmental Disorders, 33</i><span style="font-family: "georgia" , serif;">, 406-418</span><i style="font-family: Georgia, serif;">.</i><span style="font-family: "georgia" , serif;">
doi:10.1016/j.ridd.2011.09.023.</span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Hart, S. L., &
Banda, D. R. (2010). Picture Exchange Communication System with individuals
with developmental disabilities: A meta-analysis of single subject studies. </span><i style="font-family: Georgia, serif;">Remedial
and Special Education, 31</i><span style="font-family: "georgia" , serif;">, 476-488</span><b style="font-family: Georgia, serif;">.</b><span style="font-family: "georgia" , serif;"> doi: 10.1177/0741932509338354.</span></div>
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<i><span lang="EN-GB" style="font-family: "georgia" , serif; mso-ansi-language: EN-GB;">Individuals with
Disabilities Education Improvement Act of 2004</span></i><span lang="EN-GB" style="font-family: "georgia" , serif;">. Pub. L. No.
108-446, 108th Congress, 2nd Session. (2004).</span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Kabot, S., &
Reeve, C. (2014). Curriculum and Program Structure. In L. A. Wilkinson (Ed.), </span><i style="font-family: Georgia, serif;">Autism
spectrum disorder in children and adolescents: Evidence-based assessment
and intervention in schools </i><span style="font-family: "georgia" , serif;">(pp. 195-218). Washington, DC: American
Psychological Association.</span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">National Autism
Center (2015). </span><i style="font-family: Georgia, serif;">Findings and conclusions: National standards project, phase 2</i><span style="font-family: "georgia" , serif;">.
Randolph, MA: Author. Available from:
http://www.nationalautismcenter.org/national-standards-project/phase-2/</span></div>
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<span style="font-family: "georgia" , serif;">Sulzer-Azaroff,
B., Hoffman, A. O., Horton, C. B., Bondy, A., & Frost, L. (2009).</span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">The Picture
Exchange Communication System (PECS): What do the data say<b><i>? </i></b><i>Focus
on Autism and Other Developmental Disabilities, 24, </i>89-103.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Twachtman-Cullen,
D. & Twachtman-Bassett, J. (2014). Language and Social Communication. In L.
A. Wilkinson (Ed.). </span><i style="font-family: Georgia, serif;">Autism spectrum disorder in children and
adolescents: Evidence-based assessment and intervention in schools</i><span style="font-family: "georgia" , serif;">
(pp. 101-124). Washington, DC: American Psychological Association.</span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Wilkinson, L. A.
(Ed.) (2014). </span><i style="font-family: Georgia, serif;">Autism spectrum disorder in children and adolescents:
Evidence-based assessment and</i><span style="font-family: "georgia" , serif;"> </span><i style="font-family: Georgia, serif;">intervention in schools</i><span style="font-family: "georgia" , serif;">. Washington,
DC: American Psychological Association.</span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Wilkinson, L. A.
(2014). Introduction: Evidence-Based Practice for Autism Spectrum Disorder. In
L. A. Wilkinson (Ed.). </span><i style="font-family: Georgia, serif;">Autism spectrum disorder in children and adolescents:
Evidence-based assessment and</i><span style="font-family: "georgia" , serif;"> </span><i style="font-family: Georgia, serif;">intervention in schools </i><span style="font-family: "georgia" , serif;">(pp 3-13).
Washington, DC: American Psychological Association.</span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Wilkinson, L. A.
(2017). Best Practice in Special Education. In </span><i style="font-family: Georgia, serif;">A best practice guide to
assessment and intervention for autism spectrum disorder in schools </i><span style="font-family: "georgia" , serif;">(pp. 157-200)</span><span style="font-family: "georgia" , serif;">. London &
Philadelphia: Jessica Kingsley Publishers.</span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Wilkinson, L. A.
(2017). </span><i style="font-family: Georgia, serif;">A best practice guide to assessment and intervention for autism
spectrum disorder in schools</i><span style="font-family: "georgia" , serif;">. London & Philadelphia: Jessica Kingsley
Publishers.</span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Wong, C., Odom, S.
L., Hume, K. A., Cox, C. W., Fettig, A., Kurcharczyk…Schultz, T. R. (2015).
Evidence-based practices for children, youth, and young adults with autism
spectrum disorder: A comprehensive review. </span><i style="font-family: Georgia, serif;">Journal of Autism and
Developmental Disorders, 45</i><span style="font-family: "georgia" , serif;">, 1951-66. doi: 10.1007/s10803-014-2351-z</span></div>
<div class="MsoNormal" style="line-height: 106%; margin-bottom: 8pt;">
<div class="MsoNormal" style="background: white; line-height: normal; margin-bottom: 0in; mso-outline-level: 4; vertical-align: baseline;">
<b><span style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; color: #1d2129; font-family: "georgia" , serif;">Lee A.
Wilkinson, PhD</span></b><span style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; color: #1d2129; font-family: "georgia" , serif;">, is a nationally certified and
licensed school psychologist, and certified
cognitive-behavioral therapist. He is author of the award-winning books, <i><a href="http://www.amazon.com/Practice-Assessment-Intervention-Asperger-Syndrome/dp/1849058113">A
Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome
in Schools</a> </i>and<i> <a href="http://www.amazon.com/Overcoming-Anxiety-Depression-Autism-Spectrum/dp/1849059276/ref=sr_1_1?s=books&ie=UTF8&qid=1412370192&sr=1-1&keywords=overcoming+anxiety+and+depression+on+the+autism+spectrum">Overcoming
Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT</a></i>. He
is also editor of a text in the APA School Psychology Book
Series, <a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156" style="font-style: italic;">Autism
Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and
Intervention in Schools</a><u>.</u> His latest book is<i> <a href="http://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8">A
Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder
in Schools (2nd Edition)</a></i>.</span></div>
</div>
</div>
bestpracticeautism.comhttp://www.blogger.com/profile/16482478063587857508noreply@blogger.com0tag:blogger.com,1999:blog-2020163043039993952.post-79054773196360931292020-07-06T19:54:00.001-04:002021-01-06T12:18:09.349-05:00Legal and Appropriate Educational Programs for Students with Autism <div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "georgia";"><b><br /></b></span>
<span style="font-family: "georgia";"><b>Individuals with Disabilities Education Act (IDEA)</b></span></div>
<span style="font-family: "georgia";"><br /></span>
<span style="font-family: "georgia";">Since Congress
added autism as a disability category to the Individuals with
Disabilities Education Act (IDEA), the number of students receiving
special education services in this category has increased over 900 percent
nationally. </span><span style="color: #231f20; font-family: "georgia" , serif;">T</span><span style="font-family: "georgia" , serif;">he 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. </span><span style="font-family: "georgia";">It’s critically important that parents and educators understand the provisions
for providing legally and educationally appropriate programs and services for
students identified with autism.</span></div>
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<span style="font-family: "georgia";">Research indicates
that education is the most effective treatment/intervention for children with
ASD. The most recent re-authorization of the <a href="https://sites.ed.gov/idea/?src=policy-page">Individuals with Disabilities Education Act</a> (IDEA 2004) </span><span style="font-family: "georgia";">entitles
all students with disabilities to a free, appropriate public education (FAPE).
FAPE encompasses both procedural safeguards and the student’s individual
education program (IEP). The IEP is the cornerstone for the education of a
child with autism. When a student is determined eligible for special education
services, an IEP planning team is formed to develop the IEP and subsequently
determine placement.</span></div>
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<span style="font-family: "georgia";">Although clinical
diagnoses, psychiatric reports, and treatment recommendations can be helpful in
determining eligibility and educational planning, the provisions
of IDEA are the controlling authority with regard to decisions for
special education. While clinical information is professionally helpful, it is
neither legally required nor sufficient for determining educational placement.
Therefore, it’s especially important for administrators, parents, advocates,
teachers and non-school professionals to keep in mind that when it comes to
special education, it is state and federal education codes and regulations (not
clinical criteria) that determine eligibility and IEP planning decisions. </span><br />
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<span style="background-color: white; font-family: "georgia";"><br /></span>
<span style="background-color: white; font-family: "georgia";">According to IDEA regulations, the definition of autism is as follows:</span></div>
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<i><span style="background-color: white; font-family: "georgia";">(c)(1)(i) Autism means a developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age 3, that adversely affects a child’s educational performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences. The term does not apply if a child’s educational performance is adversely affected primarily because the child has an emotional disturbance, as defined in this section.</span></i><br />
<i><span style="background-color: white; font-family: "georgia";"><br /></span></i>
<i><span style="background-color: white; font-family: "georgia";">(ii) A child who manifests the characteristics of ‘‘autism’’ after age 3 could be diagnosed as having ‘‘autism’’ if the criteria in paragraph (c)(1)(i) of this section are satisfied.</span></i></div>
<div style="text-align: center;">
<span style="font-family: "georgia";"><b>Guidelines</b></span></div>
<span style="font-family: "georgia";"><br /></span>
<span style="font-family: "georgia";">Legal
and special education experts recommend the following guidelines to help school
districts meet the requirements for providing legal and appropriate educational programs and services to students with autism.<o:p></o:p></span></div>
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<span style="font-family: "georgia";">1. <i>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.</i><o:p></o:p></span></div>
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<span style="font-family: "georgia";">2. <i>School districts should
make certain that comprehensive, individualized evaluations are completed by
school professionals who have knowledge, experience, and expertise in autism. If
qualified personnel are not available, school districts should provide the
appropriate training or retain the services of a consultant.</i><o:p></o:p></span></div>
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<span style="font-family: "georgia";">3. <i>School districts should
develop IEPs based on the child’s unique pattern of strengths and weaknesses.
Goals for a child with autism 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
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.</i><o:p></o:p></span></div>
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<span style="font-family: "georgia";">4. <i>School districts should
assure that monitoring of student progress 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.</i><o:p></o:p></span></div>
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<span style="font-family: "georgia";">5. <i>School districts should
make every effort to place students in integrated settings to maximize
interaction with non-disabled peers. Inclusion with typically developing
students is important for a child with autism as peers provide the best models for
language and social skills. However, inclusive education alone is insufficient,
evidence-based intervention and training is also necessary to address specific
skill deficits. Although the least restrictive environment (LRE) provision of IDEA
requires that efforts be made to educate students with special needs in less
restrictive settings, IDEA also recognizes that some students may require a
more comprehensive program to provide FAPE. </i><o:p></o:p></span></div>
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<span style="font-family: "georgia";">6. <i>School districts should
provide on-going training and education in autism 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.</i><o:p></o:p></span></div>
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<div style="text-align: center;">
<div style="text-align: left;">
<span style="font-family: "georgia";"><span style="font-family: "georgia" , serif;">Adapted from Wilkinson, L. A. (2017</span><i style="font-family: georgia, serif;">). </i><a href="https://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8" style="font-family: georgia, serif;"><i><span style="color: #990000;">A best practice guide to assessment and intervention for autism spectrum disorder in schools</span></i></a><span style="font-family: "georgia" , serif;">. London and Philadelphia: Jessica Kingsley Publishers.</span></span></div>
<span style="font-family: "georgia";"><b><br /></b></span>
<span style="font-family: "georgia";"><b>Key References and Further Reading</b><o:p></o:p></span></div>
</div>
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<span style="font-family: "georgia";"><a href="https://sites.ed.gov/idea/?src=policy-page">Individuals with Disabilities EducationImprovement Act of 2004</a>. Pub. L. No. 108-446, 108th Congress, 2nd Session.
(2004). <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "georgia";"><span style="background-color: white; color: #1d2129; font-family: "georgia" , serif; font-size: 16px;">Kabot, S., & Reeve, C. (2014). Curriculum and program structure. In L. A. Wilkinson (Ed.), </span><i style="color: #1d2129; font-family: georgia, serif; font-size: 16px;"><a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156/ref=pd_sim_b_13?ie=UTF8&refRID=1YNW1C09SA9QG8NEF6ZH">Autism spectrum disorder in children and adolescents: Evidence-based assessment and intervention in schools</a></i><span style="background-color: white; color: #1d2129; font-family: "georgia" , serif; font-size: 16px;"> (pp. 195-218). Washington, DC: American Psychological Association.</span></span><br />
<span style="font-family: "georgia";"><br /></span>
<span style="font-family: "georgia";">Mandlawitz, M. R. (2002).
The impact of the legal system on educational programming for young children
with autism spectrum disorder. <i>Journal of Autism and Developmental
Disorders, 32</i>, 495-508.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "georgia";">National Research Council
(2001). <i>Educating children with autism</i>. 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.</span><br />
<br />
<span style="font-family: "georgia";">Wagner, S. (2014). Continuum
of Services and Individualized Education Plan Process. In L. A. Wilkinson
(Ed.). <i><a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156/ref=pd_sim_b_13?ie=UTF8&refRID=1YNW1C09SA9QG8NEF6ZH">Autism
spectrum disorder in children and adolescents: Evidence-based assessment
and intervention in schools</a></i> (pp. 173-193). </span><span style="font-family: "georgia";">Washington</span><span style="font-family: "georgia";">, </span><span style="font-family: "georgia";">DC</span><span style="font-family: "georgia";">: American Psychological Association.</span><br />
<span style="font-family: "georgia";"><br /></span>
<span style="font-family: "georgia";">Wilkinson, L. A. (2010).
Best practice in special needs education. In L. A. Wilkinson, <a href="http://www.amazon.com/Practice-Assessment-Intervention-Asperger-Syndrome/dp/1849058113/ref=sr_1_1?s=books&ie=UTF8&qid=1326065567&sr=1-1"><i>A
best practice guide to assessment and intervention for autism and Asperger
syndrome in schools</i> </a>(pp. </span><span style="font-family: "georgia";">127-146). London: Jessica
Kingsley Publishers. </span></div>
<div class="MsoNormal">
<span style="font-family: "georgia";">Wilkinson, L. A. (Ed.).
(2014). <i><a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156/ref=pd_sim_b_13?ie=UTF8&refRID=1YNW1C09SA9QG8NEF6ZH">Autism
spectrum disorder in children and adolescents: Evidence-based assessment
and intervention in schools</a></i>. </span><span style="font-family: "georgia";">Washington</span><span style="font-family: "georgia";">, </span><span style="font-family: "georgia";">DC</span><span style="font-family: "georgia";">: American Psychological Association.</span><br />
<span style="font-family: "georgia";"><br /></span>
<span style="font-family: "georgia";"><span style="font-family: "georgia"; font-size: 16px;">Wilkinson, L. A. (2017). Best practice in special education. In L. A. Wilkinson, <a href="http://www.amazon.com/Practice-Assessment-Intervention-Asperger-Syndrome/dp/1849058113/ref=sr_1_1?s=books&ie=UTF8&qid=1326065567&sr=1-1" style="color: #a62f21; text-decoration-line: none;" target="_blank"><i>A best practice guide to assessment and intervention for autism spectrum disorder in schools</i> </a>(pp. 157-200). </span><span style="font-family: "georgia"; font-size: 16px;">London</span><span style="font-family: "georgia"; font-size: 16px;">: Jessica Kingsley Publishers.</span></span><br />
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<div class="MsoNormal">
<span style="font-family: "georgia";">Zirkel, P. (2014). Legal
Issues Under IDEA. In L. A. Wilkinson (Ed.), <i><a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156/ref=pd_sim_b_13?ie=UTF8&refRID=1YNW1C09SA9QG8NEF6ZH">Autism
spectrum disorder in children and adolescents: Evidence-based assessment
and intervention in schools</a> </i>(pp. 243-257). </span><span style="font-family: "georgia";">Washington</span><span style="font-family: "georgia";">, </span><span style="font-family: "georgia";">DC</span><span style="font-family: "georgia";">: American Psychological Association.</span><span style="font-family: "georgia";"> </span></div>
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<span style="font-family: "georgia";"><a href="http://www.wrightslaw.com/">Wrightslaw: Special Education Law, 2ndEdition
(2007)</a>.<o:p></o:p></span></div>
</div>
<div class="MsoNormal">
<span style="font-family: "georgia";">Yell, M. L., Katsiyannis,
A, Drasgow, E, Herbst, M. (2003). Developing legally correct and
educationally appropriate programs for students with autism spectrum
disorders. <i>Focus on Autism and Other Developmental Disabilities, 18</i>,
182-191.<o:p></o:p></span><br />
<span style="font-family: "georgia";"><span style="font-family: "georgia";"><br /></span></span>
<span style="font-family: "georgia";"><span style="font-family: "georgia";"><b>Lee A. Wilkinson</b>, PhD, is a licensed and nationally certified school psychologist, and certified cognitive-behavioral therapist. </span><span style="font-family: "georgia";">He is author of the award-winning books, <i><a href="http://www.amazon.com/Practice-Assessment-Intervention-Asperger-Syndrome/dp/1849058113" target="_blank">A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools</a> </i>and </span></span><span style="font-family: "georgia";"> </span><i style="font-family: georgia;"><a href="http://www.amazon.com/Overcoming-Anxiety-Depression-Autism-Spectrum/dp/1849059276/ref=sr_1_1?s=books&ie=UTF8&qid=1412370192&sr=1-1&keywords=overcoming+anxiety+and+depression+on+the+autism+spectrum" target="_blank">Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT</a>. </i><span style="font-family: "georgia";">He is also editor a text in the American Psychological Association (APA) School Psychology Book Series, <a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156" target="_blank"><i>Autism Spectrum Disorder in Children and Adolescents</i>: <i>Evidence-Based Assessment and Intervention in Schools</i></a>. His </span><span style="font-family: "georgia";">latest book is<i> </i></span><span style="font-family: "georgia"; font-size: 12pt;"><i><a href="http://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8" target="_blank">A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition)</a></i>.</span></div>
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<span style="font-family: "georgia";">©Lee A. Wilkinson, PhD</span></div>
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bestpracticeautism.comhttp://www.blogger.com/profile/16482478063587857508noreply@blogger.comtag:blogger.com,1999:blog-2020163043039993952.post-54823245091827600722020-06-14T15:25:00.002-04:002021-01-06T12:17:02.260-05:00Teaching Social Skills to Students with Autism <div dir="ltr" style="text-align: left;" trbidi="on">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjI3kXczQwtDY-la8K0iA1EKmzJEn9z1zrP6cuYD6s7Hi-BkUP8jW5_ju_NNsXY-3lxRcb0Xm1lsukUhv9ZGCrHsoqg3CqgDUrfVVT0FztLHPmx0-PEvrcDLxWSUA6fznrBHilIT4XmbvE-/s1600/children-playing-together-.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="709" data-original-width="1600" height="175" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjI3kXczQwtDY-la8K0iA1EKmzJEn9z1zrP6cuYD6s7Hi-BkUP8jW5_ju_NNsXY-3lxRcb0Xm1lsukUhv9ZGCrHsoqg3CqgDUrfVVT0FztLHPmx0-PEvrcDLxWSUA6fznrBHilIT4XmbvE-/s400/children-playing-together-.jpg" width="400" /></a></div>
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<span style="font-family: "georgia" , serif;">Impairment in social communication and interaction is a core
feature of autism spectrum disorder (ASD). Social skills deficits include
difficulties with initiating interactions, maintaining reciprocity, taking
another person’s perspective, and inferring the interests of others.
Unfortunately, many autistic children do not receive consistent and
intensive social skills programming in school. This is problematic, especially
considering social impairments may result in negative outcomes, such as poor academic
achievement, social failure, isolation, and peer rejection, which often leads
to co-occurring (comorbid) anxiety and depression. <o:p></o:p></span></div>
<br />
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<span style="font-family: "georgia";">Because social skills are
critical to successful social, emotional, and cognitive development and
long-term outcomes, best practice indicates that social skills instruction should
be an integral component of educational programming for all children with autism.</span><span style="font-family: "georgia";"> Research evidence suggests
that when appropriately planned and systematically delivered, social skills
instruction has the potential to produce positive effects in the social
interactions of children with ASD. Both the </span><span style="font-family: "georgia";">National</span><span style="font-family: "georgia";"> </span><span style="font-family: "georgia";">Professional</span><span style="font-family: "georgia";">
</span><span style="font-family: "georgia";">Development</span><span style="font-family: "georgia";"> </span><span style="font-family: "georgia";">Center</span><span style="font-family: "georgia";"> on Autism (NPDC) and the National Autism Center (NAC) have identified
social skills training/instruction as an evidence-based intervention and
practice. Social skills training is typically offered as small-group
instruction with a shared goal or outcome of learned social skills in which
participants can learn, practice, and receive feedback. These interventions
seek to build social interaction skills in children and adolescents with ASD by
targeting basic responses (e.g., eye contact, name response) to complex social
skills (e.g., how to initiate or maintain a conversation). </span></div>
<div class="MsoNormal">
<br />
<span style="font-family: "georgia";">Most often, schools
are expected to assume the responsibility of delivering social skills training
programs to children with social skills deficits, because these impairments
significantly interfere with social relationships and have an adverse effect on
academic performance. Although equipped to teach social skills, implementing
social skills programming can be challenging for school personnel (teachers,
counselors, psychologists, social workers), who often have limited time and
resources. Recent meta-analysis research suggests that the effectiveness of
social skills training can be enhanced by increasing the quantity (or
intensity) of social skills interventions, providing instruction in the child’s
natural setting, matching the intervention strategy with the type of skill
deficit, and ensuring treatment integrity (fidelity). In order for students to
learn, practice, and maintain expected social behavior, educators must teach
social skills within the context of the various school settings that students
encounter each day (i.e., classroom, special subject areas such as art and
music, cafeteria, and playground). </span>
</div>
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<span style="font-family: "georgia";">The following are guidelines are recommended when developing a social skills intervention strategy:</span></div>
<ul style="margin-top: 0in;" type="disc">
<li class="MsoNormal" style="mso-list: l0 level1 lfo1; tab-stops: list .5in;"><i><span style="font-family: "georgia";">Avoid a "one size fits all" approach
and adapt the intervention to meet the needs of the individual or
particular group. </span></i></li>
<li class="MsoNormal" style="mso-list: l0 level1 lfo1; tab-stops: list .5in;"><i><span style="font-family: "georgia";">Employ primarily positive strategies and focus
on facilitating the desirable social behavior as well as eliminating the
undesirable behavior. </span></i></li>
<li class="MsoNormal" style="mso-list: l0 level1 lfo1; tab-stops: list .5in;"><span style="font-family: "georgia";"><i>Emphasize the learning, performance,
generalization, and maintenance of appropriate social behaviors
through modeling, coaching, and role-playing</i>. </span></li>
<li class="MsoNormal" style="mso-list: l0 level1 lfo1; tab-stops: list .5in;"><span style="font-family: "georgia";"><i>Provide social skills training and practice
opportunities in a number of settings with different individuals in
order to encourage students to generalize new skills to multiple, real
life situations.</i> </span></li>
<li class="MsoNormal" style="mso-list: l0 level1 lfo1; tab-stops: list .5in;"><span style="font-family: "georgia";"><i>Use assessment strategies, including
functional assessments of behavior, to identify children in need of
more intensive interventions as well as target skills for instruction.</i> </span></li>
<li class="MsoNormal" style="mso-list: l0 level1 lfo1; tab-stops: list .5in;"><i><span style="font-family: "georgia";">Enhance social skills by increasing the
frequency of an appropriate behavior in "normal" or typical
environments to address the naturally occurring causes and consequences. </span></i></li>
<li class="MsoNormal" style="mso-list: l0 level1 lfo1; tab-stops: list .5in;"><i><span style="font-family: "georgia";">Include parents and caregivers as significant
participants in developing and selecting interventions (they can help
reinforce the skills taught at school to further promote
generalization across settings).</span></i></li>
</ul>
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<span style="font-family: "georgia";">The type of skill deficit
(performance deficit versus skill deficit) should also be considered when
developing a social skills intervention plan. A performance deficit refers to a
skill or behavior that is present but not demonstrated or performed, whereas a
skill acquisition deficit refers to the absence of a particular skill or
behavior. School professionals should make an intensive effort to
systematically match the intervention strategy to the type of skill deficit
exhibited by the child. For instance, if the child lacks the skills necessary
to join in an interaction with peers, an intervention strategy should be
selected that promotes skill acquisition. In contrast, if the child has the
skills to join in an activity but regularly fails to do so; a strategy should
be selected that enhances the performance of the existing skill.</span></div>
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<span style="font-family: "georgia";">Social relationship skills
are critical to successful social, emotional, and cognitive development and to
long-term outcomes for students. Thus, systematic social skills instruction
should be considered a critical component of treatment for children with
autism. Teaching social skills can have both preventive and remedial effects
that can help reduce the risk for negative outcomes not only for children on
the autism spectrum, but for all children. </span><br />
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<span style="background: white; color: #1d2129; font-family: "georgia" , serif;"><br /></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0in; mso-layout-grid-align: none; text-autospace: none;">
<span style="background: white; color: #1d2129; font-family: "georgia" , serif;">Adapted from Wilkinson, L. A.
(2017<i>). <a href="https://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8">A best practice guide to assessment and intervention
for autism spectrum disorder in schools</a></i>. London and
Philadelphia: Jessica Kingsley Publishers.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0in; mso-layout-grid-align: none; text-autospace: none;">
<span style="background: white; color: #1d2129; font-family: "georgia" , serif;"></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0.0001pt; text-align: center;">
<span style="background: white; color: #1d2129; font-family: "georgia" , serif;"><span style="font-size: large;"><br /></span></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0.0001pt; text-align: center;">
<span style="background: white; color: #1d2129; font-family: "georgia" , serif;"><span style="font-size: large;">👉 <a href="https://read.amazon.com/kp/embed?asin=B01M7NO6Y1&preview=newtab&linkCode=kpe&ref_=cm_sw_r_kb_dp_a.j.zb4ZZEJ36&reshareId=3AW31VTAXG8SQJH909XQ&reshareChannel=system" target="_blank">Click here to read a free preview of “A Best Practice Guide…”</a></span><o:p></o:p></span></div>
<b><span style="background: white; color: #1d2129; font-family: "georgia" , serif;"><br /></span></b>
<b><span style="background: white; color: #1d2129; font-family: "georgia" , serif;">Lee
A. Wilkinson</span></b><span style="background: white; color: #1d2129; font-family: "georgia" , serif;">, PhD, is a licensed and nationally certified school
psychologist, and certified cognitive-behavioral
therapist. He is author of the award-winning books, <i><a href="http://www.amazon.com/Practice-Assessment-Intervention-Asperger-Syndrome/dp/1849058113">A Best Practice Guide to Assessment and
Intervention for Autism and Asperger Syndrome in Schools</a> </i>and <i><a href="http://www.amazon.com/Overcoming-Anxiety-Depression-Autism-Spectrum/dp/1849059276/ref=sr_1_1?s=books&ie=UTF8&qid=1412370192&sr=1-1&keywords=overcoming+anxiety+and+depression+on+the+autism+spectrum">Overcoming Anxiety and Depression on the
Autism Spectrum: A Self-Help Guide Using CBT</a>. </i>He is also
editor of a text in the APA School Psychology Book
Series, <i><a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156">Autism Spectrum Disorder in Children and
Adolescents: Evidence-Based Assessment and Intervention in Schools</a></i><i>.</i> His latest book is<i> <a href="http://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8">A Best Practice Guide to Assessment and
Intervention for Autism Spectrum Disorder in Schools (2nd Edition)</a></i><i>.</i></span></div>
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bestpracticeautism.comhttp://www.blogger.com/profile/16482478063587857508noreply@blogger.com0tag:blogger.com,1999:blog-2020163043039993952.post-51839681387427182912020-06-11T19:50:00.005-04:002021-01-06T12:15:00.874-05:00The Mental Health Needs of Young Autistic Adults<div dir="ltr" style="text-align: left;" trbidi="on">
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<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgdrvC_6-EXKnHAtcQ0O2-3denHN972lrEPiOsU0SGSh0CfI4DIfwsRYJST4-wO61OeDRW58wtxTRlhkoVLVny8C1TJ6GlrDNNsqseSw14HCaJfWcfyp1ow_kElV9Bxyj2nuX0XITp9M-Ui/s600/Mental-Health-600x330v2.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="330" data-original-width="600" height="220" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgdrvC_6-EXKnHAtcQ0O2-3denHN972lrEPiOsU0SGSh0CfI4DIfwsRYJST4-wO61OeDRW58wtxTRlhkoVLVny8C1TJ6GlrDNNsqseSw14HCaJfWcfyp1ow_kElV9Bxyj2nuX0XITp9M-Ui/w400-h220/Mental-Health-600x330v2.jpg" width="400" /></a></div><div class="separator" style="clear: both; text-align: center;"><br /></div>
<span style="font-family: "georgia";"><b>The Crisis in Mental Health Services</b></span></div>
<div style="text-align: center;">
<span style="font-family: "georgia";"><b><br /></b></span></div>
<span style="font-family: "georgia";">The increase in
the prevalence of autism spectrum conditions among children over the past decade
indicates that a correspondingly large number of youth will be transitioning to adulthood in the coming years. It is estimated that more than 50,000
adolescents with autism will turn 18 years old this year in the </span><span style="font-family: "georgia";">U.S.</span><span style="font-family: "georgia";"> As these numbers continue to rise, there is an
urgent need to address the mental health issues faced by many teens and young adults on the autism spectrum.</span></div>
<div class="MsoNormal">
<span style="font-family: "georgia";">Although we know that
children with autism grow up to be adults with autism, there are fewer mental
health services available for adults on the spectrum, particularly for
individuals who are not intellectually challenged. A review in the open access journal,
<i>Autism Research and
Treatment</i>, highlights the service needs and the corresponding gaps in care
for this population. The authors posit that the mental health system is in
crisis and that although the rates of mental health issues for adults on the
spectrum is high, accessing services to address these symptoms remains
difficult. Poor recognition tends to occur for a number of different reasons,
including restrictive intake criteria, misdiagnosis, limited knowledge or
awareness of autism spectrum conditions, clinicians who lack confidence or
experience in caring for this group of adults, and the belief that other
service providers will provide this care. Consequently, many autistic adolescents and
adults, because of their diagnosis, are excluded from
community mental health services, leaving them grossly underserved.</span></div>
<div class="MsoNormal" style="text-align: center;">
<b><span style="font-family: "georgia";">Mental Health Issues</span></b></div>
<div class="MsoNormal">
<span style="font-family: "georgia";">Comorbid (co-occurring) psychiatric
disorders are well documented in individuals with autism across the lifespan.
Research suggests that a very high proportion of autistic adults and teens present with co-occurring (comorbid) psychiatric conditions,
particularly depression and anxiety. For example, recent studies examining
psychiatric comorbidity in young adults with autism spectrum conditions found
that 70% had experienced at least one episode of major depression, 50% had
suffered from recurrent depressive episodes, and 50% met criteria for an
anxiety disorder. Unfortunately, it appears that co-occurring psychiatric
disorders and even the diagnosis of an autism spectrum condition itself often
go unrecognized among more capable adolescents and adults on the spectrum seeking
psychological or psychiatric care. Many youth and young adults report
significant difficulties accessing healthcare services, particularly
comprehensive health services. Part of the reason for this difficulty may stem
from service providers feeling ill equipped to work with individuals with
autism, particularly individuals with co-occurring mental health issues. As a
result, adolescents and adults with autism spectrum conditions have access to
significantly fewer programs than adolescents and adults with other types of
developmental disabilities. Not surprisingly then, a consistent theme for
parents of individuals with autism is the fear that their child will fall
through the cracks when transitioning from child to adult services. Similar
concerns have been voiced by autistic individuals themselves, who describe
how their needs are infrequently recognized and the programs and services
available are not designed for people with autism spectrum conditions in mind.</span></div>
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<span style="font-family: "georgia";"><b>Implications</b></span></div>
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<span style="font-family: "georgia";">Adolescents and adults on
the autism spectrum represent a complex and underserved population. Of the
studies completed to date, findings suggest that this group of adolescents and
adults faces a multitude of psychiatric and psychosocial issues, alongside
significant challenges in accessing services. Social skills deficits for autistic individuals persist into adulthood, and adults appear to be at
an increased risk for developing depression and anxiety. Despite this, very few
studies have examined treatment approaches and interventions (pharmacological
and psychosocial) for adolescents and adults with autism.
While evidence is beginning to emerge for interventions, including cognitive-behavioral therapy (CBT), mindfulness-based
therapy (MBT), and social skills training (SST), further large-scale studies comparing the effectiveness of CBT or MBT versus other
treatment options (e.g., medication, counseling, etc.) are required. Likewise, there
is an immediate need for mental health clinicians who are trained to apply
these techniques. In developing interventions, programs must also consider what
adolescents and adults want. For example, adolescents and adults on the
spectrum may be more interested in interventions which focus on vocational
opportunities than interventions targeting social skills. Moreover, both
individuals and their family must be viewed as valuable contributors and fully
involved in this process. Lastly, researchers must look at issues of service
cost and efficiency when evaluating the impact of interventions.</span></div>
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<b><span style="font-family: "georgia";">Recommendations</span></b></div>
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<i><span style="font-family: "georgia";">1. </span><span style="background-color: white; color: #222222; font-family: "georgia" , serif;">According
to the U.S. Surgeon General, over the course of a year, approximately 20% of
children and adolescents in the U.S. experience signs and symptoms of a mental
health problem. Unfortunately, most children and youth who are in need of
mental health services do not actually receive them. Psychological services should
be expanded in schools to include a major focus on the delivery of mental
health services to all students. </span></i><br />
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<span style="color: #222222; font-family: "georgia" , serif;"><o:p></o:p></span></div>
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<span style="font-family: "georgia";"><i>2. Developmental
disability agencies or agencies supporting individuals with autism spectrum
conditions must partner with community mental health agencies to help train,
mentor, and build capacity to care for this group across the lifespan. It is
important to note that many clinicians working within community mental health
agencies already have the skills to effectively deliver this care, but programs
either preclude their ability to do so or they lack the confidence to work with
this population.</i></span></div>
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<span style="font-family: "georgia";"><i>2. There is a critical
need for community mental health agencies to review their exclusion criteria to
include persons with autism spectrum conditions. For example, agencies
providing care for persons with mood or anxiety disorders should not exclude
individuals on the basis of a diagnosis of autism. Community mental health
agencies have the resources and expertise in mental health, along with the programs
to deliver services for individuals with mental health issues (e.g., vocational
programs, counseling, and therapies), but will need guidance from developmental
disability agencies to successfully adapt these programs for adults on the
autism spectrum.</i></span></div>
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<i><span style="font-family: "georgia";"></span><span style="font-family: "georgia";">3. Developmental
disability agencies must reevaluate their inclusion criteria to include persons
with autism spectrum conditions, regardless of IQ, and across the lifespan.
Organizations must work together, combining expertise in autism from
developmental disability agencies with knowledge and resources from community
mental health agencies.</span>
</i></div>
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<span style="font-family: "georgia";"><i>4. There is a need to
study and identify programs and supports that are most effective in both school
and community settings. This will require a full continuum of mental health
services including counseling, vocational training, supported employment, inpatient
services, and outpatient services. It will also require a network of
experienced clinicians and community partners. Many of these efforts are
already underway in pediatric settings; however, these same efforts are
required in adolescent and adult mental health services.</i></span></div>
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<span style="font-family: "georgia";"><i>5. Finally, there is a
need to prepare and equip older youth with autism spectrum conditions for the
transition to adult services.</i></span></div>
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<span style="font-family: "georgia";">Johanna</span><span style="font-family: "georgia";"> </span><span style="font-family: "georgia";">K.</span><span style="font-family: "georgia";"> </span><span style="font-family: "georgia";">Lake</span><span style="font-family: "georgia";">, J. K., Perry, A., & Lunsky, Y.
(2014). Mental Health Services for Individuals with High Functioning Autism
Spectrum Disorder. Autism Research and Treatment, Volume 2014, Article
ID 502420. http://dx.doi.org/10.1155/2014/502420</span></div>
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<span style="font-family: "georgia";"><b>Lee A. Wilkinson</b>, PhD, is a licensed and nationally certified school psychologist, and certified cognitive-behavioral therapist. He is author of the award-winning books, <i><a href="http://www.amazon.com/Practice-Assessment-Intervention-Asperger-Syndrome/dp/1849058113">A
Best Practice Guide to Assessment and Intervention for Autism and Asperger
Syndrome in Schools</a> </i>and<i> </i></span><i style="font-family: georgia;"><a href="http://www.amazon.com/Overcoming-Anxiety-Depression-Autism-Spectrum/dp/1849059276/ref=sr_1_1?s=books&ie=UTF8&qid=1412370192&sr=1-1&keywords=overcoming+anxiety+and+depression+on+the+autism+spectrum">Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT</a></i><span style="font-family: "georgia";">. </span><span style="font-family: "georgia";">He is
also editor of a text in the APA School Psychology Book Series, <i><a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156">Autism
Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and
Intervention in Schools</a>. </i>His latest book is</span><span style="font-family: "georgia"; font-size: 12pt;"><i><a href="http://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8" target="_blank"> A Best Practice Guide to Assessment and Intervention for Autism
Spectrum Disorder in Schools (2nd Edition)</a></i>.</span></div>
</div>
bestpracticeautism.comhttp://www.blogger.com/profile/16482478063587857508noreply@blogger.com0tag:blogger.com,1999:blog-2020163043039993952.post-41977838466922278002020-05-13T15:51:00.002-04:002021-01-06T13:17:39.090-05:00Early Social Communication Indicators of Autism <div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="background: white; font-family: "georgia" , serif;"><br /></span></div>
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<span style="background: white; font-family: "georgia" , serif;">It is well established that early
identification and intervention are critical determinants in the course and
outcome of autism spectrum disorder (ASD). Although there are no
“absolute” clinical indicators of autism, some of the early “red flags”
include: • Does not smile by the age of six months • Does not respond to his or
her name • Does not cry • Does not babble or use gestures by 12 months and •
Does not point to objects by 12 months. Children with autism typically
experience delays in speech and communication skills. Not only will they often
develop spoken language later, but they are less likely to develop non-verbal
communication skills such as “joint attention,” pointing, or gesturing. </span><span style="background: white; font-family: "georgia" , serif;"><o:p></o:p></span></div>
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<span style="font-family: "georgia";"><b>Social Communication Skills</b></span></div>
<div style="text-align: left;">
<span style="font-family: "georgia";"><br /></span></div>
<div style="text-align: left;">
<span style="font-family: "georgia";">Young children with autism
spectrum disorder (ASD) typically exhibit core deficits in social communication
skills, particularly in the areas of joint attention, shared affect,
eye-contact, conventional and symbolic gestures, and related skills in
functional and symbolic play. Children seek to share attention with others
spontaneously during the first year of life. “Joint attention” is an
early-developing social-communicative skill in which two people (usually a
young child and an adult) use gestures and gaze to share attention with respect
to interesting objects or events. Before infants have developed social
cognition and language, they communicate and learn new information by following
the gaze of others and by using their own eye contact and gestures to show or
direct the attention of the people around them. These developments in the first
two years of life are potentially important early indicators of ASD which can
facilitate earlier diagnosis. Researchers have identified five core deficits
(‘red flags’) evident in the early years, namely gaze shifting, gaze point following,
rate of communicating, joint attention and gestures; these were the strongest
predictors of symptoms of autism at three years of age.</span>
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<div style="text-align: center;">
<span style="font-family: "georgia";"><b>Research</b></span></div>
<span style="font-family: "georgia";"><br /></span>
<span style="font-family: "georgia";"></span><span style="font-family: "georgia";">Researchers in Melbourne
Australia, working on a long-term study of children from eight months to seven
years of age found that those with autism used fewer gestures to communicate
than other kids. Parents of 1,911 children participating in the ‘Early Language
in Victoria Study’ in Melbourne, Australia, completed questionnaires about
their child’s development from infancy through to school age. At four years of
age, a group of children identified with an autism spectrum disorder (ASD) were
compared to other children from within the study; those with a developmental
delay, language impairment, or typical development. Comparisons were made
between the children’s early social communication skills (including eye-gaze,
non-verbal communication, gesture, and speech skills) at 8 months, 1 year, and
2 years of age. By one year of age, children with ASD used fewer early social
communication skills than children with typical development. The only social
communication skill that was found to be significantly different between
children with ASD and all other children, however, was the use of gesture.
Children with ASD used fewer gestures for communication than all other children
at both 1 and 2 years of age. </span>
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<div style="text-align: center;">
<span style="font-family: "georgia";"><b>Implications</b></span></div>
<span style="font-family: "georgia";"><br /></span>
<span style="font-family: "georgia";"></span><span style="font-family: "georgia";">Speech pathologist Carly
Veness, who led the research, said there was a pattern of low gesture use among
autistic children between the ages of eight months and two years. "We
found that there was a decreased use of gestures like pointing, showing and
giving,” she commented. The researchers noted that gestural deficits almost
doubled the risk for ASD, pointing to the importance of targeting gesture
deficits in infant early intervention approaches. They conclude that their
results “… highlight the possibility of detecting risk signs for ASD as young
as 12 months of age in a community sample, thus allowing for earlier
recognition of the disorder.”</span>
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<span style="font-family: "georgia";"></span><span style="font-family: "georgia";">Veness, C., Prior, M.,
Bavin, E., Eadie, P., Cini, E., & Reilly, S. (2012). Early indicators of
autism spectrum disorders at 12 and 24 months of age: A prospective,
longitudinal comparative study. <a href="http://aut.sagepub.com/">Autism</a>,
16, 163-177.</span>
</div>
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<span style="font-family: "georgia" , serif;"><b>Lee A. Wilkinson</b>, PhD, is a licensed and nationally certified school psychologist, and certified cognitive-behavioral therapist. He is author of the award-winning books, </span><a href="http://www.amazon.com/Practice-Assessment-Intervention-Asperger-Syndrome/dp/1849058113"><i><span style="font-family: "georgia" , serif;"><span style="color: #990000;">A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools</span></span></i></a><i><span style="font-family: "georgia" , serif;"> </span></i><span style="font-family: "georgia" , serif;">and </span><a href="http://www.amazon.com/Overcoming-Anxiety-Depression-Autism-Spectrum/dp/1849059276/ref=sr_1_1?s=books&ie=UTF8&qid=1412370192&sr=1-1&keywords=overcoming+anxiety+and+depression+on+the+autism+spectrum"><i><span style="font-family: "georgia" , serif;"><span style="color: #990000;">Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT</span></span></i></a><i><span style="font-family: "georgia" , serif;">. </span></i><span style="font-family: "georgia" , serif;">He is also editor of a text in the APA School Psychology Book Series, </span><a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156"><i><span style="font-family: "georgia" , serif;"><span style="color: #990000;">Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools</span></span></i></a><span style="font-family: "georgia" , serif;">. His latest book is<i> </i></span><a href="http://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8"><i><span style="font-family: "georgia" , serif;"><span style="color: #990000;">A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition)</span></span></i></a><i><span style="font-family: "georgia" , serif;">.</span></i></div>
</div>
bestpracticeautism.comhttp://www.blogger.com/profile/16482478063587857508noreply@blogger.com0tag:blogger.com,1999:blog-2020163043039993952.post-22770859657435125942020-05-05T08:25:00.015-04:002021-03-27T20:09:01.981-04:00Problem Behavior in Children with Autism<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "georgia" , "times new roman" , serif;"><b>Challenging Behavior in Autistic Children</b></span><br />
<span style="font-family: "georgia" , "times new roman" , serif;"><b><br /></b></span></div>
<span style="font-family: "georgia" , "times new roman" , serif;">Challenging <span style="background-color: white;">behavior is any behavior that interferes
with a child’s learning, engagement, and social interactions with her peers or
adults. Aggression is often observed as one form of challenging behavior in
autism. Although aggression is not itself a symptom of autism and not all autistic
individuals are aggressive, research suggests that the prevalence of challenging behavior
may be higher in individuals with autism compared to typically developing peers
and those with other developmental disabilities. </span><span style="background-color: white;">Children with autism don’t necessarily express anger, fear,
anxiety or frustration in the same way as other children. However, irritability
is a symptom of autism that can complicate adjustment at home and other
settings, and can manifest itself in aggression, tantrums, and self-injurious
behavior.</span><span style="background-color: white;"> </span></span><br />
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<span style="background: white; line-height: 107%;"><span style="font-family: "georgia" , "times new roman" , serif;"><o:p></o:p></span></span></div>
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<b><span style="background: white; line-height: 107%;"><span style="font-family: "georgia" , "times new roman" , serif;">Behavior as Communication</span></span></b></div>
<div style="text-align: left;">
<span style="font-family: "georgia" , "times new roman" , serif;"><span style="background: white; line-height: 107%;">Children
engage in problem behavior to communicate. </span><span style="background-color: white;">The principles of behavior teach us that it does
not occur in a vacuum – that is, behavior does not occur without regard to the
context in which it is observed. </span><span style="background: white; line-height: 107%;">When working with autistic children we should consider problem behavior as a communication
attempt, and should determine what skill the child needs to learn in order to
reduce the need for the problem behavior or what environmental modification
makes the behavior unnecessary.</span><span style="background: white; color: #141412;"> </span><span style="background: white; line-height: 107%;">The first step to developing an
effective intervention strategy is to identify the <i>function </i>of
the behavior. By function, we mean what the child is trying to access by
engaging in the challenging behavior. In other words: you first must figure out
what it is the child is trying to communicate. </span><span style="background-color: white;">For example, a student might exhibit challenging behaviors
with the goal of escape or the goal of seeking attention. When the curriculum
is difficult or demanding, they may attempt to avoid or escape work through
challenging behavior (e.g., refusal, passive aggression, disruption, etc.).
Similarly, they may use challenging behavior to get focused attention from
adults and peers, or to gain access to a preferred object or participate in an
enjoyable activity. Problematic behavior may also occur because of sensory
aversions. Because autistic students also have significant social and pragmatic
skills deficits, they may experience difficulty effectively communicating their
needs or influencing the environment. Thus, challenging classroom behavior may
serve a purpose for communicating or a communicative function.</span></span><span style="background-color: white; font-family: "georgia" , "times new roman" , serif;"> </span></div>
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<div style="text-align: center;">
<span style="background-color: white;"><span style="font-family: "georgia" , "times new roman" , serif;"></span></span></div>
</div>
<div style="text-align: center;">
<br />
<span style="background: white; line-height: 17.12px;"><b><span style="font-family: "georgia" , "times new roman" , serif;">Common Triggers</span></b></span></div>
<div style="text-align: left;">
<span style="background: white; line-height: 17.12px;"><span style="font-family: "georgia" , "times new roman" , serif;"><br /></span></span></div>
<div style="text-align: left;">
<span style="font-family: "georgia" , "times new roman" , serif;"><span style="background: white; line-height: 17.12px;">Research suggests that common triggers include disturbing breaks in routine, lack of sleep, jarring “sensory stimuli” (noises, lights, or smells) or even undiagnosed mental health problems. Children with significant aggressive behavior also tended to have mood and anxiety symptoms, and difficulty sleeping and paying attention. Clearly, it’s important to look beyond the behavior itself to identify the underlying cause or trigger.</span><span style="background-color: white; line-height: 17.12px;"> </span><span style="background: white; line-height: 17.12px;">Children with significant aggressive behavior also tended to have mood and anxiety symptoms, and difficulty sleeping and paying attention.</span><span style="background: white; color: #666666; line-height: 17.12px;"> </span><span style="background: white; line-height: 17.12px;">The studies also indicate that symptoms of aggression often overlap in patients with extreme anxiety and attention deficit issues.</span><span style="background: white; line-height: 17.12px;"> </span><span style="background: white; line-height: 17.12px;">It has been reported that executive function deficits (e.g. issues with inhibition, working memory, planning and flexibility) are associated with anxiety and aggression in autism and may serve as a pathway to comorbid psychopathology (</span><span style="background: white; line-height: 17.12px;">sensory stimuli, a change in routine, transition between activities, or physical reasons like feeling unwell, tired or hungry. Not being able to communicate these difficulties can lead to anxiety, anger and frustration, and then to an outburst of challenging </span><span style="background-color: white;">behavior. </span></span><br /><br /></div>
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<span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia";"> </span><b style="font-family: georgia;">Predictors</b></span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia";">Although the nature and developmental course of aggression have been a focus of research with typically developing populations, there have been few large-scale studies of group-level predictors of aggression among individuals with autism. Consequently, it is unclear whether findings from the general population are applicable to autistic children and adolescents. In an effort to investigate the extent of the problem in children and adolescents with autism, a recent large-scale study published in </span><i style="font-family: georgia;">Research in Autism Spectrum Disorders</i><span style="font-family: "georgia";"> examined the prevalence and correlates of physical aggression in a sample of 1584 children and adolescents with ASD enrolled in the Autism Treatment Network (ATN), a multi-site network of 17 autism centers across the US and Canada. </span>The results indicated that the prevalence of aggression was 53% across the entire sample of children, with highest prevalence among young children. These results are highly consistent with recently reported prevalence rates (56%) in another large-scale study of children and adolescents with autism. The results also indicate that age-related decreases in aggression in autistic children are similar to what has been observed in typically developing children. It should be noted, however, that a large percentage (nearly 50%) of the adolescents in the study’s sample continued to demonstrate physical aggression. Thus, the relative decrease in aggression over time must be balanced by the finding that these behaviors continued to occur at a high rate among a large portion of adolescents with autism.</span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;">In terms of predictors, the results indicated that self-injury was highly associated with aggression among children with autism. This is consistent with the findings of other studies showing a strong association between self-injury and other challenging behaviors. The current results add to existing literature, and suggest that autistic children who demonstrate self-injury may be at risk for more severe behavioral problems.</span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;">Sleep problems emerged as a second significant predictor aggression. This association between sleep problems and aggression is largely consistent with previous findings among both typically developing children and those with autism, indicating may underlie (and exacerbate) aggressive behavior patterns for many autistic children. It should also be noted that sleep problems have been found to be associated with self-injurious behaviors among individuals with intellectual disabilities and that these two conditions may be related. In fact, there is some developing evidence suggesting shared neurobiological basis for both sleep disturbance and self-injurious behavior.</span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;">Sensory problems were also significantly associated with aggression. These findings are consistent with similar associations between sensory issues and aggression among typically developing children. While previous research has demonstrated an association between sensory problems and broadly defined behavior problems, the current results extend these previous findings by demonstrating a specific relationship between sensory problems and physical aggression.</span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;">Comparisons also indicated that children with aggression were more likely to experience GI problems, communication skill difficulties, and social skills difficulties. However, these variables did not appear as significant predictors of aggression, indicating that self-injury, sleep problems, and sensory issues accounted for the majority of the variance in predicting aggression.</span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;"><span style="background: white; line-height: 107%;"></span></span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;">In regards to potential sex differences, the results indicate that girls and boys with autism were equally likely to engage in aggression. This finding was unexpected in that research has consistently shown a significant gender difference among children without autism, with boys being much more likely to engage in physical aggression than girls. The results of the study suggest that the sex differential in aggression may not be salient in the autistic population.</span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;"><b>Implications</b></span></div>
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<span style="font-family: "georgia" , "times new roman" , serif;">This study provides evidence that challenging behavior may be much more prevalent among children with autism than in the general population and that some comorbid problems may place individuals at risk for aggression. Aggression was significantly associated with a number of clinical features, including self-injury, sleep problems, sensory problems, GI problems, and communication and social functioning. However, self-injury, sleep problems, and sensory problems were most strongly associated with aggression. These findings indicate that co-occurring problems specific to the autism phenotype may play an important role in the occurrence of aggression and that it is important to consider multiple domains of functioning when assessing and treating aggression in autistic children. For example, increased attention should be given to the identification and treatment of sleep problems, self-injury, and sensory problems. Given the significant relationship between sleep problems and aggression, it is possible that treatments targeting sleep problems may help reduce maladaptive behavior. Thus, assessment and treatment of sleeping problems might be included as a standard and integrated part of the assessment and treatment of autism. Programs for children with autism should also integrate an appropriately structured physical and sensory milieu in order to accommodate any unique sensory processing challenges. </span><br />
<span style="font-family: "georgia" , "times new roman" , serif;"><span style="background: white; line-height: 107%;"><br /></span></span>
<span style="font-family: "georgia" , "times new roman" , serif;"><span style="background: white; line-height: 107%;">Behavioral interventions, particularly those
based upon applied behavior analysis (ABA), have long had empirical support for
addressing problematic behavior (for a review, see Schreibman, 2000). A
comprehensive treatment plan for treating aggressive behaviors in children with
autism begins with a precise and thorough assessment, followed by implementation
of a comprehensive treatment plan.</span></span><br />
<span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-family: "georgia";">Although assessment tools are limited, comorbid problems should be assessed whenever significant behavioral issues (e.g., inattention, mood instability, anxiety, sleep disturbance, aggression) become evident or when major changes in behavior are reported. Co-occurring disorders should also be carefully investigated when severe or worsening symptoms are present that are not responding to traditional methods of intervention. </span><span style="background-color: white;">It is important to take the time to analyze these underlying
causes of aggressive behavior in children with autism. By understanding the
triggers of aggression, we are able to choose the most effective
intervention strategies. </span><span style="background-color: white;">Once we understand the function or goal of student behavior, we can begin to teach alternative replacement behavior and new interaction skills. </span></span><br />
<span style="font-family: "georgia" , "times new roman" , serif;"><br /></span>
<span style="font-family: "georgia" , "times new roman" , serif;">Further research is needed in order to better understand the characteristics and course of different types of aggression. For example, future research should examine the longitudinal course of aggression, the role of these associated problems in predicting improvement or worsening of aggression, and possible changes in aggression in response to treatment for these co-occurring problems. Studies are also needed to examine the role of additional family- and community-level variables in the prediction and maintenance of aggression among children with autism. </span><span style="font-family: "georgia" , "times new roman" , serif;"> </span></div>
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<div style="text-align: center;">
<span style="font-family: "georgia" , "times new roman" , serif;"><b>References and Further Reading</b></span><br />
<div style="text-align: left;">
<span style="font-family: "georgia" , "times new roman" , serif;"><b><br /></b></span></div>
</div>
</div>
<div class="MsoNormal">
<span style="background: white; font-family: "georgia" , serif;">Cervantes P, Matson JL, Tureck K,
Adams HL. The relationship of comorbid anxiety symptom severity and challenging
behaviors in infants and toddlers with autism spectrum disorder. <i>Research
in Autism Spectrum Disorders</i>. 2013;7(12):1528–1534.</span><span style="background: white; font-family: "georgia" , serif;"><o:p></o:p></span></div>
<div class="MsoNormal">
<span style="background: white; font-family: "georgia" , serif;">Chazin, K.T. & Ledford, J.R. (2016). Challenging
behavior as communication. In <i>Evidence-based instructional practices
for young children with autism and other disabilities. </i></span><span class="MsoHyperlink"><span style="background: white; font-family: "georgia" , serif;"><o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Farmer C.A. & Aman
M. G. Aggressive behavior in a sample of children with autism spectrum
disorders. <i>Research in Autism Spectrum Disorders.</i> 2011;5(1):317–323.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="background: white; font-family: "georgia" , serif;">Farmer, C., Butter, E., Mazurek M.O,
et al. Aggression in children with autism spectrum disorders and a
clinic-referred comparison group. <i>Autism</i>. 2015;19(3):281–291.</span><span style="background: white; font-family: "georgia" , serif;"><o:p></o:p></span></div>
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<span style="font-family: "georgia" , serif;">Farmer C, Butter
E, Mazurek M.O, Cowan C, Lainhart J, Cook E.H, & Aman M. Aggression in
children with autism spectrum disorders and a clinic-referred comparison
group. <i>Autism</i>. 2014<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="background: white; font-family: "georgia" , serif;">Fitzpatrick, S. E., Srivorakiat, L., Wink, L. K., Pedapati,
E. V., & Erickson, C. A. (2016). Aggression in autism spectrum disorder:
presentation and treatment options. <i>Neuropsychiatric disease and treatment</i>, <i>12</i>,
1525–1538. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Healy O., Lydon
S., Holloway J., Dwyer M. (2014). Behavioral interventions for aggressive behaviors
in autism spectrum disorders. In: Patel V., Preedy V., Martin C. (eds). <i>Comprehensive
Guide to Autism</i>. Springer, New York, NY<o:p></o:p></span></div>
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<span style="font-family: "georgia" , serif;">Hill, A. P.,
Zuckerman, K., Hagen, A. D., Kriz, D., Duvall, S., Van Santen, J., ...
Fombonne, E. (2014). Aggressive behavior problems in children with
autism spectrum disorders: Prevalence and correlates in a large clinical
sample. <i>Research in Autism Spectrum Disorders</i>, <i>8</i>(9),
1121-1133. <o:p></o:p></span></div>
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<span style="background: white; font-family: "georgia" , serif;">Hodgetts, S., Nicholas, D., & Zwaigenbaum, L. (2013).
Home sweet home? Families’ experiences with aggression in children with autism
spectrum disorders. <i>Focus on Autism and Other Developmental
Disabilities, 28</i>(3), 166-174. <o:p></o:p></span></div>
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<span style="font-family: "georgia" , serif;">Kaartinen M.,
Puura K., Helminen M., Salmelin R., Pelkonen E., & Juujärvi P. (2014).
Reactive aggression among children with and without autism spectrum
disorder. <i>J Autism Dev Disord</i>., 44(10):2383–2391<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="background: white; font-family: "georgia" , serif;">Kanne, S. M., & Mazurek, M. O. (2011). Aggression in
children and adolescents with ASD: Prevalence and risk factors.<i> Journal
of Autism and Developmental Disorders, 41</i>(7), 926-937. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Love, J.R., Carr,
J. E, & LeBlanc, L.A. (2009).Functional assessment of problem behavior in
children with autism spectrum disorders: a summary of 32 outpatient
cases. <i>J Autism Dev Disord.,</i> 39(2):363–372. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Mayes, S.D.,
Calhoun, S.L., Aggarwal, R., Baker, C., Mathapati, S., Anderson, R., & Petersen
C. (2012). Explosive, oppositional, and aggressive behavior in children with
autism compared to other clinical disorders and typical children<i>. Research
in Autism Spectrum Disorders</i>. 6:1–10<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="background: white; font-family: "georgia" , serif;">Pugliese, C. E., Fritz, M. S., & White, S. W. (2015). The
role of anger rumination and autism spectrum disorder–linked perseveration in
the experience of aggression in the general population. <i>Autism</i>, <i>19</i>(6),
704–712.</span><u><span style="background: white; color: #0563c1; font-family: "georgia" , serif;"><o:p></o:p></span></u></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Schreibman, L.
(2000), Intensive behavioral/psychoeducational treatments for autism: research
needs and future directions. <i>J Autism Dev Disord</i>., 30(5):373-378.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Shea, S., Turgay,
A., Carroll, A. et al. (2004), Risperidone in the treatment of disruptive
behavioral symptoms in children with autistic and other pervasive developmental
disorders. <i>Pediatrics,</i> 114(5):634-641.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "georgia" , serif;">Tremblay, R.E.,
Nagin, D.S., Séguin, J.R., Zoccolillo, M., Zelazo, P.D., Boivin, M., et al. (2004).
Physical aggression during early childhood: Trajectories and predictors. <i>Pediatrics</i>,
114(1):e43–e50.<o:p></o:p></span></div>
<div style="margin: 0in;">
<span style="background: white; color: #1d2129; font-family: "georgia" , serif;">Wilkinson, L. A. (2017). <i>A best practice
guide to assessment and intervention for autism spectrum disorder in schools (2nd Edition)</i>.
London & Philadelphia: Jessica Kingsley Publishers.</span></div>
<div style="margin: 0in;">
<span style="background-color: white; font-family: "georgia" , serif;"><br /></span></div>
<div style="margin: 0in;">
<span style="background-color: white; font-family: "georgia" , serif;">Williams, D. L., Siegel, M., Mazefsky, C. A., & Autism
and Developmental Disorders Inpatient Research Collaborative (ADDIRC). (2017).
Problem behaviors in autism spectrum disorder: Association with verbal ability
and adapting/coping skills.</span><i style="font-family: georgia, serif;"> Journal of Autism and Developmental
Disorders.</i></div>
<br />
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<span style="font-family: georgia, "times new roman", serif;"><span style="font-family: "georgia" , serif;"><b>Lee A. Wilkinson, </b>PhD</span></span><span style="font-family: "georgia" , "times new roman" , serif;"> is a licensed and nationally certified school psychologist, and certified cognitive-behavioral therapist. He is author of the award-winning books, <a href="http://www.amazon.com/Practice-Assessment-Intervention-Asperger-Syndrome/dp/1849058113"><i><span style="color: #990000;">A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools</span></i></a><i> </i>and<i> </i><a href="https://www.amazon.com/Overcoming-Anxiety-Depression-Autism-Spectrum/dp/1849059276/ref=asap_B002RNLQCO_1_3?s=books&ie=UTF8&qid=1416596657&sr=1-3"><i><span style="color: #990000;">Overcoming Anxiety on the Autism Spectrum: A Self-Help Guide Using CBT</span></i></a><i>.</i> He is also editor of a text in the APA School Psychology Book Series, <a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156"><i><span style="color: #990000;">Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools</span></i></a>. His latest book is<i> </i><a href="http://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8"><i><span style="color: #990000;">A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition)</span></i></a>.</span></div>
</div>
</div>
bestpracticeautism.comhttp://www.blogger.com/profile/16482478063587857508noreply@blogger.com0tag:blogger.com,1999:blog-2020163043039993952.post-86729108266350154032020-04-26T16:50:00.002-04:002021-01-06T12:11:16.294-05:00Anxiety and Depression in Autism <div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "georgia" , serif;"><b><br /></b></span>
<span style="font-family: "georgia" , serif;"><b>Comorbidity in Autism Spectrum Disorder</b></span></div>
<span style="font-family: "georgia" , serif;"><br /></span>
<span style="font-family: "georgia" , serif;">There is robust research to suggest that 70 to 80
percent of children with autism spectrum disorder (ASD) meet diagnostic criteria for one or more
co-occurring (comorbid) disorders and 40 to 50 percent meet criteria for two or
more. A Comorbid
disorder is defined as a condition that co-occurs with another diagnosis so
that both share a primary focus of clinical and educational attention. The most
prevalent comorbid conditions are anxiety, depression, attention-deficit/hyperactivity disorder (ADHD), disruptive behavior problems, and
chronic tic disorders, all which contribute to overall impairment.</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "georgia";"> </span></b></div>
<div style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "georgia";"> I</span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "georgia";">nternalizing Problems</span></b></div>
</div>
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<span style="font-family: "georgia";">Studies have consistently
reported an association between ASD and internalizing symptoms, in particular,
anxiety and depression. A bidirectional association has been identified between
internalizing disorders and autistic symptoms. For example, both a higher
prevalence of anxiety disorders has been found in ASD and a higher rate of
autistic traits has been reported in youth with mood and anxiety disorders. </span><span style="background-color: white; color: #1d2129; font-family: "georgia" , serif;">Although
prevalence rates vary from 11% to 84%, most studies indicate that approximately
one-half of children with ASD meet criteria for at least one anxiety
disorder. </span><span style="font-family: "georgia";">Individuals with ASD also display more social anxiety symptoms compared to
typical individuals, even if these symptoms were clinically overlapping with
the characteristic social problems of ASD. In addition, there is some evidence
to suggest that adolescents and young adults with ASD show a higher prevalence
of bipolar disorders as compared to controls.</span></div>
<div class="MsoNormal">
<span style="font-family: "georgia";">Depression is one of the
most common comorbid conditions observed in individuals with ASD, particularly
higher functioning youth. A study of psychiatric comorbidity in young adults
with ASD revealed that 70% had experienced at least one episode of major
depression and 50% reported recurrent major depression. Although another
documented association is with obsessive-compulsive disorder (OCD), it is
difficult to determine whether observed obsessive-repetitive behaviors are an
expression of a separate, comorbid OCD, or an integral part of the core
diagnostic features of ASD (i. e., restricted, repetitive patterns of behavior,
interests, or activities).</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "georgia";">Externalizing Problems</span></b></div>
<div class="MsoNormal">
<span style="font-family: "georgia";">An association between ASD
and attention-deficit/hyperactivity disorder (ADHD) and other externalizing
problems (i. e., oppositional defiant disorder) have been reported. Studies
have found that children with ASD in clinical settings present with
co-occurring symptoms of ADHD with rates ranging between 37% and 85%. Although
there continues to a debate about ADHD comorbidity in ASD, research, practice
and theoretical models suggest that co-occurrence between these conditions is
relevant and occurs frequently. For example, case studies suggest that ADHD is
a relatively common initial diagnosis in young children with ASD. It is also
important to note that a significant change in the DSM-5 is removal of the
DSM-IV-TR hierarchical rules prohibiting the concurrent diagnosis of ASD and
ADHD. When the criteria are met for both disorders, both diagnoses are given.</span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "georgia";">Other Comorbidities</span></b></div>
<div class="MsoNormal">
<span style="font-family: "georgia";">Tourette Syndrome (TS) and
other tic disorders have been found to be a comorbid condition in many children
with ASD. A Swedish study showed that 20% of all school-age children with ASD
met the full criteria for TS. There also appears to be a higher incidence of
seizures in children with autism compared to the general population. The
comorbidity of ASD and psychotic disorders has received some research
attention. A study of children with ASD who were referred for psychotic
behavior and given a diagnosis of schizophrenia showed that when psychotic
behaviors were the presenting symptoms, depression and not schizophrenia, was
the likely diagnosis. Thus, individuals with ASD may present with
characteristics that could lead to a misdiagnosis of schizophrenia and other
psychotic disorders. Other c</span><span style="background-color: #fcfcfc; font-family: "georgia" , serif; letter-spacing: 0.1pt;">o-occurring
conditions include </span><span style="background-color: #fcfcfc; font-family: "georgia" , serif; letter-spacing: 0.1pt;">physical</span><b style="font-family: georgia, serif; letter-spacing: 0.1pt;"><i> </i></b><span style="background-color: #fcfcfc; font-family: "georgia" , serif; letter-spacing: 0.1pt;">(cerebral palsy, atypical gait), and
medical (allergies, asthma, gastrointestinal) conditions. Behavior
problems associated with GI distress may include sleep
disturbances, stereotypic or repetitive behaviors, self-injurious behaviors,
aggression, oppositional behavior, irritability or mood disturbances, and
tantrums. In addition, unusual responses to sensory stimuli, chronic sleep</span><b style="font-family: georgia, serif; letter-spacing: 0.1pt;"><i> </i></b><span style="background-color: #fcfcfc; font-family: "georgia" , serif; letter-spacing: 0.1pt;">problems, catatonia, and low muscle tone often occur in individuals with ASD. </span><span style="font-family: "georgia" , serif;">Specific learning difficulties are also common, as is
developmental coordination disorder. </span><br />
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<span style="font-family: "georgia" , serif;"><o:p></o:p></span></div>
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<span style="background: rgb(238, 251, 255); font-family: "georgia" , serif;"> <o:p></o:p></span></div>
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<span style="font-family: "georgia";"><b>Implications</b></span></div>
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<span style="font-family: "georgia" , serif;">Many individuals with ASD have symptoms that do
not form part of the diagnostic criteria for the disorder (about 70% of
individuals with ASD may have one comorbid disorder, and 40% may have two or
more comorbid conditions). </span><span style="font-family: "georgia";">The most common co-occurring
diagnoses are anxiety and depression, attention problems, and challenging behavior
disorders. </span><span style="font-family: "georgia" , serif;">When the criteria for a comorbid disorder is met,
both diagnoses should be given. Medical conditions commonly associated with ASD
should also be noted.</span><br />
<span style="font-family: "georgia";"><br /></span>
<span style="font-family: "georgia";">The core symptoms of ASD can often mask the symptoms of a comorbid
condition. The challenge for practitioners is to determine if the
symptoms observed in ASD are part of the same dimension (i. e, the autism
spectrum) or whether they represent another condition. Although various
psychometric instruments, such as clinical interviews, self-report
questionnaires and checklists, are widely used to assist in diagnosis, these
tools are designed and standardized to identify symptoms in the general
population, and may not be appropriate and valid for use with ASD. Likewise,
their administration may be problematic in that individuals with ASD may have
difficulties in sustaining a reciprocal conversation, reporting events, and perspective taking. Nevertheless,
comorbid problems should be assessed whenever significant behavioral issues
(e.g., inattention, impulsivity, mood instability, anxiety, sleep disturbance,
aggression) become evident or when major changes in behavior are reported. </span><span style="font-family: "georgia" , serif; font-size: 12pt;">Individuals who are
nonverbal or have language deficits, observable symptoms such as changes in sleeping
or eating or increases in challenging behavior should be evaluated for anxiety
and depression. </span><span style="font-family: "georgia";">Co-occurring conditions should also be carefully investigated when severe or
worsening symptoms are present that are not responding to intervention or
treatment.</span><br />
<span style="font-family: "georgia";"><br /></span>
<span style="font-family: "georgia";"><span style="font-family: "georgia" , serif;">Further information on best practice guidelines for assessment and intervention is available from </span><a href="http://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8" style="font-family: georgia, serif;"><i><span style="color: #990000;">A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition)</span></i></a><span style="font-family: "georgia" , serif;">.</span></span></div>
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<div style="text-align: center;">
<span style="font-family: "georgia";"><b>References and Further Reading</b></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0in; tab-stops: list .5in; vertical-align: baseline;">
<span style="font-family: "georgia" , "times new roman" , serif;"></span><br />
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0in; tab-stops: list .5in; vertical-align: baseline;">
<span style="font-family: "georgia" , "times new roman" , serif;">American Psychiatric
Association. (2013). <i>Diagnostic and statistical manual of mental
disorders </i>(5th ed.) Washington, DC: Author.</span><span style="font-family: "georgia" , serif;"><o:p></o:p></span></div>
</div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0in; tab-stops: list .5in; vertical-align: baseline;">
<span style="font-family: "georgia" , serif;"><br /></span>
<span style="font-family: "georgia" , serif;">Colombi, C., & Ghaziuddin, M. (2017).
Neuropsychological Characteristics of Children with Mixed Autism and
ADHD. Autism Research and Treatment, 2017, 1-5.
doi:10.1155/2017/5781781</span><br />
<span style="background: white; font-family: "georgia" , serif;"><br /></span>
<span style="background: white; font-family: "georgia" , serif;">Doepke,
K. J., </span><strong style="background-color: #fcfcfc; box-sizing: border-box;"><span style="background: white; font-family: "georgia" , serif; font-weight: normal;">Banks, B. M.</span></strong><span style="background: white; font-family: "georgia" , serif;">, Mays, J. F.,
Toby, L. M., & Landau, S. (2014). Co-occurring emotional and behavior
problems in children with Autism Spectrum Disorders. In L. Wilkinson (Ed.), </span><em style="background-color: #fcfcfc; box-sizing: border-box;"><span style="background: white; font-family: "georgia" , serif;">Autism Spectrum Disorders in Children and
Adolescence: Evidence-based Assessment and Intervention in Schools</span></em><em style="background-color: #fcfcfc;"><span style="background: white; font-family: "georgia" , serif; font-style: normal;"> </span></em><span style="background: white; font-family: "georgia" , serif;">(pp. 125-148). Washington, DC: American Psychological
Association.</span></div>
<div class="citation" style="background: rgb(252, 252, 252); margin-bottom: 12.0pt; margin-left: 0in; margin-right: 0in; margin-top: 12.0pt; margin: 12pt 0in;">
<span style="font-family: "georgia" , serif; letter-spacing: 0.1pt;">Duerden, E. G., Oatley, H. K., Mak-Fan, K.
M., McGrath, P. A., Taylor, M. J., Szatmari, P., & Roberts, S. W. (2012).
Risk factors associated with self-injurious behaviors in children and
adolescents with autism spectrum disorders. </span><i style="font-family: georgia, serif; letter-spacing: 0.1pt;">Journal of Autism and
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& Zahid, J. (2011). Variables associated with anxiety and depression in
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<span style="font-family: "georgia";">Mazzone et al.:
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T., Chandler S., Loucas T., Baird G. (2008). Psychiatric
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and associated factors in a population-derived sample. <i>Journal of the
American Academy of Child and Adolescent Psychiatry</i>, 47, 921-929.</span><span style="color: #333333; font-family: "georgia" , serif; font-size: 12pt;"> </span><span style="font-family: "georgia" , serif; font-size: 12pt;">https://doi.org/10.1097/CHI.0b013e318179964f<o:p></o:p></span></div>
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J. F., Kenworthy, L., Daniolos, P., Case, L., Wills, M. C., Martin, A., et al.
(2012). Depression and anxiety symptoms in children and adolescents with autism
spectrum disorders without intellectual disability. <em>Research in Autism Spectrum Disorders, 6</em>(1),
406–412.</span></div>
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<span style="background-color: #fcfcfc; font-family: "georgia" , serif; letter-spacing: 0.1pt;">Tureck,
K., Matson, J. L., May, A., Whiting, S. E., & Davis, T. E., III. (2013).
Comorbid symptoms in children with anxiety disorders compared to children with
autism spectrum disorders. </span><em style="font-family: Georgia, serif; letter-spacing: 0.1pt;">Journal
of Developmental and Physical Disabilities</em><span style="background-color: #fcfcfc; font-family: "georgia" , serif; letter-spacing: 0.1pt;">. doi:</span><span class="externalref" style="font-family: "georgia" , serif; letter-spacing: 0.1pt;"> <span class="refsource"><span style="text-decoration-line: none;">10.1007/s10882-013</span></span></span></div>
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<span style="color: #1d2129; font-family: "georgia" , serif;"><span style="color: black; font-family: "georgia" , serif;">Weiss, J. A., Jason K. Baker, J. K., & Butter, E. M. (2016, September). Mental health treatment for people with autism spectrum disorder (ASD</span><i style="color: black; font-family: Georgia, serif;">). Spotlight on Disability Newsletter</i><span style="color: black; font-family: "georgia" , serif;">. </span></span><br />
<span style="color: #1d2129; font-family: "georgia" , serif;"><br /></span>
<span style="font-family: "georgia" , "times new roman" , serif;"><span style="color: #1d2129; font-family: "georgia" , serif;">Wilkinson,
L. A. (2015). </span><i>Overcoming anxiety on the autism spectrum: A self-help guide using CBT</i><i style="color: #1d2129;">. </i><span style="color: #1d2129; font-family: "georgia" , serif;">London
and Philadelphia: Jessica Kingsley Publishers</span><i style="color: #1d2129;">.</i></span><br />
<span style="background-color: white; color: #1d2129; font-family: "georgia" , serif;"><br /></span>
<span style="background-color: white; color: #1d2129; font-family: "georgia" , serif;">Wilkinson,
L. A. (2017). </span><i style="color: #1d2129; font-family: georgia, serif;">A best practice guide to assessment and intervention for
autism spectrum disorder in schools (2nd ed.).</i><span style="background-color: white; color: #1d2129; font-family: "georgia" , serif;"> London & </span><span style="background-color: white; color: #1d2129; font-family: "georgia" , serif;">Philadelphia</span><span style="background-color: white; color: #1d2129; font-family: "georgia" , serif;"> :
Jessica Kingsley Publishers.</span></div>
<span style="font-family: "georgia";"><b><br /></b></span>
<span style="font-family: "georgia";"></span>
<span style="font-family: "georgia";"><b>Lee A. Wilkinson</b>, PhD, is a licensed and nationally certified school
psychologist, and certified
cognitive-behavioral therapist. He is </span><span style="font-family: "georgia";">author of
the award-winning books, <i><a href="http://www.amazon.com/Practice-Assessment-Intervention-Asperger-Syndrome/dp/1849058113" target="_blank">A Best Practice Guide to Assessment and Intervention for Autism
and Asperger Syndrome in Schools</a> </i>and<i> </i></span><i style="font-family: georgia;"><a href="http://www.amazon.com/Overcoming-Anxiety-Depression-Autism-Spectrum/dp/1849059276/ref=sr_1_1?s=books&ie=UTF8&qid=1412370192&sr=1-1&keywords=overcoming+anxiety+and+depression+on+the+autism+spectrum" target="_blank">Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT</a></i><span style="font-family: "georgia";">.</span><span style="font-family: "georgia";"> He is also editor of a text in the American Psychological Association
(APA) School Psychology Book Series, <i><a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156" target="_blank">Autism Spectrum Disorder in Children and Adolescents:
Evidence-Based Assessment and Intervention in Schools</a>. </i></span><span style="font-family: "georgia";">His latest book is </span><span style="font-family: "georgia";"><i><a href="https://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8">A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition)</a></i>.</span></div>
</div>
bestpracticeautism.comhttp://www.blogger.com/profile/16482478063587857508noreply@blogger.com0tag:blogger.com,1999:blog-2020163043039993952.post-69753801505220844142020-04-04T17:57:00.002-04:002021-01-23T11:02:28.509-05:00Multi-Tiered Screening for Autism in Schools<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "georgia";"><b><br /></b></span>
<span style="font-family: "georgia";"><b>A Multi-Tiered Approach to Screening for Autism in Schools</b></span></div>
<span style="font-family: "georgia";"><br /></span>
<span style="font-family: "georgia";">There has been a worldwide increase in the prevalence of autism over the past decade. Yet, compared to population estimates, identification rates have
not kept pace in our schools. It is not unusual for children with less severe
symptoms of autism spectrum disorder (ASD) to go unidentified until well after entering school. As a
result, it is critical that school-based support personnel (e.g., school psychologists, special educators, school counselors, speech/language pathologists, and social
workers) give greater priority to case finding and screening to
ensure that children with ASD are identified and have access to the appropriate programs and services.<o:p></o:p><b> </b></span><br />
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<span style="font-family: "georgia";"><b> Screening and Identification</b></span></div>
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<span style="font-family: "georgia";">Until recently, there were
few validated screening measures available to assist school professionals in
the identification of students with the core ASD-related behaviors. However,
our knowledge base is expanding rapidly and we now have reliable and valid
tools to screen and evaluate children more efficiently and with greater
accuracy. The following tools have demonstrated utility in screening for ASD in
educational settings and can be used to determine which children are likely to
require further assessment and/or who might benefit from additional support.
All measures have sound psychometric properties,
are appropriate for school-age children, and time efficient (10 to 20 minutes
to complete). Training needs are minimal and require little or no professional
instruction to complete. However, interpretation of results requires
familiarity with ASD and experience in administering, scoring, and interpreting
psychological tests.<o:p></o:p></span></div>
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<span style="font-family: "georgia";">The <a href="http://bestpracticeautism.blogspot.com/2011/01/best-practice-review-autism-spectrum.html" target="_blank">Autism Spectrum Rating Scales</a> (ASRS;
Goldstein & Naglieri, 2009) is a norm-referenced tool designed to
effectively identify symptoms, behaviors, and associated features of ASD in
children and adolescents from </span><st1:time hour="14" minute="0"><span style="font-family: "georgia";">2</span></st1:time><span style="font-family: "georgia";">
to 18 years of age. The ASRS can be completed by teachers and/or parents and
has both long and short forms. The Short form was developed for screening
purposes and contains 15 items from the full-length form that have been shown
to differentiate children diagnosed with ASD from children in the general
population. High scores indicate that many behaviors associated with ASD have
been observed and follow-up recommended.<o:p></o:p></span></div>
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<span style="font-family: "georgia";">The <a href="http://bestpracticeautism.blogspot.com/2011/06/best-practice-review-social.html" target="_blank">Social Communication Questionnaire</a><b> </b>(SCQ; Rutter,
Bailey, & Lord, 2003), previously known as the Autism Screening
Questionnaire (ASQ), is a parent/caregiver dimensional measure of ASD
symptomatology appropriate for children of any chronological age older than
four years. It is available in two forms, Lifetime and Current, each with 40
questions. Scores on the questionnaire provide a reasonable index of symptom
severity in the reciprocal social interaction, communication, and
restricted/repetitive behavior domains and indicate the likelihood that a child
has an ASD. <o:p></o:p></span><span style="background-color: white; font-family: "georgia" , serif;">The lifetime version is recommended for screening
purposes as it demonstrates the highest sensitivity value. </span><br />
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<span style="font-family: "georgia";">The<a href="http://bestpracticeautism.blogspot.com/2013/01/test-review-social-responsiveness-scale.html"> Social Responsiveness Scale, Second Edition</a><b> </b>(SRS-2; Constantino & Gruber, 2012)
is a brief quantitative measure of autistic behaviors in 4 to 18 year old
children and youth. This 65-item rating scale was designed to be completed by
an adult (teacher and/or parent) who is familiar with the child’s current
behavior and developmental history. The SRS items measure the ASD symptoms in
the domains of social awareness, social information processing, reciprocal
social communication, social anxiety/avoidance, and stereotypic
behavior/restricted interests. The scale provides a Total Score that reflects
the level of severity across the entire autism spectrum.<o:p></o:p></span></div>
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<span style="font-family: "georgia";"><b>A Multi-Tier Screening
Strategy</b><o:p></o:p></span></div>
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<span style="font-family: "georgia";">The ASRS, SCQ,
and SRS-2 can be used confidently as efficient first-level screening
tools for identifying the presence of the more broadly defined and subtle
symptoms of higher-functioning ASD in school settings. School-based
professionals should consider the following multi-step strategy for identifying
at-risk students who are in need of an in-depth assessment.<o:p></o:p></span></div>
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<span style="font-family: "georgia";"><b>Tier one.</b> The initial step is case finding.
This involves the ability to recognize the risk factors and/or warning signs of
ASD. All school professionals should be engaged in case finding and be alert to
those students who display atypical social and/or communication behaviors that
might be associated with ASD. Parent and/or teacher reports of social
impairment combined with communication and behavioral concerns constitute a
“red flag” and indicate the need for screening. Students who are identified
with risk factors during the case finding phase should be referred for formal
screening.<o:p></o:p></span></div>
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<span style="font-family: "georgia";"><b>Tier two.</b> Scores on the ASRS, SCQ,
and SRS-2 may be used as an indication of the approximate severity of
ASD symptomatology for students who present with elevated developmental risk
factors and/or warning signs of ASD. Screening results are shared with parents
and school-based teams with a focus on intervention planning and ongoing
observation. Scores can also be used for progress monitoring and to measure
change over time. Students with a positive screen who continue to show minimal
progress at this level are then considered for a more comprehensive assessment
and intensive interventions as part of Tier 3.
However, as with all screening tools, there will be some false negatives
(children with ASD who are not identified). Thus, children who screen negative,
but who have a high level of risk and/or where parent and/or teacher concerns
indicate developmental variations and behaviors consistent with an
autism-related disorder should continue to be monitored, regardless of
screening results.<o:p></o:p></span></div>
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<span style="font-family: "georgia";"><b>Tier three. </b>Students who
meet the threshold criteria in step two may then referred for an in-depth
assessment. Because the ASRS, SCQ, and SRS-2 are strongly
related to well-established and researched gold standard measures and report high
levels of sensitivity (ability to correctly identify cases in a population),
the results from these screening measures can be used in combination with a
comprehensive developmental assessment of social behavior, language and
communication, adaptive behavior, motor skills, sensory issues, and cognitive
functioning to aid in determining eligibility for special education services
and as a guide to intervention planning.<o:p></o:p></span></div>
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<span style="font-family: "georgia";"><b>Limitations</b></span><br />
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<span style="font-family: "georgia" , serif; mso-fareast-font-family: SimSun; mso-fareast-language: ZH-CN;">Although the ASRS, SCQ, and SRS can be used
confidently as efficient screening tools for identifying children across the
broad autism spectrum, they are not without limitations. Some students who
screen positive will not be identified with an ASD (false positive). On the
other hand, some children who were not initially identified will go on to meet
the diagnostic and/or classification criteria (false negative). Therefore, it
is especially important to carefully monitor those students who screen negative
to ensure access to intervention services if needed. Gathering information from
family and school resources during screening will also facilitate
identification of possible cases. Autism specific tools are not currently
recommended for the universal screening of typical school-age children. Focusing
on referred children with identified risk-factors and/or developmental delays
will increase predictive values and result in more efficient identification
efforts. <span style="background: yellow; mso-highlight: yellow;"><o:p></o:p></span></span></div>
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<span style="font-family: "georgia";"><b>Concluding Comments</b><o:p></o:p></span></div>
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<span style="font-family: "georgia";">Compared with general
population estimates, children with mild autistic traits appear to be an
underidentified and underserved population in our schools. There are likely a
substantial number of children with equivalent profiles to those with a
clinical diagnosis of ASD who are not receiving services. Research indicates that
outcomes for children on the autism spectrum can be significantly enhanced with
the delivery of intensive intervention services. However, intervention services can only be implemented if students are
identified. Screening is the initial step in this process. School professionals
should be prepared to recognize the presence of risk factors and/or early
warning signs of ASD, engage in case finding, and be familiar with screening
tools in order to ensure children with ASD are being identified and provided
with the appropriate programs and services.</span><span style="font-family: "georgia";"> </span><br />
<br />
<span style="font-family: "georgia";">Best practice screening
and assessment guidelines are available from: <a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156" target="_blank"><i>Autism Spectrum Disorder in Children and Adolescents:
Evidence-Based Assessment and Intervention in Schools</i> </a>and <i><a href="http://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=sr_1_2?s=books&ie=UTF8&qid=1479742377&sr=1-2&keywords=wilkinson+autism" target="_blank">A Best Practice Guide to Assessment and Intervention for Autism
Spectrum Disorder in Schools (2nd ed.)</a>.</i></span><span style="font-family: "georgia";"> </span><br />
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<span style="background: white; color: #1d2129; font-family: "georgia" , serif;"><span style="font-size: large;">👉 <a href="https://read.amazon.com/kp/embed?asin=B01M7NO6Y1&preview=newtab&linkCode=kpe&ref_=cm_sw_r_kb_dp_a.j.zb4ZZEJ36&reshareId=3AW31VTAXG8SQJH909XQ&reshareChannel=system" target="_blank">Click here to read a free preview of “A Best Practice Guide…”</a></span><o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: 0.0001pt; text-align: center;"><span style="background: white; color: #1d2129; font-family: "georgia" , serif;"><br /></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: 0.0001pt; text-align: left;"><span style="font-family: georgia;"><b style="background-color: white; color: #1d2129;"><span style="line-height: 107%;">Lee A.
Wilkinson</span></b><span style="background-color: white; color: #1d2129; line-height: 107%;">, PhD, is a
licensed and nationally certified school psychologist, and certified cognitive-behavioral
therapist. He is author of the award-winning books, <i><a href="https://www.blogger.com/blog/post/edit/2020163043039993952/6975380150522084414">A
Best Practice Guide to Assessment and Intervention for Autism and Asperger
Syndrome in</a></i> <i><a href="https://www.blogger.com/blog/post/edit/2020163043039993952/6975380150522084414">Schools</a> </i>and <i><a href="https://www.blogger.com/blog/post/edit/2020163043039993952/6975380150522084414">Overcoming
Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT</a>. </i>He
is also editor of a text in the APA School Psychology Book
Series, <i><a href="https://www.blogger.com/blog/post/edit/2020163043039993952/6975380150522084414">Autism
Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and
Intervention in Schools</a>.</i> His latest book is<i> <a href="https://www.blogger.com/blog/post/edit/2020163043039993952/6975380150522084414">A
Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder
in Schools (2nd Edition)</a></i></span></span></div></div>
<span style="font-family: "georgia";"><o:p></o:p></span></div>
bestpracticeautism.comhttp://www.blogger.com/profile/16482478063587857508noreply@blogger.comtag:blogger.com,1999:blog-2020163043039993952.post-43368074666610339462020-03-27T09:47:00.003-04:002021-01-06T13:20:23.933-05:00Self-Motivation and Positive Self-Talk<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="background: white; color: #1d2129; font-family: "georgia" , serif;"><b><br /></b></span>
<span style="background: white; color: #1d2129; font-family: "georgia" , serif;"><b>Lee A. Wilkinson</b>, PhD, is a licensed and nationally certified school psychologist, and certified cognitive-behavioral therapist. He is author of the award winning books, <i> <a href="http://www.amazon.com/Practice-Assessment-Intervention-Asperger-Syndrome/dp/1849058113">A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools</a> </i>and </span><i><span style="background: white; color: #1d2129; font-family: "georgia" , serif; font-size: 12pt; line-height: 17.12px;"><a href="http://www.amazon.com/Overcoming-Anxiety-Depression-Autism-Spectrum/dp/1849059276/ref=sr_1_1?s=books&ie=UTF8&qid=1412370192&sr=1-1&keywords=overcoming+anxiety+and+depression+on+the+autism+spectrum">Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT</a>. </span></i><span style="background-color: white; color: #1d2129; font-family: "georgia" , serif;">He is also editor of a text in the APA School Psychology Book Series, </span><i style="color: #1d2129; font-family: georgia, serif;"><a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156">Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools</a></i><span style="background-color: white; color: #1d2129; font-family: "georgia" , serif;">. His latest book is</span><i style="color: #1d2129; font-family: georgia, serif;"> <a href="http://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8">A Best Practice Guide to Ass</a></i><i style="color: #1d2129; font-family: georgia, serif;"><a href="http://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8">essment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition)</a></i><span style="background-color: white; color: #1d2129; font-family: "georgia" , serif;">.</span></div>
bestpracticeautism.comhttp://www.blogger.com/profile/16482478063587857508noreply@blogger.com0tag:blogger.com,1999:blog-2020163043039993952.post-40550123751405879962020-03-19T15:30:00.007-04:002021-01-10T17:08:13.343-05:00Social Narratives for COVID-19<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="background: white; color: #1d2129; font-family: "georgia" , "times new roman" , serif;"><span color="rgba(0 , 0 , 0 , 0.9)">The Coronavirus, or COVID-19, may cause fear, anxiety, or confusion for many children and youth. While Social Narratives (SN) have been shown to be an effective strategy for children with autism, they are appropriate for individuals of any age who may be experiencing challenges with social communication. Social Narratives or stories can help alleviate fears and anxiety many children may be experiencing at this time and help them cope during the coming days and weeks.</span></span><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhI6X8xSa5_kBZzhsJw5QWEYxwl1ZD5jZTO71SiHp7l9Y5eEVK3KoeIPIGy_bsxaMR3TfvIAdJreatec7c_acgS8R6XNsaDXeT0xMe1ns5kDVnEkDuYLtzYCDxPjoeId0fu-HK_XtNAoVem/s1600/0+%25281%2529.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="900" data-original-width="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhI6X8xSa5_kBZzhsJw5QWEYxwl1ZD5jZTO71SiHp7l9Y5eEVK3KoeIPIGy_bsxaMR3TfvIAdJreatec7c_acgS8R6XNsaDXeT0xMe1ns5kDVnEkDuYLtzYCDxPjoeId0fu-HK_XtNAoVem/s1600/0+%25281%2529.jpg" /></a><a href="https://www.iidc.indiana.edu/irca/articles/writing-and-using-social-narratives.html" style="background-color: white; font-family: georgia, serif; text-align: left;">https://www.iidc.indiana.edu/irca/articles/writing-and-using-social-narratives.html</a></div><div style="text-align: left;"><span style="background: white; color: #1d2129; font-family: "georgia" , serif;">
<p class="Default"><span style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; color: #1d2129; font-family: "georgia" , serif;"><b>Lee A. Wilkinson</b>, PhD, is a licensed and nationally certified school psychologist, and certified cognitive-behavioral therapist. He is author of the award-winning books, <i> <a href="http://www.amazon.com/Practice-Assessment-Intervention-Asperger-Syndrome/dp/1849058113">A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools</a> </i>and </span><i style="background-color: transparent;"><span style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; color: #1d2129; font-family: "georgia" , serif; font-size: 12pt; line-height: 17.12px;"><a href="http://www.amazon.com/Overcoming-Anxiety-Depression-Autism-Spectrum/dp/1849059276/ref=sr_1_1?s=books&ie=UTF8&qid=1412370192&sr=1-1&keywords=overcoming+anxiety+and+depression+on+the+autism+spectrum">Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT</a>. </span></i><span style="color: #1d2129; font-family: "georgia" , serif;">He is also editor of a text in the APA School Psychology Book Series, </span><i style="background-color: transparent;"><a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156">Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools</a></i><span style="color: #1d2129; font-family: "georgia" , serif;">. His latest book is</span><i style="background-color: transparent;"> <a href="http://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8">A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition)</a></i><span style="color: #1d2129; font-family: "georgia" , serif;">.</span></p></span></div>
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bestpracticeautism.comhttp://www.blogger.com/profile/16482478063587857508noreply@blogger.com0tag:blogger.com,1999:blog-2020163043039993952.post-18505296470998070252020-03-04T19:31:00.004-05:002021-01-06T13:21:11.670-05:00Positive Behavior Support (PBS) Classroom Strategies for Autistic Students <div dir="ltr" style="text-align: left;" trbidi="on">
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<b>Positive Behavior Support for Autistic Students </b></div>
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<![endif]--><span style="font-family: "georgia";">The problem behaviors of
children on the autism spectrum (ASD) are among the most challenging
and stressful issues faced by many schools and parents. The current best practice in
treating and preventing undesirable or challenging behaviors utilizes the principles
and practices of positive behavior support (PBS). PBS is not a specific
intervention per se, but rather a set of research-based strategies that are
intended to decrease problem behaviors by designing effective environments and
teaching students appropriate social and communication skills. PBS utilizes primary (school-wide), secondary (targeted group), and tertiary (individual) levels or tiers of intervention, with each tier providing an increasing level of intensity and support. </span></div>
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<span style="font-family: "georgia";"> <b>PBS Strategies in the Classroom</b></span></div>
<span style="font-family: "georgia";"><br /></span>
<span style="font-family: "georgia";">Other than families,
teachers are the most influential resource for students with and without special needs. Although functional behavior assessment (FBA) and intensive individual support is recommended for students with serious and persistent challenging behaviors, teachers may prevent the possibility of problematic behavior through the implementation of class-wide and targeted group PBS strategies. For example, effective prevention of challenging social behavior can be
addressed through arranging the classroom environment and/or by adapting
instruction and the curriculum. Changing the classroom environment or
instruction may lessen the triggers or events that set off the challenging
behavior. Teaching effective social interaction and communication as
replacements for challenging behavior is also a preventive strategy for
improving little used student social interaction and communication skills.
Teachers can model, demonstrate, coach, or role-play the appropriate
interaction skills. They can teach students to ask for help during difficult
activities or negotiate alternative times to finish work. Encouraging positive
social interactions such as conversational skills will help students with
challenging behavior to effectively obtain positive peer attention. The
following are examples of PBS strategies for improving social skills and
prosocial behaviors in the classroom (Vaughn, Duchnowski, Sheffield, &
Kutash, 2005; Wilkinson, 2017). </span></div>
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<span style="font-family: "georgia";"><b>Initiating interactions.</b> Teachers
might notice that when a student with autism enters the classroom, group activity,
or other social interaction, they may have particular difficulty greeting
others students or starting a conversation. For example, they may joke, call
another student a name, laugh, or say something inappropriate. In this
situation, the student may have trouble initiating interactions or
conversations. The teacher might talk to the student individually and offer
suggestions for ways he or she can provide an appropriate greeting or introduce
a topic of conversation. The student might then be asked to practice or
role-play the desired behavior.</span></div>
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<span style="font-family: "georgia";"><b>Example:</b> <i>“why don’t you
ask students what they did last night, tell them about a TV show you watched,
or ask if they finished their homework, rather than shouting or saying ‘Hey,
Stupid.’ Other students in the class want to be your friend, but you make it
difficult for them to talk with you. Let’s practice the next time the class
begins a new group activity.”</i></span></div>
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<span style="font-family: "georgia";"><b>Maintaining interactions.</b> Many autistic students struggle to maintain a conversation (e.g.., turn taking).
Some may dominate the conversation and make others feel that they have nothing
to contribute, while other students may experience difficulty keeping up with
the flow of conversation and asking questions. Students may also have limited
topics of interest and discuss these topics repetitively.</span></div>
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<span style="font-family: "georgia";"><b>Example: </b><i>“I’ve noticed that
other students cannot share their thoughts and ideas with you when you start a
conversation because you do all the talking. It may seem to them that you don’t
care what they have to say. Other students will be more willing to talk if you
stop once you’ve stated your idea or opinion and allow them a turn to talk.
When you stop, they know you are listening. You can say to them, “What do you
think?” or “Has this ever happened to you?’”</i></span></div>
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<span style="font-family: "georgia";"><b>Terminating interactions. </b>Some
students with autism may not know how to appropriately end a conversation. They
may abruptly walk away, start talking with another student, or bluntly tell a
student they don’t know what they’re talking about. Other students may
interpret this as rude and impolite behavior. Teachers might point out to the
student some acceptable ways of ending a conversation.</span></div>
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<span style="font-family: "georgia";"><b>Example: </b><i>“You just walked
away from that student when they were talking. Rather than walk away, you might
say “‘I have to go now,’ ‘It’s time for my next class,’ ‘Or ‘I’ll see you later
and we can finish our talk.’”</i></span></div>
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<span style="font-family: "georgia";"><b>Recognizing body language.</b>
The recognition of body language or nonverbal cues is critical to successful
social interactions. Autistic students typically have difficulty interpreting
these cues from teachers or other students. Body language tells students when
they violate a person’s personal space, a person needs to leave, or they need
to change behavior. Teachers can incorporate these skills into their class time
or school day.</span></div>
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<span style="font-family: "georgia";"><b>Example:</b> <i>Before leaving
the classroom, demonstrate nonverbal cues by holding a finger to your
lips and telling students that means “quiet,” a hand held up with palm facing outward means “wait” or “stop,” and both hands pushing downward means “slow
down.” You may need to demonstrate facial expressions you use to “deliver
messages” and what they mean. Other students can demonstrate nonverbal cues
they use. When students move through the halls, you may want to teach them the
“arms length” rule for personal space.</i></span></div>
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<span style="font-family: "georgia";"><b>Transitions. </b>Many students
with autism have significant problems changing from one activity to the next or
moving from one location to another. They may be easily upset by abrupt changes
in routine and unable to estimate how much time is left to finish an activity
and begin the next one. Poor executive function skills such as disorganization
may also prevent them from putting materials away from the last activity or
getting ready for the next activity. They may also need closure and preparation
time for the transition. Problems arise if the teacher tries to push them to
transition at the last minute.</span></div>
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<span style="font-family: "georgia";"><b>Example:</b> <i>About 10 minutes
prior to the transition, refer to the classroom schedule and announce when the
bell will ring or when the next activity will begin. Provide a 5-minute and
then a 1-minute warning. This countdown helps students finish assignments or
end favorite activities. For students that have difficulty getting started
after a transition, place assignment folders on their desks so that they have
their assignments and don’t have to wait for instructions or materials. They
can use the same folder to submit assignments (the folders can be left on their
desks at the end of the period).</i></span></div>
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<b><span style="font-family: "georgia";">Conclusion </span></b></div>
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<span style="font-family: "georgia";">Students on the autism spectrum often
lack the social skills to communicate and interact effectively with peers and
adults. They may use challenging or disruptive behavior to communicate their
needs. These examples illustrate how PBS provides a proactive framework for
assessing social interaction and communication needs and for teaching new,
effective skills that replace the challenging behavior. When used consistently,
these strategies fit within the framework of the classroom and can help promote
positive student behavior.</span></div>
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<span style="background-color: white; color: #1d2129; font-family: "georgia" , serif;">Adapted from Wilkinson, L. A.
(2017</span><i style="color: #1d2129; font-family: Georgia, serif;">). <a href="https://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8">A best practice guide to assessment and intervention
for autism spectrum disorder in schools</a></i><span style="background-color: white; color: #1d2129; font-family: "georgia" , serif;">. London and
Philadelphia: Jessica Kingsley Publishers.</span><br />
<span style="background-color: white; color: #1d2129; font-family: "georgia" , serif;"><br /></span>
<br />
<div style="text-align: center;">
<span style="font-family: "georgia" , "times new roman" , serif; font-size: large;">👉 <a href="https://read.amazon.com/kp/embed?asin=B01M7NO6Y1&preview=newtab&linkCode=kpe&ref_=cm_sw_r_kb_dp_a.j.zb4ZZEJ36&reshareId=3AW31VTAXG8SQJH909XQ&reshareChannel=system" target="_blank">Click here to read a free preview of “A Best Practice Guide…”</a></span></div>
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<span style="font-family: "georgia";"><b>Key References and Further Reading</b> </span></div>
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<span style="font-family: "georgia";">Alberto, P., &
Troutman, A. (2006). <i>Applied behavior analysis for teachers</i> (7th edition). New York,
NY: Prentice-Hall.</span></div>
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<span style="font-family: "georgia";">Crone, D. A., Horner, R.
H., & Hawken, L. S. (2004). <i>Responding to problem behavior in schools:
The behavior education program.</i> New York: Guilford Press.</span></div>
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<span style="font-family: "georgia";">Crone, D. A., &
Horner, R. H. (2003). Building positive behavior support systems in schools:
Functional behavioral assessment. New York: Guilford.</span></div>
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<span style="font-family: "georgia";">Dunlap, G., Iovannone, R.,
Kincaid, D., Wilson, K., Christiansen, K., Strain, P., & English, C.,
(2010). <i>Prevent-Teach-Reinforce: A school-based model of positive behavior support</i>.
Baltimore: Brookes.</span></div>
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<span style="font-family: "georgia";">Horner, R. H., Sugai, G.,
Todd, A. W., & Lewis-Palmer, T. (2005). School-wide positive behavior
support. In L. Bambara & L. Kern (Eds.), <i>Individualized supports for
students with problem behaviors: Designing positive behavior plans</i> (pp.
359-390). New York: Guilford Press.</span></div>
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<span style="font-family: "georgia";">Martella, R. C., Nelson,
J. R., & Marchand-Martella, N. E. (2003). <i>Managing disruptive behaviors
in the schools: A schoolwide, classroom, and individualized social learning
approach</i>. Boston, MA: Allyn and Bacon, Inc.</span></div>
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<span style="font-family: "georgia";">OSEP Technical Assistance
Center on Positive Behavioral Interventions and Supports. <a href="http://www.pbis.org/default.aspx">http://www.pbis.org/default.aspx</a> </span></div>
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<span style="font-family: "georgia";">Sprague, J. R., &
Walker, H. M. (2005). <i>Safe and healthy schools: Practical prevention strategies</i>.
New York, NY: Guilford.</span></div>
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<span style="font-family: "georgia";">Sprick, R.S., &
Garrison, M. (2008). <i>Interventions: Evidence-based behavioral strategies for
individual students</i>. Eugene, OR: Pacific Northwest Publishing.</span></div>
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<span style="font-family: "georgia";">Vaughn, B., Duchnowski,
A., Sheffield, S., & Kutash, K., (2005). <i>Positive behavior support: A
classroom-wide approach to successful student achievement and interactions</i>.
Department of Child and Family Studies, Louis de la Parte Florida Mental Health
Institute. Tampa, FL: University of South Florida.</span></div>
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<span style="font-family: "georgia";">Wilkinson, L. A. (2017). <i>A
best practice guide to assessment and intervention for autism spectrum disorder in schools</i>. London: Jessica Kingsley Publishers.</span></div>
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<span style="background: white; color: #1d2129; font-family: "georgia" , serif;"><b>Lee A. Wilkinson</b>, PhD, is
a licensed and nationally certified school psychologist, and certified cognitive-behavioral therapist. He is author of the
award-winning books, <i> <a href="http://www.amazon.com/Practice-Assessment-Intervention-Asperger-Syndrome/dp/1849058113">A Best Practice Guide to Assessment and Intervention
for Autism and Asperger Syndrome in Schools</a> </i>and </span><i><span style="background: white; color: #1d2129; font-family: "georgia" , serif; font-size: 12pt; line-height: 107%;"><a href="http://www.amazon.com/Overcoming-Anxiety-Depression-Autism-Spectrum/dp/1849059276/ref=sr_1_1?s=books&ie=UTF8&qid=1412370192&sr=1-1&keywords=overcoming+anxiety+and+depression+on+the+autism+spectrum">Overcoming Anxiety and Depression on the Autism
Spectrum: A Self-Help Guide Using CBT</a>. </span></i><span style="background-color: white; color: #1d2129; font-family: "georgia" , serif;">He is also editor of
a text in the APA School Psychology Book Series, </span><i style="color: #1d2129; font-family: Georgia, serif;"><a href="http://www.amazon.com/Autism-Spectrum-Disorder-Children-Adolescents/dp/1433816156">Autism Spectrum Disorder in Children and Adolescents:
Evidence-Based Assessment and Intervention in Schools</a></i><span style="background-color: white; color: #1d2129; font-family: "georgia" , serif;">. His
latest book is</span><i style="color: #1d2129; font-family: Georgia, serif;"> <a href="http://www.amazon.com/Practice-Assessment-Intervention-Spectrum-Disorder/dp/1785927043/ref=asap_bc?ie=UTF8">A Best Practice Guide to Assessment and Intervention
for Autism Spectrum Disorder in Schools (2nd Edition)</a></i><span style="background-color: white; color: #1d2129; font-family: "georgia" , serif;">.</span></div>
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