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Supporting Students with Autism Spectrum Disorders:

Using the High/Scope Approach

A Case Study:  Seth

As Seth entered the inclusive Preschool Program for Children with Disabilities (PPCD), his mother and teacher both painted a challenging picture.  They agreed on the following description from different perspectives:  “Seth could not separate himself from me (mom).  He would scream and cry for quite awhile.”  The teacher added, “He did not communicate with us and he did not play with toys.  It was very difficult for him to separate from his mother.”

The instructional focus of the inclusive setting was oriented toward the High/Scope approach, implementing the principles of active learning, the daily routine, the learning environment and adult-child interaction.  With this as the foundation, additional structure via schedules and other visual strategies was provided.  After the first two weeks, the teacher reported that Seth would follow his own schedule, naming parts of the day.  Along with this milestone, he “stopped crying during transitions”.

After nine weeks of school, Seth’s mom reported that he no longer screamed when leaving him in the morning, but rather says “Good-Bye” and “See you later”.  Additionally, he started to walk to the cafeteria independently with his peers as models.  He also began to engage in more activities such as playing with toys, singing songs and moving to music.

Data collected over the first nine weeks of school indicated growth in the areas of social skills, communication and behavior.  In particular, one of his goals noted that “Seth will improve self-control by being able to decrease frequency and duration of yelling or screaming in the classroom when reminded by the teacher.”  He achieved this goal during the third week of school, and continued to maintain at that level.  Seth’s mother reported that “we are very happy with what we see at home.  He tries to verbalize his wants and needs.  He says more words instead of yelling”.  And from the teacher’s perspective, “Seth has made a great deal of progress in a short time.”

A Case Study:  Bobby

After a full year in an inclusive setting implementing the High/Scope approach, Bobby has shown significant gains in many areas.  Most importantly, for a student struggling with autism, he has started to make eye contact, follow the routine with minimal support and interact in a variety of activities.    

The initial days were filled with crying and screaming and an apparent lack of interest with different materials or activities.  The teacher reports that “he only wanted to scribble with markers and would get upset if he could not do that.”  So the small successes of “walking to the classroom and to the playground by following the other children” and “following the greeting circle routine” were great cause for celebration.

Other goals that have been achieved include writing his first and last name and assisting with the toileting process.  Within the year’s time, Bobby developed a broader set of interests.  These interests have, in turn, contributed to broader experiences.  And because of this impact on his experiences, Bobby’s future is yet unwritten and quite promising.

    

Behavior Planning Forms

Student Self-Evaluation:  Basic Needs

  

Student Self-Evaluation:  Perspective

Supporting Students with Autism Spectrum Disorders

Visual Strategies for Visual Learners

By Lisa Rogers

Over the years, researchers have started to provide greater insight into the neurology related to autism spectrum disorders.  It is through this insight that parents and educators can better understand the disorder and, therefore, create instructional programs that are meaningful, effective and humane.

The Brain

Children with autism exhibit abnormal brain development during the very early years of life, according to two separate studies published in an issue of Neurology, the scientific journal of the American Academy of Neurology.

Both studies used MRI (magnetic resonance imaging) scanning technology to analyze brain volume in those with autism, and age-matched control groups.

In the first study, which set out to explore anatomical differences in the brains of very young autistic children, the brain volume measurements of 45 autistic children, ages 3 and 4, were compared with those of 26 children with typical development and 14 children with developmental delay.  "We found that the autistic children had significantly increased cerebral volumes compared to typically developing children and developmentally delayed children," according to study author Stephen R. Dager, MD, with the University of Washington School of Medicine in Seattle, WA.  The average cerebral volume -- including measures of the cerebrum, cerebellum, amygdala, and hippocamus -- was 10 percent larger in autistic children than in typically developing children.  The difference was 12.5 percent between autistic and developmentally delayed children.  He said the study shows that abnormal brain development processes occur very early in autistic children.

Using a separate sample, researchers hypothesized that brain growth among individuals with autism is rapid in the early years of life, but brain size decreases slightly around age 12, about the same time that typically developing children experienced a growth spurt in cerebral volume.  The study showed that by adolescence and adulthood, brain volume levels out to a normal size.

The study measured cerebral volume and head circumference of 67 autistic children and adults and 83 healthy controls, ranging in age from 8 to 46 years old.  Among those with autism age 12 and under, average brain volume was 5 percent larger than in the controls.  By age 12, there was no difference in volume, but head circumference was 1 to 2 percent greater in autistic individuals than controls, whether children or adults.  "This increased head circumference, among adults as well as children with autism, is further suggestion of accelerated growth in brain volume among autistic children . . .” according to study author Elizabeth H. Aylward, Ph.D.

Aylward ventured that the accelerated brain growth in children with autism may be a sign of increased numbers of neurons and premature growth of synapses.  This finding may help in understanding some of the outward behaviors that are typically seen.  An increased number of neurons and premature growth of synapses would imply that information is processed via a different brain mechanism, leading to a bombardment of sensory stimuli.  Living in a chronic state of overarousal may help to explain the seemingly abnormal behaviors that actually serve a purpose; to diminish the intrusive and overwhelming arousal. 

Manuel F. Casanova, MD, a neurologist and neuropathologist at the Downtown VA Medical Center in Augusta, Georgia, further notes that the lack of lateral inhibitors, contained in the cortex, would affect an individual's ability to discriminate between competing sensory information.  All of this leads to a conclusion that individuals with autism spectrum disorders face a continual challenge of making sense of a world that is overwhelming, perplexing and stressful in a way that others could not understand.

Characteristics

Autism is a severe and pervasive developmental disorder of childhood that is characterized by disruptions in social interactions and communication, as well as stereotyped patterns of interests, activities and behaviors. 

While each individual with autism has a different personality, interests and strengths, some or all of the following characteristics may be observed in mild to severe forms:

►    Communication problems (e.g., using and understanding language);

►    Impaired social skills (e.g. difficulty in relating to people, objects, and events);

►    Impaired organizational skills;

►    Unusual play with toys and other objects;

►    Unusual sensory interpretations - for example, lights, loud noises, certain textures of food or fabrics;

►    Limited, yet highly focused interests;

►    Difficulty with changes in routine or familiar surroundings; and

►    Repetitive play, body movements or behavior patterns.

Children with autism or Pervasive Developmental Disorder (PDD) vary widely in abilities, intelligence, and behaviors.  Some children do not speak; others have limited language that often includes repeated phrases or conversations.  People with more advanced language skills tend to use a small range of topics and have difficulty with abstract concepts.  Language is often based in very literal concepts, both expressively and receptively.  This characteristic has implications for many facets of communication, such as joke telling and understanding the more abstract meaning of words.  When asked, “What does ‘open-minded’ mean?” an individual with autism responded that one would have his head cut open.

Understanding that the brain develops differently in children with autism spectrum disorders helps in understanding that the different behaviors and characteristics exhibited have a neurological basis.  This knowledge will serve to help educators and parents select methodologies and strategies that are in concert with the needs of individuals with autism.

Strength

Although individuals with autism spectrum disorders suffer through many challenges, the visual processing of information is a strength that can be targeted.  By capitalizing on this strength, educators and parents have found a key to bridging the gaps in understanding, communicating, interacting and following a routine. 

This is not necessarily so different from the general public.  Most children and adults indicate that they learn best through visual means, especially when paired with an auditory or kinesthetic experience.  Some common examples of using visuals in our everyday lives are:

►    Maps/written directions

►    Post it notes/reminders

►    Bus route schedules

►    Prescription labels

►    Road signs

►    Calendars

►    “To Do” lists

►    Recipes

►    Grocery lists

Imagine a trip to the grocery store without a list.  While it can be done, it usually results in a more stressful experience.  Trying to rely on your memory may result in several trips down the same aisle, a last minute run while you are still in line to get that one thing that you forgot, and perhaps even a late night trip back to the store to get the very important ice cream.

That same trip with a list is much more expedient, successful and most importantly, less stressful.  For individuals with autism who already experience heightened levels of stress, it seems only natural to provide those supports, visual tools, that we know can lessen some, if not most, of that stress. 

A Visual Schedule

Schedules provide individuals with an understanding of what is to come and what is expected.  This knowledge empowers an individual to have a sense of understanding and security that leads to success and independence.  The centerpiece of all subsequent strategies is the visual schedule.  Having established that a schedule is an essential tool for all individuals with autism spectrum disorders, the challenge becomes in creating a schedule that is tailored to the needs, strengths and interests of the individual. 

The first consideration when developing a schedule is the format.  What information will the student be able to understand?

►    Objects are the most concrete form.

►    Pictures and photographs are the next level of representation.

►    Graphic symbols are somewhat more complex and consist of pictographs and written language.

►    Combinations of any of the previous methods may be used to enhance student understanding.

Once the format is determined, then decisions must also be made regarding its location and size.  Some students will need larger pictures, objects and/or words while others are successful with smaller images and representations.  The schedule might be fixed on a wall, shelf or in a notebook, becoming more portable.  When possible, choose a location that is neutral from other areas of activity and visually sparse.

The schedule should represent the larger chunks of time throughout any given day.  For instance, the schedule may include pictures, objects or words indicating that first a student will go to homeroom, then to math, reading, lunch, P.E., art, science and then on to the bus to go home.  Once he/she arrives at math class, there may be a more detailed break down of the activities that will take place for that class.  This is often referred to as a “mini-schedule” or “task sequence”.  The amount of larger chunks reflected on the schedule may also vary from individual to individual.  Some persons with autism spectrum disorders find it calming to know what to expect for the entire day while others might be overwhelmed by this prospect.  A schedule may expose as little as one or two of the next parts of the day.

The concept of finished is an integral component of a schedule.  Anyone who has ever compiled and used a “To Do List” understands the joy and sense of accomplishment felt when crossing off finished tasks.  Therefore, the element of “finished” or closure must be incorporated into schedules developed for individuals with autism spectrum disorders.  This can be accomplished in a myriad of ways, ranging from a simple check mark to placing the picture or object in a finished box or envelope.  The important thing about choosing the method of indicating “finished” is like that of all other components, that it be meaningful for the student.  The best way to determine whether or not you have chosen an effective means, or need to adjust it somewhat, is through trial and error. 

An added layer of visual information that some students may benefit from is a link between the schedule and correlating location.  This link helps the student to understand where they are to go once they “read” their schedule by having a matching picture/icon/object/word in the location that they are to proceed to.  In many cases, a basket or a pocket with a matching picture/icon/object/word may be used as a receptacle for the schedule piece.

The next consideration is that of transitioning to the schedule.  How will the individual know when it is time to check his/her schedule?  This can be done with a verbal reminder or the use of a transition marker to signal that it is time to “check your schedule”, leading to future independence.   Transition markers can be something as simple as a colored card to something more complex reflecting a student’s interest.  Transition markers are especially effective for students that might not be resistant to checking their schedule.  While an individual might not want to check his schedule on his own volition, the power of a visual tool versus an auditory request can be very compelling.

As stated previously, one of the characteristics of individuals with autism spectrum disorders is limited, yet highly focused interests.  Never underestimate the power of a highly focused interest.  A perceptive teacher or parent will use that interest whenever possible rather than strive to stifle or control.  A particular young man comes to mind with two strong, if not overwhelming, interests:  Country/Western magazines and Disney characters.  When introduced to a visual schedule, he was not inclined to “check his schedule”, especially after viewing what it had to offer.  Once his interests were strategically incorporated into the daily routine, his enthusiasm for checking his schedule increased dramatically.  By knowing when good things were coming, he was able to follow the routine and stay focused during less interesting activities.

The good news is that schedules definitely help to make the world more predictable and less confusing, and by doing so can help to minimize behavioral difficulties.  The bad news is that schedules almost always require revisions after implementation.   In other words, educators and parents teach the visual tool through modeling, guiding and physical assistance, and then adjust the size, location, format, and other details based on individual performance.  The process of trial and error can be complex and frustrating, but is a necessary aspect of the development of a tailored and effective schedule.  Educators and parents must be prepared to make changes and more changes until the visual tool is effective.

One component of the teaching process is that of consistency.  When things are going well, there might be a tendency to function on an auditory level, that which is quickest, easiest and most natural.  But when things are not going well, then the visual schedule is used, usually not to any great success.  A critical key to achieving success is to remember that all visual strategies, especially schedules, must be taught during calm times in order to effective during rough seas.  It is neither fair nor realistic to expect an individual with autism to respond to something that is new or inconsistent at his /her worst, most stressful moments.

Common Traps

#1.  When will he/she be able to function without a schedule or other visual supports?

It would make just as much sense to ask a person of typical development when they would be able to stop using maps to find their way, or when they would be able to drive on the streets without traffic signs.   These supports will always be necessary, although the detail or type may evolve over time.  So rather than work toward a goal of weaning from visual supports, individuals with autism should celebrate one of their greatest strengths and learn to use visual supports to their fullest potential.

#2.  But he/she already knows the routine.

While the individual with autism has learned to cope and survive through auditory means and context clues, the cost is often undue stress and anxiety.  This heightened level of stress may result in more frequent behavioral difficulties that seem difficult to understand.   At the very least, an individual may be less content than would be otherwise.  Most adults will confess that they react differently to situations when tired, preoccupied or frustrated.  A surprise guest or unexpected illness can throw a curve into the best of dispositions.  Educators and parents have an obligation to respect the needs of individuals with autism and create as much structure and clarity to ease the stress created by the neurology of autism.

References

Activity Schedules for Children with Autism: Teaching Independent Behavior (1999). McClannaham, L.E., & Krantz, P.J. Bethesda, MD: Woodbine House.

How The Special Needs Brain Learns [2001]; David A. Sousa, 231 Pages; Corwin Press.

Visual Strategies for Improving Communication, Volume 1 [1998); Linda Hodgdon, 219 Pages; QuirkRoberts Pub.

New!

Structured Tasks

The following tasks are products from the Visually Speaking TM training that was held in Temple Independent School District in February of 2005.