Handouts from Presentation given at the NRCP 2018 Spring Conference by Courtney M. Butorac

1. Autism 101
The who, what, why and how
By Courtney Butorac, M. Ed, BCBA

2. What is Autism Spectrum Disorder?
 Autism is a complex developmental
disability affecting individuals in the areas of social
interaction and communication.
 Individuals with ASD also have restricted and
repetitive behavior, interests and activities.
 Autism is a spectrum disorder – ranging from mild to
severe. Some individuals will have mild functional
impairments, while others are unable to perform
daily activities independently

3. Early Signs of Autism
 No babbling by 12 months
 No pointing or gesturing by 12 months
 No single words by 16 months
 No 2-word phrases by 24 months
 Loss of previously acquired skills, especially language
 Lack of joint attention (child does not draw other’s attention to objects in the
environment)
 Child does not respond to his/her name
 Lack of pretend, imitative and functional play appropriate to developmental age
 Failure to develop peer relationships appropriate to developmental age
 Child does not imitate others’ behaviors
 Child is rigid in routines or has very difficult transitions
 Child engages in repetitive or stereotypical behavior
 Child has unusual responses to sensory stimuli

4. What causes ASD?
 Autism has no single cause.
 Currently, researchers believe that it is
attributed to several genes and possibly
environmental factors.
 The theory that autism is caused by
vaccines has been debunked.

5. Autism by the Numbers
 Autism is the fastest-growing developmental disability in the U.S.
 As of April 26, 2018, the prevalence of autism is 1 in 59.
 Over 1.5 million individuals in the United States have been diagnosed with
autism spectrum disorder.
 The diagnosis rate for autism is rising 10-17% each year.
 Males are 4 times more likely than females to be diagnosed with autism. It
has been shown to be much more difficult to diagnose girls.
 Autism know no racial, ethnic, or economic barriers, yet white children are
7% more likely than Black and 22% more likely than Hispanic children to be
identified with ASD
 Approximately 2/3 of children with ASD do not have an intellectual
disability
 Infants with an older sibling with an ASD diagnosis are at an elevated risk
for ASD and ASD symptoms
 More children will be diagnosed with autism this year than with AIDS,
diabetes & cancer combined
Autism Speaks 2018

6. Common saying
If you know one person
with autism, you know one
person with autism.

7. Common Strengths in Autism
 Strong rote memory and memory for facts
 Good attention to detail
 Strong ability to attend and dive into areas of interest
 Strong moral code, often very loyal and reliable
 Creative thinking skills
 Can be very logical and think of things visually
 Honest and nonjudgemental
 Strong rule followers

8. Common Challenges with Autism:
Social
 Friendship management
 Sharing a friend
 Dealing with peer pressure
 Getting attention in the positive way
 Conflict management
 Asserting yourself
 Dealing with teasing
 Giving and accepting criticism
 Play skills
 Joining in play
 Compromising
 Dealing with not getting what you want

9. Common Challenges with Autism:
Social
 Difficulty connecting to others without similar
interests
 Perceiving unwritten rules of social interaction.
 Difficulty expressing empathy in ways that others
expect or understand
 Difficulty perceiving emotional states of others
 Difficulty with perspective taking
 Theory of mind

10. This Photo by Unknown Author is licensed under CC BY-NC-ND

11. Question
How does a lack of perspective
taking make social skills
difficult?

12. Answer
 Problem solving
 Reciprocal conversation
 Sharing
 Respecting personal boundaries
 Oversharing
 Blunt/honest

13. Real life examples
Specific challenges that might come up as kids get older
 Insensitivity to other people’s feelings
 Commenting on appearance
 Inability to take into account what other people know
 Referring to events without background knowledge
 Inability to negotiate friendships by reading and responding to intention
 If people don’t respond in the expected way (the way they have been taught)
 Inability to read the listener’s level of interest in one’s speech
 Monologuing
 Inability to detect a speaker’s intended meaning
 Acting literally on what people say “you do that again…”
Simon Baron Cohen, "Teaching Children with Autism to Mind-Read"

14. More Examples
 Inability to anticipate what others might think about one’s actions
 Personal space, TMI
 Inability to understand misunderstandings
 Not understanding why others make mistakes
 Inability to deceive or understand deception
 Being open to exploitation
 Inability to understand the reasons behind people’s actions
 Not understanding the reasons for accommodations
 Inability to understand “unwritten rules” or conventions
 What you should and shouldn’t say
Simon Baron Cohen, "Teaching Children with Autism to Mind-Read"

15. Common Challenges with Autism:
Emotional
 Recognizing emotions in others and self
 Difficulty regulating emotions
 Overreaction
 Lack of coping skills
 Anxiety
Foreign country
 Depression

16. Common challenges with Autism:
Cognitive
 Executive functioning
 Initiate
 Working memory
 Shift
 Organize
 Plan
 Monitor
 Emotional control
 inhibit

17. Common challenges with Autism:
Cognitive
 Flexibility and rigidity
 Changes in schedule
 Environmental changes
 Routines
 Black and white
 Rule bound – which makes them ruler police
 Lack of adaptability

18. Common Challenges with Autism:
Cognitive – restrictive interests and routines
 Want to stick to one topic
 Order and consistency
 More rigidity
 Often highly interested in something
 https://www.bing.com/videos/search?q=autism+and+special+interest&&view
=detail&mid=915A8FC35F85C142241B915A8FC35F85C142241B&rvsmid=6ECF01
0EB13B0FC69D0E6ECF010EB13B0FC69D0E&FORM=VDRVRV

19. Example of inflexibility
 https://www.youtube.com/watch?v=WS55-q4fOjU

20. Common challenges with Autism:
Academics
 Reading
 Main idea/summary
 Inferential reasoning
 Prediction
 Math
 Word problems
 Explaining thinking
 Writing
 Multiple executive functioning skills
 Explaining thinking

21. Common Challenges with Autism:
Verbal Communication/Language
 Rules of conversation (Initiating, maintaining and ending conversations, turn
taking, eye contact, face the speaker, stay on topic, personal space)
 Talking too much about their topic
 Inability to verbalize (communicate other ways)
 Literal interpretation of language
 Asking for help or clarification
 Formalized use of language
 Coping with uncertainty (saying “I don’t know)
 Slow processing
 Knowing when to interrupt

22. Common Challenges with Autism:
Verbal Communication/Language
 Melody of speech/tone (prosody)- tone, volume, and intonation
 https://www.bing.com/videos/search?q=fun+with+flags+sheldon+body+language&
&view=detail&mid=F92727D8515E2ABB24E1F92727D8515E2ABB24E1&&FORM=VRDG
AR
 Understanding tone of voice
 “I didn’t steal the cookie from the cookie jar.”
 Vocalizing thoughts – no social filter
 Verbal fluency
 Joint attention
 Commenting
 Repetition of the same phrases
 https://www.bing.com/videos/search?q=laurie+bream+silicon+valley&&view=detai
l&mid=A30F87FCE341FB46B148A30F87FCE341FB46B148&&FORM=VRDGAR

23. Common Challenges with Autism:
Nonverbal Communication
 Reading social cues
 Hidden rules of society
 Reading emotions
 http://www.msnbc.msn.com/id/7019005/ns/nbcnightlynews/t/movies-help-
doctors-discover-autistic-minds/#.UCGZGKPO-So
 https://www.bing.com/videos/search?q=diary+of+a+wimpy+kid+musical+tryo
uts&&view=detail&mid=E46CE3757B74F228AA91E46CE3757B74F228AA91&&FO
RM=VRDGAR
 https://www.bing.com/videos/search?q=the+best+of+the+office&&view=deta
il&mid=A4C81F7EAB8E01F81FFFA4C81F7EAB8E01F81FFF&&FORM=VRDGAR
 Minute 2:56

24. Common Challenges with Autism:
Sensory
 Visual – lights, busy environment
 Hear – clock ticking – Youtube video
 Smell – scents like perfume, food
 Taste – hot/cold
 Tactile – textures scratchy/ tags

25. Common Challenges with Autism:
Sensory
 Proprioceptive – sensations from joints, muscles
and connective tissues that underlie body
awareness
Hanging, pushing heavy objects, carrying
 Vestibular – the sense of movement, centered in
the inner ear
swinging, spinning, hanging upside down

26. Common Challenges with Autism:
Motor
 Difficulties with prediction and anticipation
 Affect motor planning and motor learning
 Also affects postural stability and balance
 Joint hypermobility/low muscle tone
 Affect stability and muscle strength
 Associated with toe walking
 Anxious/fearful temperament
 Affects willingness to participate in challenging tasks
 Leads to avoidance and limited experience
 Other: Ball skills, running gait, rhythm

27. Common Challenges with Autism:
Restrictive Interests and Routines
 Want to stick to one topic
 Order and consistency
 More rigidity
 Often highly interested in something
 https://www.bing.com/videos/search?q=autism+and+spec
ial+interest&&view=detail&mid=915A8FC35F85C142241B9
15A8FC35F85C142241B&rvsmid=6ECF010EB13B0FC69D0E6E
CF010EB13B0FC69D0E&FORM=VDRVRV

28. Analyze this video
 Sheldon goes to jail
 https://www.bing.com/videos/search?q=sheldon+goes+to+jail&view=detail&
mid=BEB18E5A9F3F0B83C2BCBEB18E5A9F3F0B83C2BC&FORM=VIRE

29. How do we Teach Students with Autism:
General
 Visual supports
 Social stories
 Power cards
 Top secret mission cards

30. How do we Teach Students with Autism:
Social
 Teach social skills!
 Role play
 Superflex
 The A-team
 Social scripts
 Video modeling
 https://www.youtube.com/watch?v=9GofBaXi2sE
 Set up situations for practice

31. How do we Teach Students with Autism:
Social
 Use other children as cues of what to do (do you see other
children…)
 Use proximal praise (great job sitting Michael)
 Encourage cooperative games (you may need to support them)
 Encourage friendships – recess club, lunch buddies
 Use minimal and consistent language and model appropriate
interactions
 Teach the whole class about tolerance and ways to make
friends
 Teach general social skills

32. How do we Teach Students with Autism:
Social
 Perspective taking
 Bubble talk
 Scenario from multiple perspectives
 Pictures with different perspectives
This Photo by Unknown Author is licensed under CC BY-
NC-ND

33. How do we Teach Students with Autism:
Emotional
 1-5 chart
 Zones of regulation
 Big deal vs little deal
 Calm down strategies
 Watch movies and read books pointing out emotions and asking about
them, how they would feel in that situation
 Role play
 Point out their body language and feelings (it looks like you are angry…)
 Anxiety workbooks
 Think good, Feel good – Paul Stallard
 Exploring Feelings – Tony Attwood

34. How do we Teach Students with Autism:
Cognitive
 Extra time
 Teach how to self monitor
 Use timers, motivators
 Teach planning skills
 Use checklist/charts/to do lists
 Teach desk organization (pictures, tape)
 Teach about impulse control
 Give warnings about changes and transitions
 Use schedules

35. How do we Teach Students with Autism:
Cognitive
 Flexibility training
 “Max gets Inflexible” – Courtney Butorac
 Stroop test
 Teach flexible categories
 Play mad-libs
 Change endings to stories
 Teach about the “Ruler Police”

37. How do we Teach Students with Autism:
Academics
 Reading
 Access and build background knowledge
 Preteach vocabulary, show pictures
 Create mental images
 Picture walk through the book
 Make connections
 Venn diagram
 Engage in consistent discussion
 Graphic organizer
 Summarize understanding
 Main idea – practice this

38. How do we Teach Students with Autism:
Academics
 Math
 Break down the problem
 Read the problems aloud
 USE VISUALS!
 Use concrete items
 Writing
 Lego writing
 Comic strip writing
 Use their special interests to build
 Graphic organizers
 Assistive technology
 Prewriting sensory activities
 Editing checklists
 Hand over hand, highlight, copy

39. How do we Teach Students with Autism:
Verbal Communication & Language
 Work with the SLP (Speech Language Pathologist)
 Model commenting and compliments
 Model tone and emphasis
 Use social scripts
 Video modeling
 Pragmatics – look at a picture and describe what is happening
 Questions
 Assistive technology
 PECS

40. How do we Teach Students with Autism:
Verbal Communication & Language
 Think it, don’t say it
 Personal thought bubbles
 Teach about when to interrupt
 Teach how to ask for help
 Use visual cards
 Model sympathetic comments
 Teach turn taking in conversation
 Teach idioms and metaphors
 Verbally demonstrate different emphasis and tone

41. How do we Teach Students with Autism:
Nonverbal Communication
 Watch videos
 Demonstrate body language
 Charades
 Emotions bingo
 Teach the hidden rules
 Go through different scenarios and teach how to act in those
situations
 Role play
 https://www.youtube.com/watch?v=jSiPHq-UTJA

42. How do we Teach Students with Autism:
Sensory
 Work with the OT (Occupational Therapist)
 Vestibular – swing, spin, run around
 Proprioceptive - Heavy work – carry, push, recycle – lap pad, chewing gum
 Tactile – kinetic sand, water beads, beans, squeeze balls
 Visual – hats, dim lights, minimize visual distractions, study carrels
 Smell – just be aware of what you are wearing, what you are cooking
 Hear – headphones, music
 Include sensory breaks
 Meaningful jobs
 Meditation
 Different kinds of chairs, allow for standing, fidgets,

43. How do we Teach Students with Autism:
Motor
 Work with your OT/PT
 Hand strengthening
 Practice ball skills
 Balance boards – catch ball
 Handwriting exercises
 Assistive technology
 Mazes

44. Behavior
 Behavior is a big part of Autism
 Next session, we will talk about small ways to prevent big behaviors

45. Resources
 The A-Team books - www.sociallearning.org
 Superflex, Social Behavior Mapping, Social Thinking –
www.socialthinking.com
 Everyday Speech *video modeling - www.everydayspeech.com
 PECS - https://www.nationalautismresources.com/the-picture-exchange-
communication-system-pecs
 “Zones of Regulation” - http://www.zonesofregulation.com/index.html
 “Think Good, Feel Good” – Paul Stallard
 “Exploring Feelings” – Tony Attwood
 www.autismspeaks.org