Teaching Sexual Health

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Tip of the Month:
September, 2017

Why teach sexual health to students with ASD?
People with Autism are like all people and have the right to learn all they can to enable them to become a sexually healthy person. However, because of to the social challenges a person with autism faces, learning about sexual health can be even more important. Many individuals with ASD do not have even basic knowledge about sexuality. Many individuals with ASD do knot know when and whom to ask questions with regards to sex and sexuality. Teaching sexual health is important to help prevent the spread of STD’s, unwanted pregnancies, and abuse. Many young people with ASD or other disability are at an increased risk of sexual abuse. Many young people do not know the difference between an appropriate and inappropriate touch. Often sex and sexuality, as serious topics, are ones many of us would rather avoid than address. This may be more so when the issues is sexuality and students with ASD. Individuals with ASD may have sexual feelings that are “out-of-sync” with their level of social development and awareness. As children grow, their social and sexual skills sets are likely to become different to their chronological age and appearance. Other people, however, will base expectations on their chronological age, and NOT their developmental age.

How to teach sexual health:
Start earlier rather than later! Preparation is key! It might take our students with ASD to understand and process information and thus starting earlier gives them more time to come to terms and understand important skills and concepts. TEACH (Treatment and Education of Autistic and Communication related Handicapped Children) suggest that parents and professionals begin the discussion about sexuality at around the age of 10 which is (two-three years before the average child enters puberty. Students with ASD can be reluctant to change, so it is important to give them plenty of notice regarding what will happen when they enter puberty.

Be clear, direct, and honest!
It is important to answer your child or student’s questions about puberty, their body and sexuality. This helps the student understand that puberty and sexuality is not something to be embarrassed about and that they can trust you. Using clear and correct terminology to describe body parts is also essential and is the most effective approach when teaching sexual health. Using visual supports is a key strategy for students with ASD. You can use visual supports to explain basics of development, such as showing the student photos of themselves as babies and toddlers, and of other children at different ages to help your student to understand about when puberty happens in life.

You can also use a body outline, labelling all of the body parts and pointing out how each part will change and talking about what fluids come from each part (sweat, tears, urine, semen, menstrual blood).

Teach private versus public!
It is vital to give students guidelines about the difference between private and public. Some topics that can be covered are: What parts of my body are private? Who can touch certain parts of my body? What body parts can I touch on other people? What is a private room and what can I do in that room (Masturbate, undress)?

Resources list
• Making sense of sex by S.Atwood and J.Powell
• A 5 is against the Law! Social boundaries straight up! By K.D. Buron
• Intimate relationships and sexual health: A curriculum for teaching adolescents/adults with high functioning ASD and other social challenges by C.Davies and M. Dubie
• Teachngsexualhealth.ca (go to teacher’s portal- lesson plans- lesson by grade-differing abilities)

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Supporting Literacy Skills

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Tip of the Month:
August, 2017

According to the article Autism, Literacy, and Libraries (Akin and Mackinney, 2004) “research yields a link between increasing literacy efforts, such as guided reading and improved skill levels in autistic children”. Research also indicates that read-alouds show that autistic children benefit from oral readings and may be able to uncover story structure. Repetition is a key strategy to support students with autism’s literacy skills. In repeated storybook readings, the story provides a venue for joint attention and turn taking. Engaging, colourful picture books can help a child learn to focus on the pictures and narrow the avenue of referents (Akin and Mackinney, 2004). It is important to have the word and picture near so that the student will begin to associate the word with the picture. Some students with autism may become fluent readers but struggle with comprehension. The student may acquire reading ability without fully understanding the process. The student may be very good at reading because they have good visual learning skills. However, some students can decode words beyond the level of their comprehension. As educators, it is vital to examine how much of the material the student with autism is comprehending when they are reading. Comprehension can be difficult for some students with autism because they struggle with ‘Theory of Mind’. ‘Theory of Mind’ relates to a person ability to interrupt and understand the motivation and intentions of others. Students that struggle with ‘Theory of Mind’ find it difficult to understand and relate to characters in the book. They may understand the facts of the story but are unable to answer deeper ‘why” questions.

Along with reading and comprehension difficulties, students with autism often struggle with creative writing due to lack of imagination. They may find it difficult to get started and organise their thoughts in a coherent sequence. The student may not be able to write about anything outside of their own personal experience.
How can you support literacy?
• Use a student’s special interest in all aspects of their literacy. If the student likes things related to construction/trucks use words associated with that topic for spelling and reading.
• Create your own storybooks- books with familiar photos and stories about the student’s family, pets and activities can be more meaningful
• When expecting a student to do a creative writing piece give the student some specific story starters. Students can waste a lot of time trying to think of a story topic. Also allow the student to write about personal experiences. Then to develop creativity ask questions like. “What would happen if…?” and have the student write an alternative ending.
• Once a student knows a book by heart, create sentence strips from the book and ask the student to put them in the right order to help develop comprehension skills.
• Practice sequencing using pictures that show a sequence of events. Get the student to retell the event in their own words. This will help the student understand preposition in stories such as what happened before/after/next.
• If a student struggles with organizing their creative writing task or getting started ask them to draw a picture first to aid in organizing their thoughts.

Akin, L. (2004). Autism, Literacy, and Libraries. Children and Libraries, 35-43.
Gateways Support Services, www.autismhelp.info

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Supporting numeracy skills

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Tip of the Month:
July, 2017

Students with autism vary greatly in their strength and weaknesses within academic skills. Some students with autism have a particularly difficult time developing numeracy skills. Traditional methods of teaching math are through language and this is problematic for many students with autism as many struggle with weak language skills. “Some of the most difficult aspects of math for ASD students are language of math (words describing mathematical concepts), work problems (accurately translating from language to mathematical problems), estimation and prediction (Bell, January 2002). Many students with autism find it easy to learn by rote, so you may find they are very good at reciting times tables; however, can not answer more complex word problems.
• Some students with autism like the rigidity of math, working though the same problems over and over and getting the same answer
• Some students will quickly grasp the math concept after doing one or two questions and then they will not see the point of doing an entire page of additions and may refuse to do so
Strategies to support numeracy
• Concrete to abstract- start with concrete examples to help the student understand abstract concepts. Giving the student examples they can touch, see, or feel (blocks, objects, toys, abacus).
• Use examples from everyday life- everywhere you look, everywhere you go, you can always find something related to math. Ex- if you have 5 cheerios and you eat 2 how many are left?
• Use the students special interest to help motivate the student to learn mathematics. For example, if the student likes Thomas the Tank, use pictures of Thomas for counting.
• Create with the student a dictionary of math words and have it accessible for the student
• Computer or iPad math games/programs can help with motivation. Many students with autism are very good at using computers and they like the fact that computers present information in a logical, predictable sequence.
• Reduce the amount of work the student must complete
• Use simple language
• Present shapes e.g. rectangles in different forms with bases in different places (point out that the refrigerator is rectangle)

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Supporting Functional Communication in students with ASD

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 Supporting Functional Communication in students with ASD
 Supporting Functional Communication in students with ASD
Tip of the Month:
June, 2017

Communication is the process by which we assign and convey meaning to create a shared understanding. Communication should be viewed as a 2-way process in which there is an exchange of ideas, thoughts, and feelings. A significant number of students with autism are non-verbal and therefore it is important to encourage functional communication, regardless of approach. Students with ASD often use less-conventional means to communicate. Auditory information may not be the most to meaningful way for them to learn and communicate.

Functional communication has three key components:
Function- what is the purpose of the communicative exchange (e.g., comment, request, reject)
Example of Functional communication:

  • A student says truck while looking towards the person who is holding the Thomas truck.
  • A student gives teacher a pic symbol with a picture of a cookie on it to request a cookie for snack.
  • A teacher gives a student a sticky note/white board that says “Open Math textbook, turn to page 12 and do questions 4,6,8. The student then does what is asked on the sticky note/white board.
  • Form- what means or mode works best? (e.g., pictures, photos, objects, sign, verbal)
  • Fit – does the communication mode suit the student’s needs in a variety of different environments and contexts
  • Communicative Functions:

  • Behavioural Regulation- requesting, protesting
  • Social interactions- greetings, requesting permission, engaging with peers
  • Joint Attention- commenting, requesting information, providing information
  • Expressing emotions, thoughts, and feelings
  • How to help students with little or no functional communication

  • Present the student with a desirable or interesting object (e.g truck, food item, bubbles)
  • Create familiar routines and situations and structure the communication interactions around those times (snack time, during centers time)
  • Wait expectantly for the student to indicate their desire for more
  • “Tender loving sabotage”- sabotage the environment (e.g. move desired item out of reach of the student, forget to put out a spoon for their soup or paintbrush for art)
  • Initiate and direct the students behaviour towards other people (e,.g, getting the students coat and giving it to the E.A. to request going outside)
  • Use consistency- people have the tendency to just give the student what they want because we know them well. However, this will create dependency and will stop the student from gaining better functional communication skills with a variety of different people in a variety of different settings.
  • Use fewer gestures and more symbols to request, respond and reject
  • Focus on teaching joint attention skills
  • Provide the opportunity and need for the student to request in a wider variety of situations and activities
  • Expand their symbolic repertoire (look at communication programs such as Picture Exchange Communication Systems)
  • Use social scripts and rules for conversation
  • Use visual supports; which can include
  • Body language (e.g. gestures)
  • Tools for organization/giving information (e.g. calendars, schedules)
  • Use environmental cues ( e.g., objects, signs, labels,)
  • Social scripts, choice boards, reinforcement
  • Visual Support Examples, top right:.
    This picture board was made to accompany a student when they go out on Community Based Instruction trips or when at home. This sample shows one for shopping so that conversation can be generated while the student is engaged in the activity. Questions are posed such as, “Where did you go?” and the varying responses are located on the right.
    Conversation starters are listed on the left and possible remarks are on the right. This board was made to expand and expect language and participation from all students.

    a simple printed/laminated request board and is printed on both sides to make communication quick, easy and efficient. You can use this method by placing boards in the areas where they will be used by attaching a plastic bag to the side of a table or on the back of a wheelchair, wherever the child will need it to communicate. One side has the carrier phrase, “I want” or I need” and then the desired items are pictured on the right.

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Using Consequences to Manage Behaviour

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Tip of the Month:
March, 2017

A consequence is any event that occurs immediately after behaviour. Consequences can be used to reinforce and increase behaviours (e.g., giving a student a high-5 for finishing a math assignment) or to punish and decrease behaviours (e.g., telling a student to “quiet down” after talking out in class).

Behaviour management both at home and school often focuses on consequences intended to punish or decrease undesirable behaviours. Common punishments include response cost (e.g., losing privileges), time out, or reprimands. Punishment can be effective in that the challenging behaviour may immediately stop; however, this type of consequence is unlikely to be effective in changing behaviour over the long term.

Why do we rely on punishment?

  • Punishment is quicker and easier to deliver (e.g., telling a student to leave the room).
  • Punishment often has an immediate effect in that the student will stop the challenging behaviour.

Problems with punishment:

  • It focuses only on stopping behaviour at the surface level (e.g., a quick fix).
  • It does not teach students appropriate replacement behaviours (e.g., telling students to “quiet down” in class does not teach them to raise their hands instead).
  • It may not address the function or purpose of the behaviour. For example, if a student talks to peers during math class to avoid doing the work, sending him or her out of the classroom only reinforces that avoidant behaviour. Similarly, if a student calls out in class to get adult attention, telling him or her to “quiet down” reinforces that attention-seeking behaviour.
  • Punishments may be applied continuously over time, and the student may develop negative associations with the adult delivering the punishment.

How to use consequences more effectively:

  • Gather information on when and where the challenging behaviour is likely to occur and what purpose it may serve.
  • Focusing on delivering reinforcement for desirable behaviours will lead to a better pay off long term.
  • Ensure that the consequence delivered is instructional.
  • Take time to reflect on your own practice as a teacher or caregiver, switching from punishment-to reinforcement-based consequences takes time and thoughtful effort.

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Attention and Concentration

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Attention and Concentration
Attention and Concentration
Attention and Concentration
Tip of the Month:
February, 2017

A Student sitting next to Mark is tapping his pencil on the desk to the degree that Mark cannot concentrate and wants to get out of the room.
Many Students find paying attention can be hard work. However, Students with autism spectrum disorder (ASD), attention and focus can be an even more challenging. When we are asked to pay attention, we are able to focus on one thing and put other thoughts out of our mind temporarily. For example, if we are listening to music quietly while we are reading the newspaper and somebody comes in the room to ask us a question we can filter out the music and listen to what the person is saying. Paying attention is a skill that develops over time. To pay attention we need to be attentive to our surroundings so we can sort out and put together the right information.
Paying attention is a key skill for learning. For example, a Student needs to pay attention to adult requests. Students need to be able to pay attention to have positive interactions with their peers.
Students with ASD can find it increasingly challenging to focus on things that don’t interest them (reading, writing, gym etc.). However, Students with ASD can focus their attention on things they like (trains, video games, Minecraft).

Characteristics of a Student/Student with attention and focus challenges

  • Student appears to struggle with understanding what she/he need to focus on. They may be aware of the “Main Idea”
  • They easily get distracted or appear overwhelmed by different scents such as strong perfume/deodorant
  • The student takes along time to get started on a task
  • The student may not answer when their name is called
  • The Student may have restricted interests/obsessive interest that can intrude on their thoughts
  • The student may ignore group instructions because they don’t realize they are meant to contribute to the group.
  • Student may be very rigid in what they eat and will only eat certain foods (texture/colour).

Tips for supporting Attention and Focus

  • Pay attention to the student's learning environment. Students with ASD can be easily distracted by background noise, flickering lights, movement. Environments that are very busy visually can be overwhelming for the Student with ASD.
  • Strong smells lie perfume/deodorants/soaps can be overwhelming for a Student with ASD. If possible, avoid strong scents in the classroom
  • Eye contact is one of the first steps to help your Student pay attention to people. Try calling the students name, placing a desired object within his/her line of sight and then moving the object towards your eyes. Eventually the student may start to look towards your face when you call their name. You need to be patient and persistent as it can take awhile.
  • For older students who can read, leave sticky note or reminder card with the instruction/expectations written down. These on placed on their desk or even inside the text book.

Reminder/Expectation Cards

    Reminder cards may be used as a visual aid to prompt the student to complete his work during class. The reminder card will outline what the expectations are for each of his classes. The cards may be placed on the inside of his binder or notebook. You can also use a sticky note and write the expectation on the sticky note and then place it on his desk.
  • Visual supports are a key support strategy for all students to help with attention and concentration. A visual support refers to using a picture or other visual item to communicate with a child who has difficulty understanding or using language. Visual supports can be photographs, drawings, objects, written words, or lists.
  • Keep your language clear and consistent, giving one instruction at a time. Give the student enough time to process the instruction and follow up that he understood.
  • Make sure the student understands the activity and knows how to start and when to finish. Using timers will be useful for the student as it also tells them learn about the concept of time.
  • Try to keep tasks functional and relent to the student and when possible incorporate their special interests. For example, if a student won't concentrate on math worksheets, but loves Thomas the tank, place a sticker of Thomas on the worksheet. This may me motivating to the student and draw their attention to the work sheet.

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Sharing Your Child’s Diagnosis of Autism Spectrum Disorder with Him or Her

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Tip of the Month:
November, 2016

Many parents wonder about the right time to tell their child that he or she has autism spectrum disorder (ASD). Common concerns centre around the child feeling different or ostracized, the child having limited options, or the child using the diagnosis as an escape technique (e.g., “I can’t do my homework because I have ASD”). Although parents and family members may waver about whether or not to reveal the diagnosis, it ultimately helps the child understand his or her own thoughts, feelings, and behaviours.

Problems and challenges may be more likely to arise if the child is unaware of the diagnosis and therefore does not seek the appropriate support. For example, the children may not understand why:

  • they frequently see adults or therapists for support
  • social interactions and relationships can be so challenging
  • they are frequently reprimanded for not displaying skills that they don’t have
  • they have low self-esteem

There is no universal time to share your child’s diagnosis; this all depends on individual abilities, challenges, and personality. It may be best to aim to share the diagnosis at a younger age as long as the child appears ready.

Some approaches to take for how to share the diagnosis may include discussions about:

  • individual differences and likes/dislikes
  • visible and invisible differences
  • positive aspects of the diagnosis

Family resources for more information:

Faherty, C. (2000). Autism: What does it mean to be me? A workbook explaining self-awareness and life lessons to the child or youth with high-functioning autism or Aspergers. Arlington, TX: Future Horizons, Inc.

Jackson, L. (2003). Freaks, geeks and Asperger Syndrome: A user guide to adolescence. Philadelphia, PA: Jessica Kingsley Publishers Ltd.

Elder, J. (2006). Different like me: My book of autism heroes. Philadelphia, PA: Jessica Kingsley Publishers Ltd.

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Transitioning from ABA Programs to Kindergarten

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Tip of the Month:
October, 2016

With the start of the new school year, students with Autism Spectrum Disorder (ASD) have entered into Kindergarten classrooms all over British Columbia. Beginning Kindergarten is an important milestone for all children and families, but this transition may present unique opportunities and challenges for children with ASD.

Many children with ASD are transitioning from a clinical Applied Behaviour Analysis (ABA) program into elementary school. The goals of ABA programs typically involve teaching foundational skills and behaviours that can be transferred, or generalized, into other settings like school. However, the school team should not expect an immediate transfer of skills and behaviours without careful planning. The team should acknowledge that the ABA program will likely not be replicated in the school setting and instead focus on specific elements from this program that may be feasible to implement in the classroom. Moreover, the team should acknowledge that staffing or adult support will change; the typical one-on-one instruction in an ABA program will become a classroom of 25 to 30 students with one or two adults.

Establishing a transition team can facilitate the student’s entry into Kindergarten. The school’s Kindergarten teacher or learning support teacher may visit the student in the clinical setting to examine current goals and instructional strategies. Similarly, the Board Certified Behaviour Analyst (BCBA) and Behaviour Interventionist working with the student in the ABA program should be welcomed into the school to observe the student’s transition and provide support. The student’s ABA program should be amalgamated with the general education curriculum as well as Individual Education Plan (IEP) goals. Above all, educational goals should be functional, meaningful, and applicable for school settings. Remember: quality over quantity. If the school team feels overwhelmed with an abundance of skills and behaviours to teach, consider choosing the fewest high-priority goals to work on at school. It’s more beneficial for the student to acquire, practice, and maintain core skills and behaviours than to receive infrequent instruction across many different areas.

Overall, schools and other service providers should embrace a collaborative approach and welcome input from those that know the student best. BCBAs and Behaviour Interventionists working in clinical settings have extensive knowledge in evidence based practices to manage behaviour and provide instruction. Teachers and school personnel have extensive knowledge in implementing individualized educational plans and goals in a classroom and school setting. Uniting perspectives will promote long-term success.

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ASD in the Classroom

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Tip of the Month:
September, 2016

Whether you have a student with autism spectrum disorder (ASD) in your classroom for the first time or have had many students on the spectrum in previous teaching years, there are few things to remember or to help prepare yourself for the upcoming year.

  • One size doesn’t fit all. There are many individual differences among students with ASD. It is important to get to know your student at the beginning of the year. Look at the student file, talk to other teachers, and spend time with the student to become aware of communication abilities, preferences, ability level, etc. Additionally, it is important to remember that effective strategies used for a previous student may not work for your current student. Each student is different and will require various and alternative strategies.
  • Use the Individualized Education Plan (IEP) to focus on the student’s strengths and challenges. The goals (measureable and specific) listed in the IEP should include details around the accommodations that will be used to meet those goals. Teachers should be included in the IEP meeting and partake in data collection for the specific goals.
  • Learn about autism. If this is your first student with autism, it may benefit you to research ASD and supports for students in your classroom. There are some general evidence-based strategies that can be extremely helpful (see August Tip of the Month). Research shows that teachers are more likely to implement new strategies and interventions when they are familiar and comfortable with those strategies. If your staff contains teachers familiar with ASD, talk about their experiences and gain some suggestions from them. For those teachers with ASD experience, take some time to familiarize yourself with new research and interventions. The ASD literature base is evolving and there are many new interventions that can be implemented in the classroom.
  • Education for other students in the classroom regarding differences may be provided. For some students, this could be the first time they encounter a student with autism. Education of differences among students will help other students recognize the challenges that your student with autism may encounter.
  • Environmental accommodations should be made. There are various strategies that teachers can implement to help the student with autism feel safe and comfortable. Accommodations such as alternative lighting, alternative seats and desks, quiet/break space, visual supports, etc. Remember, it’s ok to change things throughout the year. The strategies that worked in the beginning of the year, may not work towards the end. Make sure the student is comfortable and safe!

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A Visually Supported Classroom

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A Visually Supported Classroom
A Visually Supported Classroom
A Visually Supported Classroom
Tip of the Month:
August, 2016

Some children with autism spectrum disorder (ASD) have auditory processing difficulties and/or expressive and receptive language challenges. These students may have difficulty with comprehension of verbal information and expression of their wants and needs. Concrete visual teaching methods are required to ensure students can understand and express language (may comprise of pictures, words, or both). Visual supports help increase language comprehension, provide environmental expectations (e.g., rules, activity schedules, etc.), and structure. Visual supports help children with ASD to communicate and allow abstract concepts to become more concreate; however, the strategies will additionally help a variety of other students within the class.

When setting up a classroom for September, teachers may wish to consider some of the following suggestions:

  • Label each area of the classroom. Although younger grades may have more variety within different areas (e.g., a break area, quiet area, centers area, reading area, carpet time area, etc.), there are areas in secondary grades that can also be labelled (e.g., break area, computer area, etc.).
  • Use a class-wide visual schedule. As students become aware of upcoming activities and tasks, predictability is increased while anxiety and challenging behaviours decrease.
  • Label supplies within the classroom (e.g., art supplies, books, different bins, toys, etc.). If a student is asked to retrieve an item or clean up, they can determine the location of the item without adult prompting. Since the supplies will be in one location, students eventually learn where items are located based on the visual supports. Additionally, other students and adults who work in the classroom will benefit.
  • Provide within-activity visual schedules for various areas. For example, if students are expected to shut down the computer after use or provide log in information, a small visual support that demonstrates how to complete the task can be placed above the computer. It is important not to assume all students will remember how to execute those tasks from memory. Other examples include, a clean up visual in the play area, remove shoes before the student enters the classroom door, specific instruction for different centers, etc.
  • Keep important visuals close to the classroom door. A stop sign to remind students to stop before they leave, a bathroom and water visual can be used for students with limited expressive language, or a line up and wait visual can help students remember to line up when they leave the room.
  • Classroom expectations should be placed in the classroom for all students to see. Some students are not able to remember the rules and may need frequent visual reminders.
  • Use a visual timer to represent time in the classroom. Many children have difficulty with the abstract concept of time and a visual representation will alleviate consistent inquires. It can also reduce anxiety when the student is aware how much time remains in an activity.
  • Use a choice board for students to pick an item as a reinforcer, a reward, or a task to complete. Other students with expressive language challenges will benefit from a visual choice board.

Regardless whether you choose to implement one or all of the suggestions, it is important to recognize that students with ASD will require additional visual supports within the classroom. Teachers have indicated when they use visual supports to help with ASD students, more students tend to rely on the visuals as well.

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