Children with autism are individuals, first and foremost. Each one of them comes to us with an array of cognitive abilities, learning styles, sensory irritants and impairments, need for routine, visual or auditory preferences, movement disturbances, varied and intense communication disturbances, and difficulties with social interactions. One or more commingling conditions such as obsessive compulsive disorder, hyperactivity, opposition defiance disorder, psychosis, acute anxiety, post traumatic stress syndrome - the list goes on-may also exist. No one program will best meet the needs of all children. Intuition, flexibility and a willingness to use a variety of approaches will best insure progress of each individual child.
A teacher or parent may choose to use a combination of incidental teaching, child-directed activities, and discrete trial format. Errorless teaching, prompting where necessary to keep the child from floundering keeps the child engaged and comfortable. Backward chaining of desired sequences-teacher or parent motors the child through most of the sequence and lets the child complete the last step. Then it is the last two steps and so on. Motored and visual prompts are ramped down as acquisition of skills develops. Communication, social skills and behavior should be taught during all activities, dependent on the child's communicative level and individualized motivational factors.
Start by addressing attending behaviors. Attempt to make a connection with the child in hopes of establishing a relationship. Elect to take a submissive role in an attempt to show the child that he has influence over his environment and that action creates reaction. Allow the child to use you as a tool; or, mirror his activity. Any attempt to interact or have his needs met should be rewarded.
Continues to analyze what changes to make to increase attention. Is there too much environmental stimulation? Are sensory irritants overwhelming? What can be done to make the child more comfortable? Can he attend to preferred activities? Can he attend during one-on-one interaction? Is he having difficulty switching attention? Does music help? Can a particular toy to engage him? What suggestions do his parents have? Keep asking questions! If a strategy is ineffective, remain flexible and try again.
Can the child imitate? If he is unable, attempt to determine why. Is it a problem of attention? Is it a movement problem? If it were a problem of attention, go to a quiet space devoid of sensory distraction. If it were a movement problem, attempt to have someone motor the child from behind during gross and fine motor activities, again ramping prompts down. Do the same when expecting the child to perform actions with objects. I would Mirrored his movements and entice him to mirror yours.
Evaluate communication. Does the child demonstrate communicative intent? What is his communication mode? Does he demonstrate verbal capability? Does he respond to visual strategies? Does he respond to signs? Is he able to imitate them? When appropriate, incorporate either PECS (Picture Exchange System) or prerequisite adaptations.
How are the child's social skills? Is the child seemingly aware of others? Does the child interact? Does he only give rote replies? Are his responses echolalic? The parent or teacher should initially use themselves as the initial interacting agent so necessary prompts can be given.
Movement is a large component. Sensory input facilitates an organized use of the body. An organized body leads to an organized mind; even language is dependent on motor skills. Exercise should be a combination of free play and motored prompts of designated body postures. Exercises that cross the mid-line and engage both brain hemispheres have added benefit.
Nature walks force the child to attend to his environment as they follow trails, on uneven terrain, attempting to avoid or conquer nature's obstacles. The sights and sounds of nature appear to have a calming effect - as opposed to the artificial sights, sounds, noise, and smells of the home or classroom environment.
Plays skills vary depend on the level of interaction with toys and peers. Does he interact with toys? Does he use them appropriately? Does he participate in parallel play? Does he engage in a shared activity? Parents and teachers should serve more as a facilitator than a teacher in these interactions.
As the child gets older, it is important to see how he operates in a home, school or community, and in vocational and recreational environments. It is important for teachers and agencies to provide information on guardianship, financial planning, advocacy, outside therapies, peer relationships and counseling. The ASA (Autism Society of America) is a valuable resource.
Keep reassessing! Are his goals still effective or should they be changed to suit current needs? Do his classes have long-term significance? Does his participation enhance social relationships? Does he have friends or social activities outside of school? How are issues being dealt with? Is the pace and scope of instruction adequate? Are sensory issues, motor adaptations, interfering communication challenges, transition and generalization issues being addressed in all environments. Are his social and emotional needs being met? What are his needs for predictability, repetitions, direct instruction, and generalization? What are his strengths and weaknesses? In short, what changes and adaptations need to be made?
Visualize where you would like to see him at 21. Match the work environment to his needs and style. Determine the level of support he will need and who will be responsible. Each individual is a unique blend of strengths and weaknesses. It is not easy to find the right fit. Remain flexible and keep trying. If the child is not suited for a typical work environment, continue to advocate for stimulating experiences to insure that he will be a life-long learner
Summary
1. Make sure the child is comfortable.
2. Let him know he is safe.
3. Address movement and sensory issues.
4. Form a relationship with the child.
5. Engage him in activities of joint attention and cause and effect.
6. Teach him to imitate, motor him when necessary.
7. Set up situation that encourage him to initiate.
8. Provide visual strategies.
9. Continually reassess behavior, learning rate and style
10. Stay flexible
I have served as a teacher of individuals with autism of different ages and abilities.
I have served as a teacher of individuals with autism for 18 years. What they have taught me was to be sure of nothing, and open myself to the extraordinary. It has been and continues to be a remarkable ride.
Mary Ann Harrington
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