In So Many Words

The holiday season is upon us, and people everywhere are fretting over what to get for their loved ones, searching for meaningful gifts that will enlighten and inspire.

Well, no need to fret any longer! Future Horizons has put together three suggestions for great books for parents of a child with autism. Put these books on the top of your shopping list and you will give a gift that will bring smiles not only through the holiday season, it will be also something your friend or family member will hold dear for all the days next year and thereafter.

Or, make gift-giving easier for someone else! Put the books on your own wish list and receive a gift that keeps on giving—to you and your child!

1.) Apps for Autism is a book written as a primer on the newest technologies so a parent can confidently access and utilize tools that are just a touch away to maximize your child’s success.

For those new to apps, worry not! The author takes you by the hand and teaches you how to get started (from selecting a device, to opening an account, to downloading your first app). Apps include just about any subject imaginable—communication, language, math, literacy, hygiene, sign language, aphasia, music, eating gluten free—you name it, and you’ll find an app for it. The author guides you through, explaining what each app can and cannot do. Finally, the world’s best digital tools are right at your fingertips!

2.) Bobbi Sheahan is not only a beautiful writer, she is frank and funny. People just can’t put down her book What I’d Wish I’d Known about Raising a Child with Autism. She and her coauthor, psychologist Kathy DeOrnellas, Ph.D., take readers on a personal and professional tour of autism—from the moment parents realize their child is different (“My, what a quiet baby I have!”), to self-righteous moms on the playground, to holding a marriage together in the realm of routines.

No one could read this book without both laughing and crying. So if you want some humor and understanding in your life this holiday season, read Bobbi Sheahan’s book. Her candidness and her coauthor’s expertise will help you help the child you love.

3.) The holidays are the single most stressful time of the year for many reasons: long to-do lists, financial strains, traveling, preparing for houseguests, and more. It’s a time when families get together with relatives they don’t see frequently, including some they may not see again because of their age, infirmities, or illness.

Catherine Faherty’s masterpiece Understanding Death and Illness and What They Teach About Life: An Interactive Guide for Individuals with Autism or Asperger’s and their Loved Ones is, without doubt, the best book ever written about teaching the children you love about how to act, what to say, and, in the process, how to grapple with your beliefs about death and illness and their relationship to life itself. This book is really for people of all ages and abilities, but it’s particularly a Godsend to the parents of a child on the spectrum. Beautifully, caringly written, this book gives meaning to the holiday season in a way you can’t imagine.

If you take my advice and give this list to your nearest and dearest, he/she can order the book(s) – or any items from the Future Horizons online store – at a 15% discount from www.fhautism.com by using the special coupon code INTERRUPTED.

You not only get something memorable, you’ll get it at a bargain!

And, if you’re looking for a great gift for a child with autism or sensory processing disorder, check out Sensitive Sam. It’s a charming illustrated story that will help children understand more about what it’s like to have Sensory Processing Disorder (SPD). It is written and illustrated by Marla Roth-Fisch, a happily married mother of two, including a son with SPD.

Note: I am an affiliate of Future Horizons and receive a small amount of compensation for any sales made using this code. You can use the code INTERRUPTED when ordering books or other materials to receive 15% off plus free shipping in the continental US. Discount also applies to conference registrations.

I’m finally getting back to my notes from the National Autism Conference. After the great afternoon spent learning about motor planning, I was more than ready to hear this presentation on physical education the following morning.

The speaker was Garth Tymeson, a Professor of Adapted Physical Education in the Department of Exercise and Sport Science at the University of Wisconsin – Lacrosse. Initially, the session was advertised as being on adapted physical education, but Dr. Tymeson revised it to the broader topic of “Preparing for an Active and Healthy Lifestyle in the Community.”

Following are some of the notes that I took during his presentation:

Collaboration Between Teachers and Parents

The starting point for any physical education program is the goals, and the goals should reflect the functional skills we want to see them using in the community.

In order to create goals that will mean something for the student after they leave school (for the day or for good), there must be collaboration between teachers and parents. Teachers must find out what parents what their kids to be able to do.

So, what do parents was their kids to do? Parental goals for physical education usually include things such as:
- socialization
- learning basic skills
- acquiring functional physical fitness
- finding things that provide success and enjoyment
- having a positive self-concept, reduced anxiety and frustration

More specifically, parents most often want their kids to learn to:
- ride a bike
- swim
- play individual sports
- know the basics for sports of interest
- understand how to use exercise equipment
- BE SAFE

His main point was that the goals should reflect these things. One of the most useful things a student can learn is how to utilize fitness equipment and set goals and routines for themselves related to ongoing physical fitness. That is far more helpful than knowing how to play dodgeball.

Program/Class Challenges

Another important area to look at is what is preventing a child from achieving in physical education and deriving these benefits. Is it related to social communication difficulties? Physical/motor issues? Staff?

Dr. Tymeson strongly recommended that kids with ASD who are in regular PE classes have an assessment done by an adapted PE teacher to determine what physical skills they need to develop. They may need specially designed instruction, possibly in a smaller group, and/or the regular PE teacher may need ongoing consultation on adapting the class for the student.

Sample Assessment Tools
Test of Gross Motor Development 2 (TGMD-2)
Brockport Physical Fitness Test
Fitnessgram
Peabody Developmental Motor Scales 2 (PDMS-2)
Adapted Physical Education Assessment Scale (APEAS II)

He also pointed out that adapted physical education does not have to be all or nothing. A student may be able to participate in the regular class but need an extra session each week to work on specific skills.

I remember during first grade that we would have the physical education teacher let us know what sport or skill was going to be introduced next. Since the school insisted that they were not able to provide any pre-teaching due to the lack of available time and staff, we could at least find books related to that topic at the library and help our son gain some familiarity with what was coming.

Considerations for Students

In the Adapted PE program at the University of Wisconsin, learning management and instructional techniques is considered to be just as important as the rest of the curriculum. The focus is on how to make things predictable and successful for the students, and they are taught to use things such as:
- picture and communication boards
- lanyards with laminated icons in place of the usual whistle
- schedule boards
- visual aids
- social stories
- smart boards and iPads

For kids at home, he strongly recommends getting them up and moving and playing outside as much as possible. The use of active video games, such as the Xbox Kinect or certain games on the Wii (like Outdoor Challenge, Dance Dance Revolution, or Wii Fit), can also be very helpful in motivating kids to engage in physical activity.

During the break, I asked Dr. Tymeson about my son’s biggest challenge, which is competition. He can make anything into a competition, even an individual sport.

His response was to teach my son that there are other ways besides winning to have success are improvement and accomplishment. Practical suggestions might be giving him a pedometer or heart rate monitor and helping him set a target so that he can focus the competitive aspect on himself.

IDEA requirements for Physical Education

Under IDEA, physical education is a required service, not a related service or therapy. A variety of placements should be available and placement should be made based on an assessment of the unique needs of each student.

Dr. Tymeson’s advice is to “Get it on the IEP and KEEP IT THERE.” I would say this is much easier said than done.

I did ask for an assessment by an adapted PE teacher and was told no because the team feels he does not have gross motor issues and that his problems in PE are related to his autism and could be addressed by the autism consultant. This seems to be a reflexive no on the school’s part, especially since he has not had any formal evaluation of his gross motor skills in well over 4 years, but I chose not to pursue it since the teacher he was assigned for PE this year is one who works very well with him and with the rest of the team.

I would be greatly interested in hearing if any of you have had success with convincing your school district to pay attention to this area of your child’s education, especially with regards to accommodations and specially designed instruction.

Recommended Reading

Physical Education (PE) & Adapted Physical Education (APE) on Wrightslaw.com

Adapted Physical Education and Sport – 5th Edition, Edited by J. Winnick

Asperger’s From the Inside Out: A Supportive and Practical Guide for Anyone with Asperger’s Syndrome
by Michael John Carley
Perigee (2008)
250 pages

Asperger’s From the Inside Out was written by Michael John Carley, who was diagnosed with Asperger’s shortly after his son was given a diagnosis. He has since become involved in helping others with AS and is the Executive Director of GRASP, which is the Global and Regional Asperger Syndrome Partnership.

The opening chapters cover some background information on Asperger’s Syndrome, as well as Carley’s own experience being diagnosed and then examining his past through that filter. The book also brings out the issues surrounding disclosure and provides some possible coping strategies, a discussion of special interests and, finally, a fascinating look at what happiness really is.

I really like what he has to say about the diagnosis of AS:

Diagnosis is not intended as a eulogy, but almost instead as a starting point, a context, or a filter through which to discover the person’s individuality–far quicker that without it.

He makes another great point in the chapter about coping strategies, talking about how strategies that are offered in books like this are theoretical and are not going to work the same for every person. He stresses that they are not foolproof but are worth trying – in quantity – in order to find the ones that make a difference.

All in all, I think this would be a great book for anyone who either has Asperger’s Syndrome or is close to someone who does. Carley provides a tremendous amount of helpful information while emphasizing the individuality of every person on the spectrum.

Note: This is Book #108 of my 2011 Reads (master list here).

This month’s Best of the Best topic is on the use of medications: Have you used them with your child or considered using them? If you have used medications with your child, do they help or have they helped? Have medications been recommended but you’ve avoided them and why? Have you had a difficult time finding a qualified pediatric psychiatrist to monitor your child?

I am assuming from the last question that the focus of this topic is primarily on psychiatric medications, as this is the category most people are referring to when they say, “I would never medicate my kid,” or “The schools, or doctors, or nameless, faceless bad guys just want to over-medicate our kids!”

Frankly, I cannot really address this topic on any sort of large scale, being a parent with a non-medical background, so I am simply going to share what our own experience has been with the use of psychiatric medication for our son.

I’ve written a bit over the last few months about our own journey on this front, here, here and here, so I’m going to be referencing some of what I wrote previously as well as sharing where we are now with it.

A psychiatric medication was first suggested to me in the spring of 2009 by my son’s OT, who felt that he would need it for anxiety. The facts that he was only a kindergartner at the time and that the suggestion came to me from a school team member rather than a medical professional caused me to have a very negative reaction to the idea.

In the spring of first grade, Michael had some extreme behavior problems, and the school was asking about it again, so I began taking him to a psychiatric nurse practitioner to get an informed opinion from the appropriate professional, if only to make them stop bringing it up.

With her help, we first worked with the school and his psychologist to address his issues without medication, and it was only after we got to the spring of second grade and saw the same types of major issues that I agreed to consider a medication trial. By this time, we had also had a full evaluation done (for the first time since he was 5) and were given independent recommendations regarding medication from that source as well.

At that point, it was May 2011, and here’s part of what I wrote about the whole idea:

Considering medication is a big step for me. It is scary to consider possible side effects, both short term and longer term that may yet be unkown, plus I keep wondering if there’s something else we could do that would help.

I have even considered moving him to a more restrictive environment at school for part of the day. Although that may be helpful or necessary at some point, we do see the mood swings no matter what environment he is in, even when he is completely in control of what he is doing.

After discussing the specific issues that Michael was facing and the pros and cons regarding medication for each of them, we decided to do a trial of Risperdal for his mood instability, with a follow-up two weeks after starting the lowest dose. We also did not tell anyone at the school except for the nurse about the trial, so that we could get some objective feedback on how he was doing.

Surprisingly, we saw an improvement not only in his mood, but also with his ability to organize his thoughts. Here were some of my comments at the time:

After two weeks, we have not seen any negative reaction to the meds, and we have seen some positive things that cause us to be cautiously optimistic about it.

He has been more communicative with us, sharing stories about what happened in school and expressing concern for his dad’s feelings. He also came up with a plan to do chores to earn money for a video game that he wants!

Things continued to improve as we reached the halfway point of the summer months:

He has been on .2 mg of risperidone since mid-May, and we have continued to see a huge improvement in his mood, as well as more flexibility and organized thinking.

During his two weeks at the babysitter’s he only had 2 or 3 outbursts, and only one of those included aggression. And he has only had 3 aggressive incidents during the first four weeks of his summer program. This is a huge improvement over how school was going and is even better than he did last year at the same sitter and program.

Going back to school was the biggest test, and even that has gone remarkably well. Michael has met his goal with regard to timeouts at school both months so far, even with his full-time aide leaving to take another job and the agency/school scrambling to cover even a few of the hours.

Because he responded so well to the smaller dose, we did not increase it at all and he is continuing at that level even now. As long as it continues to work well and there are no adverse indications from the twice yearly blood tests, we plan to keep giving it to him for at least a year before deciding on the next steps.

My best advice if you are considering the use of a psychiatric medication for your child is to find a qualified professional with strong knowledge and experience in this area, clearly identify the major issues you are dealing with and implement any non-medication related suggestions that may resolve them first.

If you do decide on a medication trial, have a clear time frame and know the criteria you will be using to evaluate the outcome and make the decision regarding ending it, continuing it or changing it in some way. And remember this is not a once and done decision, but an ongoing question to be answered as many times as necessary based on your child’s best interests.

Note: This post was written for the S-O-S Best of the Best, Edition 12: Medications and Their Use with Special Needs Kids, which will be published on November 15th.

How Do I Teach This Kid to Read? Teaching Literacy Skills to Young Children with Autism
by Kimberly A. Henry, M.S.
Future Horizons, 2010
97 pages

About the Book

Reading is so much more than reciting words on a page!

Reading provides personal enjoyment, access to information, and opens doors to opportunities throughout life, both recreational and occupational. Reading helps us grow and vicariously experience things we are curious about, and dream about.

But for many young children with autism, reading is often a factual memorization of letters and words. The playful, imaginative qualities of reading may be missed in favor of the repetitive, predictable alphabet and visual appearance of words on a page.

This book presents simple instructional strategies that can be used to help develop early literacy skills in young children with autism. Award-winning author Kimberly Henry provides dozens of fine-tuned, easily adaptable activities that teachers and parents can implement separately or in infinite combinations. Included are units on phonemic awareness, vocabulary, comprehension, and fluency. Kim also lists numerous other resources you can use to supplement the lessons.

Best of all, this book comes with a FREE CD of printable, visual tools, such as:

• ABC Books
• Text-Picture Matches
• Songs, Chants, and Poems
• Word Webs
• Visual Organizers
• Sentence Builders
• Graphics for Games
• And many more!

My Thoughts

I was extremely impressed by this book. Even having had a child who started reading on his own, I can see where the activities in this book would have helped me expand and direct his learning, especially in those areas where having autism impacted him more.

Kim makes an important comparison in the introduction when she says:

Because the ability to read and comprehend is closely linked to an individual’s language abilities and social understanding, children with autism often struggle with the process of reading.

For my son, the biggest issue thus far has been comprehension. I recall asking him what he thought would happen next as I reached the end of a page in a storybook, hoping to prompt some sort of prediction from him, and being told, “You’re going to turn the page.” It makes an adorable story, and he has progressed past that point, but there is still a gap between how he interprets what he reads and how his teachers expect him to see it.

As Kim points out, amongst other considerations related to comprehension:

Children with ASD characteristically are challenged by a lack of social understanding and “theory of mind”—the ability to take the perspective of another person and recognize their emotions, interests, and motivations. This area of deficit, then, affects their ability to understand and relate to characters in fictional text.

The book itself is laid out nicely, with helpful information regarding each area of literacy prefacing a number of activities directly related to that area. It also includes a CD with printable resources for many of the activities described, which is worth as much as the price of the book over again.

The subtitle reads, “Teaching Literacy Skills to Young Children with Autism, from Phonics to Fluency,” and I agree that it is probably best suited for those working with younger kiddos or early readers. But I would say that it could be very useful even with children who appear to be progressing independently with both phonics and fluency, especially with regard to the area of comprehension.

How Do I Teach This Kid to Read? is available directly from Future Horizons, where you can use the code INTERRUPTED to receive 15% off and free shipping in the continental US.

Note: This is Book #99 of my 2011 Reads (master list here). I received a review copy of this book for free, and the Future Horizons discount code is an affiliate link. All opinions are my own.

I haven’t written much about our daily lives lately – there has actually been so much going on that it’s been hard to distill it into a coherent blog post. The other day I woke up early and was thinking about where Michael is with things right now and what I want to focus on in the immediate future.

So, please take this as a reflection of my thoughts about our personal situation at the moment and not an editorial on how anyone else should think or act with regard to their own child.

Third grade so far has been a highly positive experience for all of us. Michael’s teacher is extremely good, and the whole team seems to be working together quite well towards the goal of encouraging Michael towards more independence in his organizational skills as well as self-regulation.

Of course, there is always the tendency to move too fast towards lowering the level of reinforcement and support. When people see success, they seem to want to breathe a sigh of relief and say, “Okay, that’s taken care of.” But I see it as a much more gradual process. I think the first sigh of relief should be that we have found a level of support that is appropriate for him right now and that we should continue at that level until he is clearly showing that he doesn’t need it so much.

When anyone on Michael’s team mentions pulling back in any way, I tend to panic and react negatively to the suggestion, not because I don’t have the same desires as they do for his independence, but because I instinctively sense that he needs an extremely gradual transition towards a different kind of support than he is currently getting.

(Ironically, the day after I wrote this the Learning Support Teacher was talking about lengthening the interval at which Michael earns checkmarks toward his rewards. For now, we are just going from 3 minutes to 5 minutes, so that should be a negligible change for him.)

Notice that I say “different kind of support.” He will still need support from other people – we all need that in our lives.

One reason for this is because of his maturity level, especially in terms of emotional and social functioning. Another is that he is not at the point where he can always identify when he needs additional help or ask for it if he does realize it. That skill is one of the most important ones I can think of for him to learn, actually.

As I am writing this, I am thinking that another thing I need to emphasize more with him is that everyone needs help and support from other people, to varying degrees based on what is happening in their lives. Pointing out to Michael when others are asking for help or making mistakes or struggling to learn a new skill helps him see that everyone has difficulties at times and that it is actually a sign of maturity to know when to ask for help.

I think a lot of his “self-regulation” issues come down to this perception that he should be able to do everything right and win all the time and understand everything immediately, and that when things don’t go the way he expected, he has trouble identifying what is happening and then either communicating it to someone or figuring out what to do about it.

So (and pardon me as I use my writing to think through the issue), perhaps my focus should be more on helping him to notice and understand what is going on around him so that he can engage in more communication and interactions that are meaningful for him.

This may sound sort of touchy-feely, so let me say that I definitely think it is critical to provide clear instruction on “expected behaviors” and related topics, and that using tangible reinforcements for motivation on non-preferred tasks meets his needs at the moment. And these strategies are incredibly useful to get through the school day, and for structured events in the home and community.

Sometimes I wonder if I am being hypocritical by advocating for such a high level of support at school, while tending towards a more natural interaction at home. But ultimately I don’t think I am, for several reasons:
1. School is by its very nature a more structured environment, with many people who all need to work together in a safe and responsible manner to accomplish specific goals.
2. There is less time and opportunity to provide the in-depth explanations and time to process situations within the constraints of the school day.
3. A teacher with a class full of students cannot possibly attend to all of the signals that Michael may not be paying full attention or understanding the dynamics of what is going on or even that something is upsetting to him. (His current teacher is by far the best at this that I have seen, but it’s a completely different situation than him being with just me or with a therapist one-on-one.)

Recognizing these things has helped me gain a better perspective for myself on what I advocate for school supports. At home, I may not need to provide such a high level of reinforcement*, simply because I am able to focus more intently on his needs at that moment, whether it be adjusting the environment or having an in-depth conversation about perception versus reality.

At school or in a more structured community setting, he needs the higher level of reinforcement to motivate him to accept what is happening around him or what he is being asked to do as necessary, even if he doesn’t like or understand it completely. And learning that different situations and environments have different rules and expectations is a good thing too.

Edited to add: *Re-reading this, I think I should say I don’t need to provide as much tangible reinforcement such as physical rewards or a token economy, but can rely more on social and emotional reinforcers.

Everyone’s been telling me third grade is when it gets harder, especially with the homework. So far it has actually been nice to have a bit more challenging assignments – Michael protests less when it doesn’t seem like busy work, but I’m sure we are still in the honeymoon phase of the school year!

What a timely opportunity it was for me to be able to read and share this article from the July/August 2007 issue of the Autism Asperger’s Digest (www.autismdigest.com).

It’s a lengthy article, but well worth the read. It has a ton of great ideas and an excellent resource list at the end.

Our daily lives are made up of an endless stream of thoughts, decisions, actions and reactions to the people and environment in which we live. The internal and external actions fit together, sometimes seamlessly sometimes not, largely dependent upon a set of invisible yet highly important skills we call Executive Functioning (EF).

These skills, which involve planning, organizing, sequencing, prioritizing, shifting attention, and time management can be well-developed in some people (think traffic controllers, wedding planners, business CEOs, etc.) and less developed in others. They are vital in all parts of life, from making coffee to running a profitable business. The skills develop naturally, without specific, formal training, and we all have them to some degree – or at least, we all assume we all have them.

Things are never quite as simple as they seem, and these EF skills are no exception. They require a multitiered hierarchy of decisions and actions, all coming together within the framework of time, knowledge and resources.

Imagine trying to navigate life when EF skills are impaired or nonexistent, as they are with individuals on the autism spectrum. For most of us, our imagination won’t stretch that far. Therefore, we assume all these kids – especially those who are “bright” – have EF skills and we act and react to our spectrum children or students as if they did.

Nowhere does this EF skill deficit cause more turmoil than in the area of homework, producing monstrous levels of anxiety and dread in students, parents and teachers alike. The myriad of details that need to be accomplished in a student’s class, school day or week can overwhelm even the healthiest student; it can shut down our ASD kids.

I am regularly asked: if tasks are so overwhelming to their EF systems, should we just avoid having students deal with them? The answer is an unequivocal emphatic “NO!” Organizational skills are life skills, not just school skills, and even though they are “mandatory prerequisites” for succeeding at school, like social skills they are rarely directly taught. Few states include explicit teaching of EF skills in their “standards of education.”

So where do we start?

First, by understanding how complex organizational systems become by the time students reach middle school. We can only be good teachers if we appreciate the demands the skills we teach place on our students.

Second, by understanding organization as a skill set, which involves static and dynamic systems.

Static organizational systems and skills are structured: same thing, same time, same place, same way. Static organizational tasks are introduced in kindergarten, first and second grade. We break down tasks and ask students to explicitly complete very defined units of information, at a certain time and place. Write your name at the top of the page, read the instructions, complete the work, when done turn the paper over and sit quietly until time is up.

Dynamic organizational systems and skills involve constant adjustments to priorities, workloads, timeframes, tasks and places. They are less teacher directed and more student-directed. By 4th grade, teachers are introducing dynamic assignments to students with moderate levels of support. Soon after that we expect students to be able to manage increasingly dynamic workloads with little extra support or direct teaching. By high school, almost all school and homework has dynamic components requiring students to use EF skills to allocate time, resources, places to work, etc.

Here’s the good news: most of us understand that to tackle a dynamic task we have to break it down into its static elements. The dynamic part of the task requires thinking; the static part of the task requires doing. A dynamic assignment such as writing an essay requires a significant portion of the task be spent thinking about the topic before the static tasks of actually writing the paper at a table, at a specified hour, etc. One of the great challenges for our spectrum students is learning to break down dynamic tasks into more concrete, static chunks of work.

Fostering organizational skills in students with ASD requires an evolutionary approach towards teaching students, one that is ideally started at an early age. Students hone organizational skills starting in preschool, when we first ask them to clean up their toys. Teachers can accurately identify organized versus disorganized students as early as kindergarten. By 4th grade teachers expect students to be proficient with EF skills.

However, the reality is that the majority of our ASD students of all ages desperately need help with homework, specifically, and EF skills in general. Help is available.

The following 10 steps illuminate specific aspects of EF skills that increase students’ static and dynamic organizational coping mechanisms. While these steps are interrelated and synergistic, avoid trying to teach them all at the same time. Each may be difficult to grasp and master for the student with ASD; allow learning to take its own pace. Keep expectations realistic, talk things through regularly, and probe for misunderstandings or miscommunication. Learning EF skills is a dynamic system of its own, with its static components. Make sure your child or student experiences success and feels competent at each stage of the process.

10 Steps to Foster Organization Skills

1. Clearly define what needs to be done
Too often, parents and schools view organization goals too simply: “the student must write the assignment in his planner.” Clearly this is not nearly enough detail for most tasks and may not even be the best starting goal for a particular student. Adults must be organized in their own thinking if they are to effectively teach students with EF deficits this skill. Go beyond giving out assignments; help the student understand how to also approach the task from an organizational standpoint.

2. Move it with motivation
Almost all students with weak organizational skills also struggle with motivation to accomplish homework tasks. Parents and teachers often don’t realize this lack of motivation can stem from feeling overwhelmed by the task demands. Students with the greatest motivational challenges are often our most intelligent students (e.g. those with high IQ scores). We often assume “smart” means “organized” and say things like “come on, I know you can do this, I know you are smart.” Yet, they may have the hardest time motivating themselves when overwhelmed because they have never had to work at learning. Learning just happened if they stayed attentive.

By adolescence, students need to appreciate that completing work – even work that seems somewhat ridiculous to them – has its rewards. It establishes them as hard working in the eyes of others, improves their grades and increases feelings of self-worth through meeting their grade level academic expectations. However, as obvious as this sounds, this level of cause-effect can still be too overwhelming to some spectrum students because it requires delayed gratification.

Many students need to start at a much more concrete level of motivation, with very small work steps combined with reward early in the task completion process. For example, if a student cannot easily work for an hour, have him work successfully on a single part of the task for just 10 minutes before he gets to pause and congratulate himself. Self motivation increases when students feel confident in understanding and accomplishing the task before them. It doesn’t matter how “well” you teach students these EF skills; if they are unmotivated, they will not implement the ideas. Work directly on helping students tackle and overcome motivation challenges.

3. Prepare the environment
Most adults familiar with helping students “get organized” understand this point. Establish a dedicated workspace for homework that includes the essential tools: pen, pencil, paper, etc. Color coding tasks, making sure the student has an organized binder, possibly access to a time-timer (www.timetimer.com) create structures that promote success during homework time.

4. Chunk and time it
Assignments that sound coherent and structured to teachers can still overwhelm a student with EF challenges. For example: “write a report focusing on the economy, culture, weather and climate of a specific country.” Clear enough, you think? Maybe to us, but not to them. Make sure the student understands how to “chunk” an assignment (break it down into smaller pieces) and how the individual parts create the larger whole. For example, not all students will know their report needs four sections, essentially “miniessays” worked on separately and then joined together.

Furthermore, once they “chunk” the project students also need to predict how long each chunk will take to complete. The majority of our students with poor organizational skill have a resounding inability to predict how long projects will take across time. In fact, they tend to be weak in all aspects of interpreting and predicting time. Consider this: Is there anything you do without first predicting how long it will take? We “time map” everything, gauging how the task will or will not fit into what we’re doing now, an hour from now, later in the day or later in the week.

Homework functions in much the same way. Students are more willing to tackle homework when they can reliably predict how long they will have to work on the task. For example, a student will usually calmly do math if it should only take 5-10 minutes. However, for those spectrum students who can’t predict time, the nebulous nature of the activity incites anxiety such that they may cry 45 minutes over doing a 10-minute math assignment. When the student does not – or cannot – consider time prediction as part of his organizational skill set, he is likely to waste a lot of time rather than use time to his advantage.

5. Use visual structures
As the school years progress, homework shifts from mostly static tasks doled out by one teacher to mostly dynamic tasks assigned by many different individuals. We expect students to self-organize and know how to juggle the many pieces of learning that make up each class, grade and level of education. Yet, this valuable skill is never directly taught!

Visual long-term mapping charts, such as a Gantt Chart, (www.ganttchart.com) can help students plan and monitor multiple activities. These bar type graphs allow a student to visually track multiple projects across time, determine when they are due and how much time is available to work on each.

For example, a history paper may be assigned in February and due in late March; a line would run from early February to late March to indicate the time allocated to the project. A math project assigned in early March is also due in late March; another line would represent this project. Visually the student can see that two big projects are due at about the same time, and both are worth significant grade points. This then helps the student understand why he should not wait until the last minute to start one or both assignments. Gantt charts are frequently used in business, but have yet to make it into student software for school/homework planning. However, they are easy to create and use at home or in the classroom. For students with ASD, they are invaluable tools for organization.

Visual structures can represent entire projects and then also be used for individual chunks, creating the visual organizational framework students with EF deficits need. Once assignments are understood as needing to be worked on across time, we can encourage students to chunks tasks to be worked on during specific weeks, then make related lists of things to do on specific days.

6. Prioritize and plan daily
Learning to prioritize is a valuable skill and helps the student get things done. Keep in mind that many of us make daily lists but don’t always complete all tasks on our list, and that priority is largely based on the value we place on the assignment. Within the school setting, “value” is often dictated by the teacher. Priority is a factor of the task’s value overall, its deadline and the time to complete it. However, just because a task is due does not mean a student needs to make a decision to complete it, especially if it is a low priority or low value task to the student or the teacher.

For example, during her sophomore year in high school my daughter was looking at her math grades online. I looked over her shoulder and saw she had mostly A’s and B’s but noticed she had two F’s. I exclaimed, “Robyn, you have two F’s”, to which she replied, “Mom, they were each worth one point. They were hardly worth doing.” Robyn realized that in light of the many assignments she had to juggle for all her classes, projects with the least point value were not worth doing; she’d rather save her time and effort for the larger, more important projects.

With a prioritized plan in hand, many students will still struggle with actually working on the tasks. Even students with high intelligence may have difficulty getting themselves to work on projects not of their liking. Their baseline attention span may be no more than 7-10 minutes. (Test one of your student’s baseline attention span by observing how long he can attend to mundane projects without self-distracting. You may be surprised by how short it is!)

Help students succeed with their daily schedule by teaching them to take frequent small breaks at the end of their baseline attention span. For example, a graduate student in theology found he could only push himself through 10-minute work cycles before feeling overwhelmed or internally distracted. He used a visual time-timer and gave himself a short stretch break every 10 minutes. Once he completed a number of these short work cycles he gave himself a larger reward.

The key to using self-reward is to make sure the small reward isn’t likely to be distracting or absorbing (computer games, TV, reading a book). Instead make these small breaks quick and refreshing, just to refocus attention: sensory based activities (stretching or movement), a small snack, a quick trip to the bathroom or pencil sharpener.

7. Hunt and gather
Simply put: students need to plan time into their schedule to locate different resources to complete a task. For example, research at the library might be a “chunk” they plan for on their homework list (don’t forget travel time!).

8. Consider perspective
Homework is more effectively completed when students start by considering the teacher’s perspective before diving into the assignment. An assignment done well is one that meets the teacher’s expectations and follows the teacher’s instructions. A high school student went to great lengths to develop a computer program for his computer programming class. His teacher came to me exasperated, explaining that while well done, the project was totally unrelated to the class assignment.

Parent perspectives enter into the homework plan also. Many parents expect children to finish homework before watching TV. Even though children may have accomplished a great deal of homework (in their mind “enough”), trouble can still erupt because it wasn’t “finished” in the parent’s mind.

Perspective taking can be quite overwhelming to many students with social learning and organizational problems. A strategy called “social behavior mapping” (Winner, 2007) can help students understand how expectations, actions and reactions affect not only how we are viewed by others, but how their responses ultimately impact the way we view ourselves.

9. Communicate and then communicate some more
Homework assignments often result in students needing help from others. Knowing when and how to ask for help can be challenging for students with social learning and organizational weaknesses. Avoid assuming students – especially “bright” students – should intuitively know how to ask for help, clarification or even how to collaborate with others on assignments. These skills are not nearly as simple as they seem and may need to be explicitly taught by the special education teacher or speech language pathologist at your school.

Tip: as students age into middle school and beyond, most are turning to their peer group rather than their teacher for help. This fosters peer support networks desperately needed for success in college and later life.

10. Completion and Reward
Having a clearly defined “end” to a task is important for the concrete thinking minds of students with ASD. Be sure the child knows what “finished” means, both at school and at home. For instance, a homework assignment is not truly “done” until it is turned in to the teacher at school. While homework turn-in boxes (static) are commonly found in elementary school, they all but vanish during middle and high school years when even the act of turning in homework becomes dynamic.

Make sure your students know where to turn in homework. Also, parents should save big celebrations for completed projects until the assignments are actually turned in. Some students may need reminder systems set up to make sure work is turned in on time. Visual notes, PDA messages or watch timers can be used to help.

At home, “finished” homework yields its own rewards when students can engage in more personally pleasing activities, such as a computer game, watching TV, reading for pleasure, etc. Even our favorite activities have a finite time frame attached to them before it is time to go to bed. Many of these organizational strategies can be used to help a student learn to shut down a favorite activity and get his brain ready for bed.

“Planning takes time!” This is a message we need to constantly reinforce with our spectrum students.

“Teaching organizational skills takes time, across months and even years!” This is a message we need to reinforce to parents and teachers. Whether students are using organizational skills for homework, doing chores, preparing for a weekend activity or something as simple as getting a snack, as children grow and develop, tasks become increasingly complex and dynamic with each passing year. Teachers and parents need to work together, while children are still in elementary school, to identify and teach any or all of the 10 steps mentioned in this article that are problematic for the spectrum child. In doing so, we give children the tools not just to handle homework, but to be successful in all areas of life.

Michelle Garcia Winner is internationally recognized as an innovative clinician, enthusiastic workshop presenter and prolific author in the field of social thinking and social cognitive functioning. Visit www.socialthinking.com for additional information.

References
Allen, D. (2001). Getting Things Done. The art of stress free productivity. Penguin Books: New York. (recommended by an adult with AS)
Dawson, P. and Guare. R. (2004). Executive Skills in Children and Adolescents: A Practical Guide to Assessment and Intervention. The Guilford Press: New York.
Giles-Brown, C. (1993). Practical Time, Language and Living Series. Imaginart. www.proedinc.com
Hyerle, D. (1996). Visual Tools for Constructing Knowledge. Association for Supervision and Curriculum Development: Virginia.
Myles, B. & Adreon, D. (2001). Asperger Syndrome and Adolescence: Practical Solutions for School Success. AAPC: Kansas. www.asperger.net
Soper, M. (1993). Crash Course for Study Skills. Linguisystems: Illinois. www.linguisystems.com (highly recommended for building a curriculum!)
Winner, M. (2005). “Strategies for Organization:Preparing for Homework and the Real World.” The Gray Center: Grand Rapids, Michigan. www.socialthinking.com
Winner, M. (2007). Social Behavior Mapping. Think Social Publishing, Inc.: San Jose, California.

A few months ago, I was approached about helping to beta test a new site for caregivers of loved ones with issues such as Alzheimer’s, autism, and more. The site offers a way to connect with other caregivers through online journals and book clubs, and it provides lots of resources related to caregiving as well as to self-care.

Sounds pretty good so far, but what really made this site so interesting to me is that the site is built around an online game where you learn about caregiving while also solving a mystery and having the option to solve various puzzles along the way! I have been through the first two episodes of the game, which primarily discuss caring for an elderly relative with Alzheimer’s or a similar illness, and it really opened my eyes to what my father-in-law and sister-in-law have been experiencing in providing the day-to-day care for my mother-in-law, who has Alzheimer’s.

Of course, I blog mostly about autism and many of my readers are more interested in that topic. There are at least two book clubs specifically focused on autism and a fair amount of resources such as recommended books and tip sheets on various issues. A quick search of the term autism on the site turns up a number of related journal entries and book club discussions.

So, if you or someone you know could use a little break from the stress of the day, or would benefit from connecting with someone else in a similar situation, I would encourage you to check out this site. Right now, they are offering a free one year membership and will also contribute $1 to the Autism Society for anyone who joins using this link.

If you want to stop reading and go check it out, feel free! And if you’d like a bit more information about the site first, I am happy to oblige…

New Resource for Family Caregivers

Despite millions of dollars and hundreds of dedicated websites, family caregivers are still in trouble.

Over 60 million family caregivers in the U.S. alone are sick (with nearly twice the rate of chronic illnesses as their non-caregiving peers); they’re depressed (40-60% report significant feelings of depression) and they’re frustrated, unable to find resources or solutions they need to help with the basic, day-to-day caregiving tasks they face. They’re also costly to our economy, accounting for an estimated $29 billion in lost productivity to our country’s businesses.

It’s time to change this description of the family caregiver. It’s time to do just one thing: Improve the lives of family caregivers. Caregiver Village, a brand new place on the web, is dedicated to doing exactly this.

• Caregiver Village is dedicated to building better health, using an innovative, engaging virtual game to inspire better self-care, teach stress management skills, and build more positive attitudes about caregiving.
• Caregiver Village is dedicated to increasing happiness, by helping caregivers connect more with others, choosing their caregiving journey and encouraging mindful support of each other.
• Caregiver Village is dedicated to easing frustration, by linking to resources caregivers need to make a tangible difference in their lives.
• To achieve such an epic change it will take a true Village – a Caregiver Village – reaching out, inviting friends, family and acquaintances to join with us as we raise our voices, affirm our choices and change the world of caregiving today.

Join in. Make a Difference.

You can be a part of this transformation. All it takes is a few simple steps:

JOIN – Become part of Caregiver Village and join a community of supportive, positive, life-changing individuals.

SOLVE THE MYSTERY – Put the “fun” into what is perceived as a terrible drudgery by others. Play the Village Chronicles virtual game, and have a little fun while learning valuable self-care techniques.

SHARE YOUR STORY – Creating and sharing a journal can be an incredibly helpful experience. No writing expertise required. Everyone’s welcome.

GET CONNECTED – Join one of the many book clubs within Caregiver Village. You’ll find a group of people ready to help, support, educate and amuse you. They’re waiting just inside.

FIND RESOURCES – Caregiver Village has a selection of resources selected just for busy family caregivers. Find resources that can make daily caregiving tasks much more manageable. You’ll find links to important organizations as well as exclusive Tip Sheets and Online Training courses designed just for you.

Join me today in reaching out and improving your life – my life – and the lives of other family caregivers all over the country.

LIMITED TIME OFFER:
Join NOW and receive a year’s membership free – $50 value! In addition, when you join using this link, Caregiver Village will donate $1 to the Autism Society.

This month’s topic is on helping special needs kids to calm down and/or refocus after a meltdown or stressful event and asks, “What works for your child?”

For this question, I thought I would go straight to the source. I interviewed Michael until he said it was too boring to talk about anymore and got a few ideas of what he finds the most helpful. So here goes:

• A hug or a squeeze – “nice and tight” is best.
• Snuggling on the couch or his bed. (I sometimes turn his music on as well, but he said that is for bedtime, not for calming down.)
• Tickling or doing something funny to make him laugh. He said this makes him happy, which helps him calm down.
• Having Mommy explain what is going on so he won’t be confused. (Many times his meltdowns are triggered by misunderstandings or not stopping to realize that something can easily be fixed.)

He also said the first step is to stop him when he is whining. And he’s right, it’s so much easier to head off a meltdown than to actually recover from one.

Note: This post was written for the S-O-S Best of the Best, Edition 10: Calming Techniques for Stress and the Special Needs Child, which will be published on September 15th.

I apologize for the short post this month. We got a ton of rain after the hurricane went through and ended up with almost two feet of water in our basement. We have spent several days sorting and tossing stuff, as well as doing a major cleaning.

Move About Activity Cards: Quick and Easy Sensory Activities to Help Children Refocus, Calm Down or Regain Energy
by David Jereb, OTR/L & Kathy Jereb, COTA/L
Sensory World, 2010
64 cards

About the Book

Winner of an iParenting Media Award, this colorful 64-card deck provides fun-filled activities that will help children develop their sensory-motor skills in a game-like format. These cards offer delightful activities for children of all ages and abilities.

Many activities require no special equipment, while others make use of standard, classroom equipment to develop children’s sensory-motor skills and improve their learning and behavior. A great tool for parents, teachers, or therapists to use at home, at school, or in the clinic!

Includes 64 cards on a convenient a snap-ring holder, “How to Use” pamphlet, and sturdy storage box.

My Thoughts

My son and I were both delighted by the adorable illustrations and fun activities in this card pack from the moment we opened it. We took turns finding some activities we were already familiar with and then picking out some new ones to try.

Of course, he quickly decided that his favorite was the most involved one – creating a five-part obstacle course. But he also enjoyed things like walking over a gym ball and back, or passing a weighted ball above your head to a friend while standing back-to-back.

I took them to school last week to show the team and talk to the OT about having him use some of them there during sensory breaks. She was very receptive to the idea and, after discussing which types of activities would be appropriate for school and what equipment she could provide, we picked out about 8 to let him choose from during his breaks. We plan to rotate the cards once a month so the activities stay fresh, and then we can use the others at home as needed.

I think these are great because they provide that much needed visual component and are kid-friendly in appearance and ease of use. They also give the adults a good selection of ideas and a way to structure the timeframe for the kids.

MoveAbout Activity Cards is available directly from Sensory World/Future Horizons, where you can use the code INTERRUPTED to receive 15% off and free shipping in the continental US.

Note: This is Book #78 of my 2011 Reads (master list here). I received a review copy for free, and all opinions and comments are my own. The Future Horizons discount code is an affiliate link.