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Autism

 

What is autism?

Autism is a lifelong developmental disability that affects a childs ability to communicate with and relate to the world around them.

The impact varies from child to child and the care that they receive therefore needs to be customised to their individual needs.

Current thinking suggests that there are 2 main areas of impairment:

1. Social communication & interaction.

2. Restricted,repetitive patterns of behaviour,interests or activities (this includes sensory behaviours).

Social communication & Interaction

People with autism have difficulty with both verbal and non-verbal communication. Comments might be taken literally as there is a lack of understanding of context.

Affected individuals may talk at others rather than engaging in a proper two-way conversation or there may be a “flatness” to their speech. Those affected may also use repetitive speech or learnt phrases. Responses to others can be viewed as being rude or inappropriate .

People with autism can have difficulty responding to social cues such as facial expression or body language. Jokes may be hard to comprehend and subtle comments may be taken literally.

People with autism can struggle to fit in socially. This may be due to an inability to express themselves in a normal manner or to understand others expressions or feelings. There is a lack of response to normal social cues.

Conversations may be difficult and there may be repetition of what the other person has just said (echoing or echolalia)

A lack of imagination or structured ideas can lead to a lack of imaginative play or even a lack of appreciation of danger because of the lack or inappropriate processing of information.

Restricted, repetitive patterns of behaviour,interests or activities

Unusual behaviours or movements occur frequently in patients with autism. These may include stereotypical movements such as hand-flapping, body rocking whilst standing, spinning or finger flicking.

Play may be repetitive and there may be an exagerrated focus. There is often a strong preference for familiar routines and a dislike if these routines are interrupted.

Occassionally there may be an imbalance in developmental skills with areas of difficulty accompanied by areas of high performance. Social and emotional dvelopment may be more immature than other areas of development.

What do we know about autism?

The following video by Wendy Chung summarises some of the facts we know about autism and also some of the misconceptions

The sections below cover some of the management challenges with autism, such as professionals involved in long term care, how a diagnosis is reached and how best to integrate education and social care.

If you have found this article useful please consider making a donation to the children’s e-hospital. This will allow us to continue to operate & no donation is too small. To donate please click on the link at the top of the page, thank you.

Author: Aimee Wray

Editor: Dr Tim Ubhi

Review date: August 2017

  • Professionals
  • Toys & equipment
  • Diagnosis
  • Education
  • Tips for parents

SENCO – Special Educational Needs Coordinator

  • The SENCO will co-ordinate additional support for pupils with SEN.
  • To  liaise with their parents, teachers and other professionals who are involved with your child.
  • The SENCO has responsibility for requesting the involvement of an Educational Psychologist (ED PSYCH.)
  • This also includes general SEN assessments and administration.
  • Parental support- during assessment processes, statementing processes and review meetings.
  • With the support of the head teacher and other teachers the SENCO should try and develop effective ways of overcoming barriers your child’s learning and ensure that they receive effective teaching through assessing the child’s needs and setting targets for improvement.
  • SENCO’s must also work with curriculum co-ordinators at the school to make sure that the learning requirements of all children with SEN are given equal importance and priority.
  • A SENCO will work with the class teacher to consider the child’s needs, and will take the lead role in getting further assessment of a child where necessary, by contacting the LEA.
  • They normally will be responsible for making a request of the LEA for a Statutory Assessment which may result in a  Statement of SEN.

Lead Practitioner

  • A lead practitioner will be involved in all aspects of support to those pupils with autism.
  • Being an advocate your child with autism or your child who is being assessed for autism.
  • Supporting pupils, families and staff.
  • Having a secure knowledge of the key areas of difference experienced by those pupils with autism.
  • Understand and be able to respond to the ways in which autism may present your child’s barriers to learning.
  • Consistently employ knowledge of your child in their decision making regarding advice on effective strategies.
  • Access support from outside agencies, where necessary.
  • Keep up to date with relevant training and good practice to support and be an advocate for your child.

Educational Psychologist (Ed Psych)

An educational psychologist helps children or young people who are experiencing problems within an educational setting with the aim of enhancing their learning.

  • assessing your child’s learning and emotional needs by observing and consulting with the multi- agency team working with your child
  • advising your child’s multi agency team on the best approaches and provisions to support learning and development
  • developing and supporting your child’s therapeutic and behaviour management programmes.
  • They may provide information on your child to the LEA as part of a statutory assessment for a Statement of SEN.
  • designing and developing courses for parents, teachers and others involved with the education of children and young people on topics such as bullying
  • designing and developing projects that may be beneficial for your child and others with similar learning and emotional needs
  • writing reports to make formal recommendations on action to be taken, including formal statements
  • advising, persuading, supporting and negotiating with teachers, parents and other education professionals
  • attending case conferences involving multidisciplinary teams on how best to meet the social, emotional, behavioural and learning needs of your child and other children and young people in their care.

Speech and Language Therapist (SALT)

Speech and language therapists (SALT’s) work closely with babies, children and adults who have various levels of speech, language and communication problems, and with those who have swallowing, drinking or eating difficulties.

  • identifying your child’s developmental speech and communication difficulties/disorders;
  • assessing and treating swallowing and communication difficulties arising from a range of causes, e.g. congenital problems (such as cleft palate) or acquired disorders after a stroke or injury.
  • devising, carrying out and revising relevant treatment programmes for your child.
  • advising carers on carrying out  treatment programmes and training other professionals in speech and language therapy delivery.
  • assessing the environments in which communication takes place with your child and advising on strategies to make these more accessible.
  • monitoring and evaluating your child’s progress
  • working with your child on a one-to-one basis, and in groups, to delivering therapy when appropriate
  • writing and maintaining your child’s confidential case notes and reports.
  • The SLT may plan and deliver training sessions for other professionals who work with you child.
  • They may provide information on your child to the LEA as part of a statutory assessment for a Statement of SEN.

Special Educational Needs Teaching Assistant (SEN TA)

  • Assist in the educational and social development of your child under the direction and guidance of the head teacher, SENCO and class teachers
  • Assist in the implementation of Individual Education Programmes for your child and help monitor their progress
  • Provide support for your child inside and outside the classroom to enable them to fully participate in activities
  • Work with other professionals in the multi-agency team who work with your child, such as speech therapists, educational psychologists and occupational therapists, as necessary
  • Assist class teachers with maintaining your child’s records
  • Support your child with emotional or behavioural problems and help develop their social skills
  • Adapt the curriculum to support your child’s needs.

Speech and Language Teaching Assistant (SLTA)

  • To ensure your child receives targeted support associated with speech and language, appropriate to their needs
  • To work with the headteacher, specialist speech and language therapist,  SEN teaching assistant and class teacher in supporting your child.
  • To with the class teacher, SENCO, specialist speech and language therapist, SEN teaching assistant to assist in planning and implementation of any individual programmes of work for your child, such as those relating to IEP targets and speech and language development.
  • To assist your child to access the full curriculum.
  • To be actively involved and undertake general care and supervision of other members of the class or group.
  • To assist in monitoring the progress of the pupil in all areas of learning and to keep records as requested.
  • To liaise with the specialist speech and language therapist, support teacher for early years children with special needs, support teacher for the hearing impaired, and any other services as required.
  • To develop a good working relationship with your child, the family/carer and any other professionals involved.
  • To contribute to and attend any review or liaison meetings for your child as requested by the headteacher.
  • To provide information to other staff members working with your and in particular new or supply staff etc.
  • To liaise with the family of the pupil regularly to ensure that they are kept informed of progress etc.
  • To prepare, modify and adapt resources and learning materials for your child as agreed with the class teacher and other professionals.

Class Teacher

  • Organising the classroom and learning resources and creating displays to encourage a positive learning environment for your child and their peers
  • Planning, preparing and presenting lessons that cater for the needs of your child as well as a range of other abilities.
  • providing feedback to parents and carers on a pupil’s progress at parents’ evenings and other meetings
  • Working with the SEN TA and others to plan and coordinate work for your child.
  • Liaising with other members of staff who may work with your child e.g. SEN TA, SENCO, Lead Practitioner, SLTA etc.
  • They may provide information on your child to the LEA as part of a statutory assessment for a Statement of SEN.
  • Meeting with other professionals who work with your child such as educational psychologists and speech and language therapists etc.

Broker

  • Local support brokers can provide one-to-one support and additional continuous support for those who need it to manage your child’s personal budget.
  • This can be face to face, or by phone or online.
  • To recognise your child as an individual with hopes, fears, preferences and goals, all of which must shape the final plan.
  • To fashion your child’s care plan in a person- centred fashion, though often in a simplified form.
  • Discovering and inventing ways in which your child’s needs and wishes might be met, not just through standard solutions, but informal support, community resources and ordinary answers.
  • To evaluate the risks and benefits of each idea – where necessary gathering more information – to arrive at one detailed and coherent plan
  • To present your child’s plan in written form and to submit to the council for approval.
  • To turn the plan into reality, including by agreeing contracts or recruiting staff, and co-ordinating all the plan’s elements.

Clinical psychologist

  • A clinical psychologist looks at what function your child’s behaviour has and may introduce a behaviour management plan.
  • Specialist clinical psychologists may be involved in the process of diagnosis of your child as part of a multi-professional team.
  • To look at your child’s strengths and difficulties put current emotional or behavioural issues into the bigger picture of their life-long development.
  • They may use questionnaires, psychological tests, and interviews to gather information on behaviour, intellectual skills, sensory needs and attentional processes.
  • They may provide information on your child to the LEA as part of a statutory assessment for a Statement of SEN.
  • They may also offer a follow-up service.

Counsellor and psychotherapist

  • Counsellors and psychotherapists are able to talk through various issues with individuals and families.
  • Counsellors and psychotherapy help offer support with problems that may arise for your child because their autism may hinder their ability to cope with everyday situations. They may be more vulnerable to experiencing depression and anxiety than other people, especially in late adolescence and early adult life.
  • Counsellors will carry out cognitive and behavioural therapy to help your child change the way that they think about themselves and other people (and what has happened in the past, or will happen in the future) so will be able to function better in daily life.
  • They may provide information on your child to the LEA as part of a statutory assessment for a Statement of SEN.

GP (General Practitioner)

  • Your GP or family doctor can make referrals to relevant professionals for you, such as clinical psychologists, counsellors, psychotherapists, educational psychologists, occupational therapists, psychiatrists and speech and language therapists.
  • Although responsible for the general health of their patients, GPs do not usually offer specialist advice or treatment.
  • They may provide information on your child to the LEA as part of a statutory assessment for a Statement of SEN.

Health visitor

  • Health visitors are specially-trained nurses responsible for the promotion of health and development in pre-school children.
  • They may raise concerns about development about your during routine developmental assessments.
  • If they deem that there are any concerns about your child’s development you may then be referred to other professionals.
  • They may provide information on your child to the LEA as part of a statutory assessment for a Statement of SEN.

Occupational therapist

  • Occupational therapists are concerned with the difficulties your child has in carrying out everyday activities, such as getting dressed, engaging in social interactions, completing school activities, and working or playing.
  • They can help with therapeutic techniques, identifying sensory sensitivities, adaptations to the environment, and specialist equipment e.g. they may introduce games to help aid social interaction, equipment such as fiddle toys and chews to help reduce anxiety or computer programmes to aid everyday activities.
  • They may work collaboratively to other members of the multi-disciplinary team e.g. Ed Psych, SLT, SLTA, SENCO,  who support your child
  • They may provide information on your child to the LEA as part of a statutory assessment for a Statement of SEN.

Outreach worker

  • An outreach worker can help your child access opportunities and activities outside their home.
  • They may find opportunities related to their interests such as sports or youth groups or it may be related to furthering their development such as a college course or support group.

Paediatrician
Paediatricians are experts in the health and development of children, particularly those with developmental disorders.

  • Paediatricians are often involved in the initial diagnosis of autism and offer follow-up support in some cases.
  • They may work with the multi-disciplinary team who support your child e.g. psychiatrists, psychologists etc.
  • They may be involved in the diagnosis other clinical conditions your child may have and prescribe and monitor medications and treatments for these.
  • They may refer your child to other health and welfare professionals such as psychologists, psychiatrists, social workers, occupational therapists, speech and language therapists, counsellors etc.
  • They may provide information on your child to the LEA as part of a statutory assessment for a Statement of SEN.

Psychiatrist

  • Psychiatrists can diagnose autism and may offer a follow-up service.
  • Psychiatrists may diagnose other behavioural issues or mental health difficulties, and are able to prescribe and monitor medication.
  • They may work with the multi-disciplinary team who support your child e.g. paediatricians, psychologists, occupational therapists etc.

• They may provide information on your child to the LEA as part of a statutory assessment for a Statement of SEN.

Social worker and care manager

  • Social workers and care managers are involved in assessing care needs of your child and your family.
  • They are also involved in arranging services to meet those needs, this may involve referrals to other professionals, agencies, brokers or staffing a support team for your child.
  • They may work with the multi-disciplinary team who support your child e.g. paediatricians, psychologists, occupational therapists, teachers etc.
  • Parental support- during assessment processes, statementing processes and review meetings.
  • Providing information on your child to the LEA as part of a statutory assessment for a Statement of SEN.

Fidgets or fiddle toy

  • Fiddle toys are a resource for helping your children when faced with new situations. The fiddle or fidget toy focuses your child’s mind on an activity. This stops anxiety or boredom taking over, they can also help develop fine motor skills. Examples of fidgets or fiddle toys are tentacle balls, bendy dolls, stress balls, wind up toys, fickle foam.

Tactile toys

  • Tactile toys allow a child who is tactile defensive to explore various other types of sensation, they can help children for whom tactile discrimination is an issue and the tactile toys allow the child to work with various other textures through play.

Therapists work with tactile-sensitive individuals to desensitize them to unavoidable textures and touch sensations. This is accomplished gradually over time using tactile products which provide proprioceptive feedback, gross motor control, and muscle movements

  • Using tactile toys can also help with fine motor skills and hand and eye co-ordination.

Sensory clothing and blankets

  • Deep pressure, weighted vests and blankets can be highly beneficial to some children with autism.
  • Based on the sensory integration technique, the added weight or pressure provides the special needs child with unconscious information from their muscles and joints.
  • Sensory clothing and blankets help autistic children to better integrate sensory information, calm, become more organized and improve their ability to concentrate, learn or eat.
  • The proprioceptive input helps children who are easily distracted, hyperactive and lacking in concentration.

Oral motor toys and chews

  • Oral, gustatory, and respiratory resources involving the mouth, to promote speech, language and communication skills.
  • Oral motor resources to promote blowing, chewing, biting and sucking skills.
  • Oral motor toys can increase awareness, making learning new facial expressions and mouth movement fun, and increase control of the muscles of the mouth and face for eating, drinking, saliva control and speaking.
  • Chews act as a pacifier for sensory overload and can help children focus.
  • Oral motor toys and chews include blowers, teething rings, bubbles, chewing necklaces, kazoos and whistles.

Eye candy and visual toys

  • Toys with a visually stimulating element to promote visual processing.
  • May include UV toys, toys with flashing lights, colour changing toys, reflective/mirrored toys, spinning toys, magnifying toys, projectors, liquid and gel toys like lava lamps and glitter wands and motion toys like egg timers.

Auditory toys and noisy toys

  • Toys with a auditory stimulating element to promote auditory processing .
  • This may include squeaky or scrunchy toys, shakers, click-clackers, musical toys and instruments and boom tubes.

Proprioceptive toys

  • Toys that promote proprioceptive feedback and processing.
  • This may include weighted toys, massagers and vibrating toys, ball pools, squeezers and body rollers, pods, body brushes, tunnels, hot water bottles and other heated toys.

Vestibular toys

  • Toys that promote vestibular feedback and help to develop balance skills.
  • These may include swings, hoists, rockers and bouncy chairs, spinners and roundabouts, trampolines and boxing bags.

Motor skill toys

  • All things movement, all things muscle-related are termed “motor”.
  • Toys that concern the manipulative “Fine” motor skills, like gripping and twisting, but also the core “Gross” motor skills used to reach out, balance and move us about.
  • Fine motor toys may include peg boards, fiddle toys, figits, screw toys, mazes, wind-up toys and rainmakers.
  • Gross motor toys may include spinners, rockers, activity centres, cushioned toys, seesaws, balancing beams, space hoppers, hula hoop, balls, scooters, tunnels and hobby horses.

Cognition toys

  • Toys that help the brain make associations, sequence, predictions and grasp cause and affect.
  • These may include, building blocks, sorting toys, puzzles and jigsaws, postboxes, mazes, matching and pair games.

The four key areas of difference 

  • These are the four areas of difference that professionals and frontline workers that need to be taken into account in the education of pupils with autism. They include social communication, social understanding, interests and information processing and sensory processing.

Social communication 

  • Children with autism may experience differences in understanding communication and language, jokes, sarcasm, tone of voice, facial expression and gestures.

Social understanding

  • Children with autism may experience differences in understanding social behaviour, showing empathy, how to start an informal conversation and forming relationships.

Interests and information processing 

  • Children with autism may experience differences in perception, planning, understanding concepts, generalising and predicting, transitions and passions for interests. This may result in children developing fixations, habits and strict routines, distress at unfamiliar surroundings and routines and struggling with figures of speech and metaphorical language.

Sensory processing

  • Children with autism may experience differences in perceiving sensory information. They may experience hypo (low sensitivity) or hyper (high sensitivity) responses to touch, sight, hearing, smell, taste, vestibular inner ear (balance) and proprioception (body awareness).

Proprioception

  • The body awareness and feedback sense, all about reaction. As you move Proprioception tells your brain how things are progressing and your brain responds with subtly different movement orders e.g. how tightly to hold a pencil, what grip to use when opening a jar.

Vestibular 

  • The sense associated with balance in the inner ear. It helps us to keep our balance and posture.

Olfactory 

  • Sense associated with smell and odour.

Tactile

  • The sense associated with touch, pressure and pain threshold.

Auditory

  • The hearing sense and processing sound.

Sensory levels

Hypersensitivity 

  • Autistic children may display oversensitivity to some of the seven senses.
  • This may mean that they show negative responses in environments.
  • This may mean they show unsafe behaviours e.g. they may not listen by a road because they are visually stimulated by traffic lights etc.
  • They may frequently want different types of sensations.
  • Or they may avoid environments where they may experience particular hypersensitivities.

Hyposensitivity 

  • Autistic children may display under sensitivity to some of the seven senses.
  • This means they may lack or have a low response to sensations.
  • This again may mean they may show negative responses in environments.
  • This may mean that they actively seek out the sensory experiences that they lack.
  • This may mean they show unsafe behaviours e.g. their hearing may be hyposensitive so they may not hear a car on a busy road.

Sensory Assessment 

  • Children with autism may experience difficulty in regulating their sensory levels. These levels can fluctuate between hypersensitive and hyposensitive. This can lead to negative responses to their environment. Sensory assessments help to monitor these fluctuations and can help identify high arousal and low arousal situations and environments and therefore can help practitioners and frontline workers plan and take action on the negative behaviour. This may also work in conjunction with a STAR assessment (Setting, Trigger, Actions and Result).
  • Here is an example of a chart of behaviours associated with sensory processing from a table provided by STARS (Specialist Teachers Autism Response Team) in Leeds;

High/Low Arousal States

  • A state of high arousal, neurons have a much lower threshold for activation. This means it takes less incoming information for our neurons to respond. When a child is in high arousal the littlest bit of sensory stimulation can send a child giddy or emotionally overwhelmed e.g. a breezy day, a phone ringing, alight being turned on. In this high arousal state children react quickly, to less stimulation and it takes us longer to recover. When children are in this state you are more likely to be distracted by details that they could otherwise tune out and they are less able to learn new information than when they are in a more relaxed state.
  • In a state of low arousal, neurons have a much higher threshold for activation. This means it takes a lot more incoming information for neurons to respond. For example you may call the child’s name a few times and they may be unresponsive. In this low arousal state the child reacts more slowly, they need more stimulation to react and tend to recover more quickly. When the child is in this state they are more likely to miss details and less able to learn new information than when they are in a more alert state.

STAR (Setting, Trigger, Actions and Result) Assessment 

  • Assessment used to analyse autistic children’s negative responses. It has four areas that are assessed the Setting, Trigger, Actions and Result.
  • Setting- this may environmental or personal, it may include the physical environment (is it busy, noisy, hot, too bright?), the social interactions and relationships within the environment (Was the child’s usual support worker away, were they put with someone unfamiliar, were their visitors, do they struggle to socialise with their peers?), the activities that the child is doing (Were they enjoying the activity and asked to stop, was it making them anxious, were they struggling with the activity and getting frustrated, were they over stimulated by the activity?) , his/her physical well-being (Were they hungry, tired, thirsty, hot etc?), his/her thoughts and mood (Were they in a state of high/low arousal?), his/her physical state (Were they anxious, in fear of something?)
  • Trigger- These are the things that may ‘set off’ a particular behaviour and usually occurs shortly before the behaviour of concern. Had the child been asked to do something? Were they requesting something from you, something they wanted? Had the activity just finished/started? Was something happening that the child dislikes or fears? Was it something the child associates with a particular event?
  • Actions- What behaviours did the child display? Were they physically/verbally violent? Did they become unresponsive? Did they become distressed? Did they run/shut themselves away etc.
  • Result- What events that follow the action? The results will influence the likelihood of the action happening again. If the results are rewarding for the child, they increase the chances of the behaviour happening again. Did the child’s behaviour result in them getting something they didn’t have before (object, food)? Were there sensory results? Did the child gain sensory pleasure or avoid sensory overload? Were there social results? Did the child gain attention or comfort OR succeed in avoiding unwanted social contact? Were there occupational results? Did the child get to do a desired activity OR escape an unwanted activity?

CAF (Common Assessment Framework) 

The CAF can be used by practitioners across children’s services in England to:

  • assess a child’s needs at an earlier stage
  • develop a shared understanding of a child’s needs
  • work with families, other practitioners and agencies to meet these needs more effectively
  • It is an early intervention tool and that helps to avoid children and families having to tell and re-tell their stories.
  • You could undertake a common assessment when, you believe a child will not progress towards the five Every Child Matters outcomes without additional services, the child or their parent has raised a concern with you, the child’s needs are unclear or broader than your service can address, a common assessment would help you to identify the needs and /or get other services to help meet them.
  • You may not undertake a common assessment when, the child is progressing well, the child’s needs are already being met, the child’s needs are obvious, you have assessed them using your agency’s assessment tool and your service can meet the full range of those needs, the child/parents do not consent to the common assessment and you are worried that a child may have been harmed or may be at risk of harm.

Cognitive Behavourial Therapy (CBT) 

  • Therapy to break down your problems into their separate parts – such as your thoughts, physical feelings and actions.
  • CBT aims to help you crack this cycle by breaking down overwhelming problems into smaller parts and showing you how to change these negative patterns to improve the way you feel.

Self-regulation 

The process in which one controls and stabilises their own emotions and behaviour. Autistic children often struggle with this. They struggle to understand their own emotions and behaviour and the effect this has on other people.

Intensive interaction 

  • Intensive interaction is an approach to teaching the pre-speech fundamentals of communication to children and adults who have severe learning difficulties and/or autism and who are still at an early stage of communication development. It is based on the principles of the first interactions of a baby and their mother.
  • enjoying being with another person
  • developing the ability to attend to that person
  • concentration and attention span
  • learning to do sequences of activity with the other person
  • taking turns in exchanges of behaviour
  • sharing personal space
  • using and understanding eye contacts
  • using and understanding facial expressions
  • using and understanding physical contacts
  • using and understanding non-verbal communication
  • using vocalisations with meaning (for some, speech development)
  • learning to regulate and control arousal levels

IEP (Individual Education Plan) 

  • An IEP or Individual Education Plan is a plan or programme designed for children with SEN to help them to get the most out of their education.
  • An IEP builds on the curriculum that a child with learning difficulties or disabilities is following and sets out the strategies being used to meet that child’s specific needs.
  • An IEP is a teaching and learning plan and should set out targets and actions for the child that are different from or additional to those that are in place for the rest of the class.

Zones of Regulation 

  • A cognitive behaviour approach to self- regulation. It takes the form of a sort of traffic light system to identify the way a child is feeling and their state of alertness.
  • The Red Zone is used to describe extremely heightened states of alertness and intense emotions.  A person may be elated or experiencing anger, rage, explosive behaviour, devastation, or terror when in the Red Zone. A person is described as “out of control” if in the Red Zone.
  • The Yellow Zone is also used to describe a heightened state of alertness and elevated emotions; however, one has some control when they are in the Yellow Zone.  A person may be experiencing stress, frustration, anxiety, excitement, silliness or nervousness when in the Yellow Zone.
  • The Green Zone is used to describe a calm state of alertness. A person may be described as happy, focused, content, or ready to learn when in the Green Zone.  This is the zone where optimal learning occurs.
  • The Blue Zone is used to describe low states of alertness, such as when one feels sad, tired, sick, or bored.

P.A.P.A (Presence, Acceptance, Participation, Achievement)

  • P.A.P.A is an Education Psychology model for integration it stands for Presence, Acceptance, Participation and Achievement.
  • Presence- the child has to be present amongst their peers.
  • Acceptance- the class teacher must plan to include the child, the targets and actions included in the child’s IEP.
  • Participation- the child’s targets and actions from their IEP must be connected with their peers learning, there must be some activities and interactions that are accessible to the child in their learning environment.
  • Achievements- when the child meets the targets in the IEP, their achievements must be recorded, recognised and celebrated.

PECS (Picture Exchange Communication) 

  • A system of symbols in which a child with communication difficulties can communicate their wants and needs with others.
  • The goal of PECS is for spontaneous and functional communication.
  • PECS begins with teaching a student to exchange a picture of a desired item with a teacher/communicative partner, who immediately honours the request.
  • After the student learns to spontaneously request for a desired item, the system goes on to teach discrimination among symbols and then how to construct a simple sentence. In the most advanced phases, individuals are taught to respond to questions and to comment.

Now and then board 

  • A board with two spaces for PECS symbols one for Now and Then.
  • allows the learner to see what they are doing now and what they will be transitioning to next
  • relieves anxiety over the unknown by making the next activity predictable
  • visually portrays an end to the current activity or the beginning of something preferred
  • accommodates photographs as well as icons
  • this is the first step in training for the visual timetable.

Visual timetable 

  • Visual timetable is a visual aid for young people with autism to see what they are doing for the rest of the day and helps with transitioning.
  • It uses PECS symbols of activities.
  • It relieves anxiety of the unknown by making the next activity predictable.
  • Visually portrays an end to the current activity or the beginning of something preferred
  • accommodates photographs as well as symbols.

1.Attend an early bird/cygnet/ASCEND course

2. Join an autism support group

3. Focus on social skills training

4. Use the 6 second rule. Children with autism take longer to process information.

5. Note that tasks may need to be broken down into smaller units.

6. Remain calm & consistent.

7. Take time out for both of you.

8. Ask to be put on the carers register at your GP’s

9. You may be allowed disability living allowance or carers allowance. Your local citizen advice bureau may be able to help with this

If things go wrong:

1. Remember that an autistic child in meltdown is in severe distress

2. Ensure the child feels safe

3. Do not worry what anyone else thinks

4. Be calm & count to 10.