Autism Spectrum Disorder

EDUCATION SESSION FOR PARENTS

Autism: A Triad of Impairments

An impairment of social interaction Difficulty interacting with peers including sharing, turn taking and attending to tasks An impairment of social communication Difficulty conveying or receiving messages, understanding verbal and non verbal means of communication An impairment of social imagination Difficulty engaging with imaginative play, repetitive play, restricted interests, repetitive and bizarre behaviours

Graham, C. (2013)

Triad of Impairments: Autism

Social Relationships
ASD

Social Communication

Rigidity of Thought, Behaviour and Play ( Social Understanding )

The Impact of the Triad of Impairments Social Interaction

Can be socially isolated Social demands of others causes anxiety May find social cues difficult to read May behave in socially inappropriate ways

May lack the strategies to establish and maintain friendships

May cause offence without being aware Can appear egocentric or insensitive Does not know how to react to others feelings

Graham, C. (2013)

Communication

May have spoken language that is formal and pedantic Voice may lack expression Can not understand implications of different tones of voice May have difficulty using and understanding non-verbal communication Often takes things literally Inability to understand implied meaning

Graham, C. (2013)

Theory of Mind

Difficulty explaining ones behaviours and understanding emotions Inability to understand and identify the thoughts, feelings and intentions of others May not realise if another persons behaviours are intentional or unintentional Problems understanding the perspectives of others Lack of understanding of how others think and/or feel Problems with joint attention and behaviour and other social conventions Problems differentiating fiction from fact

http://www.autismspeaks.org/docs/family_services_docs/AS-HFA_Tool_Kit.pdf

Executive Functioning

Poor Impulse control and self-regulation Pay attention to minor details, but fail to see how these details fit into a bigger picture Difficulty maintaining their attention

Reduced ability to make a plan and work through the logical steps to achieve the goal
Impulse control is very difficult Can mean that self-organisation in order to settle down to work is a huge hurdle

Rigidity of Thought

Unusual and absorbing special interests Insistence on certain rules and routines Limited ability to play and think creatively Problems transferring skills from one setting to another

Graham, C. (2013)

Strategies to help Rigidity/Flexibility of Thought

Ensure consistency Use prompt cards with pictures Plan for change using visual timetables Give structure to the day using timetables Have clear start and end to activities Use special interest as a reward

Graham, C. (2013)

Getting Organised
Organise the information and records that you collect for your child. Organisation is an important part of managing his or her care and progress. Many parents find that binders are a great tool for keeping paper work manageable. Items worth filing include

Contacts Doctors, Service providers, caregivers, relatives Schedules Therapy times, program start and end dates, deadlines Diagnosis Medical documents and any prescriptions Therapy Speech, Occupation Therapy, e.t.c and reports Individualised Education Plan IEP related documents

Strategies to Improve Sleep

Many children with ASD have difficulty with sleep. This can be stressful for children and their families. Sleep problems such as trouble falling asleep, saying asleep, or early morning waking are common. It is important to address your childs sleep habits. This can mean changes to your childs sleep setting as well as how you talk with your child at bedtime and during the night waking. Typically developing school-aged children require 10-11 hours of sleep. However, many children with ASD appear to need less.
http://www.autismspeaks.org/docs/sciencedocs/atn/sleep-tool-kit.pdf

To help your child get a better nights sleep and improve their sleep/wake schedule.
Provide a comfortable sleep setting Establish a regular bedtime routine Tips to keep a regular schedule

Teach your child to fall asleep alone

Promote daytime behaviours

Providing a Comfortable Sleep Setting

Your child should have a place to sleep that is his/her own and the same each night. The bed room should be comfortable (not too hot or cold), quiet, and dark. You can add a night light if the room is too dark and if there is light coming into the room from streetlights or early morning sun, consider adding heavier curtains. Keep the room quiet at night. It is best to avoid radio, television or music when your child is going to sleep. Noises like these stop during the night and can wake your child. Some children find low, quiet back ground noise like a fan soothing. Consider the environment. Children with ASD are more aware of noises such as water running or other household noises and can affect their sleep. Texture of bedding and pyjamas may cause sensitivity problems to your child. Does your child prefer tight or loose fitting pyjamas, or light or heavy covers?

http://www.autismspeaks.org/docs/sciencedocs/atn/sleep-tool-kit.pdf

Establish Regular Bedtime Habits

Bedtime habits should be short, predictable and expected Routine will help teach your child how to relax before sleep Include activities that soothe your child Avoid activities such as television programs, movies, electronic games, computers, loud music, bright lights, running, jumping or rough housing Start the routine 15 to 30 minutes before the set bedtime. (Younger children require shorter routines, routines should never go for more than 60 minutes).

http://www.autismspeaks.org/docs/sciencedocs/atn/sleep-tool-kit.pdf

Tips to a Better Bedtime Routine

The bedtime routine should take place in the bedroom where it is quiet (other than bathing/teeth brushing/toilet). Your child be calmed when the routine is done in the same order each night. A visual schedule my help (e.g. pictures, words, or both) to remind them of each step. This helps the child to know it will be the same each night which will provide consistency and stability for your child. Determine which events are calming and which are stimulating for your child. Only calming events should be part of the bedtime habit. More stimulating activities should be moved to earlier in the evening. (e.g. If tooth brushing is stressful for your child you could do that straight after dinner).

http://www.autismspeaks.org/docs/sciencedocs/atn/sleep-tool-kit.pdf

A Bedtime Visual Schedule

Put on pyjamas

Use toilet

Wash hands

Brush teeth

Drink water

Read story

Go to bed

Sleep

Keep a Regular Schedule

Choose a Bedtime.and Keep It. Your child should have an age appropriate bed time and wake time that is the same 7 days per week. If it has to be moved due to an event keep track of how this impacts your childs sleep. Time It Right. Many children get a second wind the hour before bedtime, and may have trouble falling asleep if the bedtime is too early. If your child takes more than an hour to fall asleep, think about putting bedtime off by 30 minutes to an hour. As they Get Older. Bedtime will get later as your child grows always allow enough sleep each day. Early to Rise. Even if your child goes to sleep late at times, keep the wake time the same. It may seem better to allow your child to sleep in however the more regular the wake time, the better sleep will be. Food Counts. Your child should eat breakfast each morning at the same time, weekdays and weekends. No heavy meals or large snacks at night. However, a light snack with carbohydrates may help your child fall asleep. Good Morning Sunshine, Good Night Moon. Exposure to sunlight in the morning and darkness at night help keep regular schedule. Open the curtains and let natural sunlight in the home in the morning and turn lights off and down low at night.

http://www.autismspeaks.org/docs/sciencedocs/atn/sleep-tool-kit.pdf

Teach Your Child to Fall Asleep Alone

Why Should Children Learn to Fall Asleep Alone?
We all wake during the night, check out our sleep environment and fall back to sleep several times each night. When a child cannot fall asleep alone, each time he or she wakes it is harder for them to fall back to sleep. When a child learns to fall asleep alone they also find it easier to fall back to sleep at times of natural night wakening , and wake more rested in the morning.

How Do I Teach Them?

Gradually over a few weeks if you lie down with them, change your pattern by sitting on the bed for a few nights, then sitting in a chair and slowly moving the chair closer to the door, finally out of view. Reduce the amount of attention you pay your child as you do this such as talking, eye contact, facial expressions.

If you need to go back into the room wait a little longer each time and keep it brief (less than a minute), give limited physical or verbal contact (e.g. a quick hug) Gently but firmly say, It is time for bed. You are O.K. Good night, and leave the room.

http://www.autismspeaks.org/docs/sciencedocs/atn/sleep-tool-kit.pdf

Encourage Behaviours That Promote Sleep

Physical Activity Exercise during the day helps your child sleep better at night. Children and adults who exercise find it easier to fall asleep at night and have deeper sleep. Aside from going to school, try to schedule exercise at home. Make time for exercise as early in the day as possible, as stimulating exercise close to bedtime may make it harder to fall asleep. Be sure all hard or tiring activity ends two hours prior to bedtime. Investigate Recreation Activities for your child- Add a recreational activity, such as gymnastics or swimming to broaden your childs development.