Departments

Life Construction Ahead

Getting Ready for the First Day they DON’T Go to School! Teaching the “Hidden Curriculum” of Post-Secondary Life

By Teresa Bolick, Ph.D., BCBA-D

Synopsis:

Clinical psychologist and adolescent specialist, Dr. Teresa Bolick, tackles transition planning by outlining the specific skills to teach, and discussing practical ways to prepare for the years AFTER high school.

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You too?! Common Stories from an Uncommon Parent

The Search for Solitude

By Alyson Beytien, BCBA, M.S./Autism

Synopsis:

Alyson Beytien discusses the elusive search for solitude in a household with three “ever-present” individuals with ASD.

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Quirks and Perks – Perspectives on ASD: Just One of Those Days

I’d Pick You!

By Donna Aumann Cooper, M.O.M.

Synopsis:

Donna Aumann Cooper, M.O.M., discusses the ups and downs of “life on the spectrum.” Readers will love the decided tilt to the UP side of the story!

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Tips for Preparing Your Child for a New School Year

By Jennifer Twachtman-Bassett, M.S., CCC-SLP

Synopsis:

Tips for how to prepare children for the academic year ahead. To read this entire column  Subscribe »

 

Click here to read the referenced column from ASQ Spring 2009.

Review

SUPERHEROES Social Skills

By Jennifer Twachtman-Bassett, M.S., CCC-SLP

Synopsis:

Jennifer Twachtman-Bassett reviews a brand new comprehensive multimedia social skills program that is research-based and ideally suited to the needs of students with ASD.

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Feedback from our facebook friends

Synopsis:

Our facebook friends weigh in on when to begin the transition process; the types of social skills programs they would like schools to address; and they share their children’s experiences regarding school recess. To read this entire column Subscribe »

 

Straight Talk About Autism

The Use and Misuse of Evidence-Based Practice: Implications for Persons with ASD

By Barry M. Prizant, Ph.D., CCC-SLP

Synopsis:

Dr. Barry Prizant does a tremendous service for parents and service providers in this comprehensive article by detailing what we need to know about evidence-based practice in order to do right by individuals with ASD.

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Great Resources for Families and Professionals

Synopsis:

Outstanding books and resources for parents and professionals. To view resources Subscribe »

The World According to Teddy Bears

Late for School

By Brendan Keeley

Synopsis:

An original cartoon designed especially for ASQ by Brendan Keeley, a UK cartoonist and illustrator with Asperger syndrome. To view this cartoon Subscribe »

Celebrations of Excellence and Originality

An interview with Meagan Breaux

By Liane Holliday Willey, Ed.D.

Synopsis:

Dr. Liane Holliday Willey interviews a Mississippi State University alum with a keen interest in psychology and a desire to help disadvantaged ASD populations to find support. To read the entire interview  Subscribe »

The Cutting Edge

The Need for Subspecialty Consultation in Some Children with Autism Spectrum Disorders

Synopsis:

Maria Santaella, M.D., brings her training in Internal Medicine and Allergy and Clinical Immunology to bear on her comprehensive discussion of allergies / food sensitivities and gastrointestinal symptoms, and she also connects the dots on these important issues.

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Research Newsdesk

Synopsis:

In this issue we report on the growing question of whether the balance is tipping toward environmental influences (versus genes) in autism, and a new study that may shed light on apparent self-awareness deficits in humans. To read this entire column Subscribe »

Call For Research Subjects

Synopsis:

ASQ welcomes researchers to post information concerning their requirements for participation in their research studies. Recruitment announcements are accepted on a first-come, first-served basis and are posted, at no charge, as a service to the research community. To read this entire column Subscribe »

Article Sample

Crisis and the Individual with Autism

Authors: Scott Newgass, M.S.W., L.C.S.W., and Robin Gurwitch, Ph.D.

No one is immune to crisis. While there are differences in the way typical individuals handle crises, generally most of us have coping strategies that help us to get through times of severe stress. In contrast, individuals with autism have vulnerabilities that make it difficult for them to handle crisis situations. They do not do well with change and unpredictability. Since a crisis represents a “mega watt” change in the status quo, the individual with autism will likely react negatively to it. Their difficulty with language and the expression of complex feelings also puts them at a disadvantage when it comes to dealing with the aftermath of a crisis. Hence, without thoughtful and careful guidance during such times, people with autism may have difficulty coping with trauma and could become caught in a pattern of negative behaviors and feelings.

Consider what happens in a crisis. Typically, one is affected on many different levels, as traumatic events impact how we think, feel, and act. Furthermore, physiological reactions, over which we have limited control, influence how our bodies respond—for example, the so-called “fight or flight” response. While the manner of response “in the heat of the moment” may be similar for most people, the reaction of those with autism may differ considerably in intensity. Thus, it may be helpful to consider their response as an exaggeration of the norm.

Typical and Atypical Responses to Crisis

The most important differences between typical individuals and those with autism generally occur after the crisis has passed. In the aftermath of a traumatic event it is common for thoughts about the ordeal to intrude unexpectedly, causing distress. Where typical children have the ability to ask questions about the event and externalize their thoughts to relieve their anxiety, often these channels are closed to those with autism. For example, they may worry about their safety and security and that of their loved ones, but be unable to express those fears. Hence, while they may perseverate on the events, they do not have the language skills or coping mechanisms to dissipate the anxiety that comes from re-living the experience over and over in their minds.

In addition, children with autism who have been exposed to a traumatic event may experience regression in the following ways:

  • New skills that they have mastered may seem to disappear.
  • They may become more withdrawn, thus undermining previous gains in social skills development.
  • They may have difficulty sleeping.
  • There may be changes in appetite.
  • Repetitive behaviors, such as hand and finger posturing, may increase.
  • There may be an increase in inappropriate behavior, such as aggression.

When the crisis involves a death, reactions may be even more intense, since the individual must not only adjust to the event itself, but also to the lasting changes that flow from the event. When grief is present, the person with autism may express his or her loss in unusual ways. For example, where the typical child exposed to a crisis may cry inconsolably, the child with autism may engage in repetitive behaviors or unusual rituals. When this occurs, it may be interpreted as an inappropriate behavior rather than the child’s response to grief. It is important to note that atypical responses to crises occur quite frequently in individuals with autism, and when they do, misinterpretation of their behavior may follow. It is also important for adults to be mindful of this so that they can, (a) refrain from reacting simply to the external behavioral itself; (b) view the behavior as the child’s response to the crisis; and (c) provide the support the child needs. Suggestions for parents to assist them in helping their child to cope with crisis will be given elsewhere in this article.

The Role of the School

It is important to underscore that the school’s ability to deal effectively with a crisis will depend upon the quality of the supports they put in place prior to the crisis event. Today, most schools have systematic crisis plans to address what to do when a traumatic event occurs; however, some plans contain only minimal information. Table 1 outlines some of the major areas to target in constructing a comprehensive crisis plan that also takes into account children with special needs.

Table 1 Important Areas to Consider in Crisis Plan Development

  • Consider how the structure and setting are likely to change (e.g., moving classrooms, changing schedules, etc.), and determine how these disruptions may be minimized / handled for children with special needs.
  • Ensure that the unique needs of students with atypicalities are anticipated in decisions concerning procedures.
  • Provide professional staff development regarding the social-emotional supports needed for all students, with specific attention to those with special needs.
  • Anticipate the use of contingencies / supports (and how they may need to be modified for those with special needs) to accommodate the students’ responses to change, noise, and unfamiliar people and events.
  • Conduct regular crisis drills that incorporate special strategies for students with special needs, and build in time for staff to process these experiences with their students.
  • Coordinate with community services to ensure that adequate supports are provided both during, and in the aftermath of a crisis.
  • Consider the use and possible role of mental health responders to work alongside school personnel during and after a crisis.
  • Have a plan in place by which to give parents of children with special needs specific information regarding their child’s reaction to the crisis and his or her response to supports.
  • Prior to any crisis, meet with parents of children with special needs to obtain their input; plan for specific contingencies that may be needed; and discuss the impact that any potential actions and/or restrictions may have on their children.

Good plans also include how to talk to students about what is happening; how to identify and meet students’ individual needs; and how to augment services in the classroom. Great plans, however, don’t just obliquely mention the unique needs of students with special healthcare, developmental, or emotional needs, but also directly outline what needs to be done. Table 2 lists additional steps specifically tailored to the needs of children with autism that can help them to cope with traumatic events. These special considerations are intended to complement the more generic recommendations listed in Table 1.

Table 2 Special Considerations for Students with Autism

  • Establish a plan to ensure that children with autism receive focused and individualized assistance in understanding what is taking place during the crisis event. For example, provide appropriate support and explanation when class activities are restricted during a “lockdown” exercise.
  • Consider assigning an aide or peer buddy to remain with the child during the event to provide emotional support.
  • Modify crisis drills so that they accommodate the needs of students with autism.
  • Modify the way in which information is presented so that it is conveyed in a manner that students with autism can comprehend.
  • Provide the specific supports needed to help the child with autism process the traumatic event after it is over.
  • Re-establish routines and increase the use of visual supports as soon as possible after a crisis to provide stability and predictability.
  • Report any and all unusual behaviors to parents, and collaborate with them to develop a plan for addressing them.

The Role of the Family

Parents, as the most important people in the child’s life, can do a great deal not only to aid the school in helping the child to cope with crisis, but also provide their own in-home supports to help the child deal with the aftermath of traumatic events. Table 3 contains important steps for parents to take to ensure that the school is adequately prepared to provide support to their child with autism. Since not all schools have crisis plans in place—and those that do may not include information specific to students with special needs—Table 3 includes things that parents can do to ensure that all “bases” are covered.

Table 3 Steps Parents Can Take to Prepare for and Deal with Crisis

  • Ask your school administrator if there are procedures in place to address and process crises with students, and if so, whether the needs of students with autism have been taken into account.
  • If the needs of students with autism have not been included in the school’s crisis plan, provide information such as that included in Tables 1 and 2.
  • Meet with school personnel to discuss information specific to your child that the school needs to know in order to help him or her to cope with a crisis situation.
  • Dissuade the school from any plans to isolate your child from his or her peers (or from the classroom) after a crisis event, unless there are safety concerns for your child or others; however, this is not intended to preclude individual meetings with the student or temporary separation under conditions of extreme stress.
  • Determine how follow-up will consider the unique needs for recovery of students with autism, and provide input to assist in this process.
  • Do not plan to keep your child home from school unless his or her safety or the safety of others is a consideration, since interaction with peers and being a part of the classroom experience can help the child cope with the aftermath of a crisis.
  • After your child returns home, ask about the day and try to help him or her process the experience. If anxiety is high, encourage your child to engage in a soothing activity for a time-limited period, and let him or her know that talk can come later.<
  • Report any unusual or exaggerated behaviors, and keep the school informed with respect to how your child is progressing following a crisis.
  • Develop a family crisis plan that includes information regarding how your children will be able to contact you or another caregiver in the event of an emergency; specifies alternate locations for the family to meet should your home become compromised; and lists any special dietary or medical/medication needs. Include any other information unique to your child or family situation.

It is important for parents to remember that they need not be alone in helping their child to deal with a crisis. School personnel share many of the same concerns regarding the child’s reaction to a crisis, and as such they can often be tremendously supportive at such times. Hence, children are well-served when parents and schools collaborate on issues related to crisis.

Final Thoughts

Both the family and the school are essential “players” in providing support and building a foundation for recovery for youngsters with autism following a crisis. Taking steps to maintain familiarity and increase predictability will go a long way toward re-establishing a secure environment in the aftermath of the disorganization that accompanies a crisis. Likewise, allowing the child to express his or her anxiety and engage in calming strategies such as rocking can also help him or her cope with the traumatic event. However, it will also be important to help classmates to understand that we all seek ways to sooth ourselves during times of stress, and that this is one strategy that works for some, but not all. While both of these systems—the family and the school community—provide unique contributions, it is important that there be collaboration between the parties, as well. This will help to ensure consistency of response to the child’s behaviors and expressions (possibly idiosyncratic) of feeling. It will also provide a vehicle for the exchange of information with respect to progress or regression, and enable coordination regarding reinforcement for the child’s efforts to cope with intense feelings.

Crises seem to happen when we least expect them. Clearly, there is never a good time or a good crisis! That said, being prepared is the first step toward helping the child with autism—or any child for that matter—to weather the impending storm. Families of children with autism are well-versed in meeting challenges on a regular basis, as well as in working with multiple systems that serve children with special needs. Building upon these strengths, families can not only take steps to increase their children’s resilience to stress and support them during and after a crisis, they can also work with school personnel to assist them in helping their children cope with crises when they occur. 

Feature Articles

Technology Transforms the Autism Classroom of the Future

By Lauren Stafford

Lauren Stafford, M.Ed. shares “nuts and bolts” information on the ways in which technology is transforming the autism classroom of the future at the Monarch Center for Autism in Shaker Heights, Ohio.

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Co-Regulation: Creating Opportunities within Natural Environments and Routines

By Linda K. Murphy, M.S., CCC-SLP

Linda Murphy, M.S., CCC-SLP brings her speech-language pathology background and RDI® training to bear on how to get in sync with the child with autism across the school and home settings.

 

 Click here to read the referenced column from ASQ Summer 2011.

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To Work or College and Beyond

By Mary Ann Devine, Ph.D.

From money management and leisure skill development to exploring the social aspects of careers, this article leaves no stone unturned!

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Why is Recess so Hard for Students with Autism?

By Deborah Leutkenhoelter, M.A., CCC-SLP

You’ll find 10 great ideas for reducing “recess anxiety” and preparing the child with ASD to join in the games!

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Addressing the Physical Fitness Needs of Adolescents with Autism Spectrum Disorders

By Dana Battaglia, M.Phil, CCC-SLP, Mary McDonald, Ph.D., BCBA, Melissa Keane, M.Ed.

Great information and everything you need to replicate a community-based fitness program in your own locale

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Self, Family, and Beyond—Topics Relevant to the Autism Community— Beyond Medication: A Psychiatrist’s Journey with Families Affected by ASDs

By Todd Levine, M.D., F.A.A.P.

Readers will find Dr. Levine’s inaugural article for his brand new regularly-occurring ASQ column both insightful and uplifting!

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