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What is Autism Spectrum Disorder?

Autism Spectrum Disorder (ASD) is a life-long developmental disorder that affects a child’s development in three main areas: social, communication and behaviour/play.

Diagnosis

  • Who can make the diagnosis?
    Diagnosis can be made by a medical doctor, psychologist or psychiatrist, preferably with expertise in ASD.
    A team assessment including a speech and language pathologist, occupational therapist and social worker is preferred but not necessary.
  • How is the diagnosis made?
    Diagnosis is made based on behavioural observation compared to a list of specific characteristics. The specific diagnosis depends on the number and intensity of these characteristics that the child has.
    There is no blood test, medical test, scan or x-ray that can diagnosis autism spectrum disorder.
  • What causes ASD?
    The exact cause is still not known but most experts believe it is caused by multiple, interacting genes leading to a genetic susceptibility triggered by an unknown environmental event.
  • Is there a cure for ASD?
    There is no cure for ASD. However, early intervention that addresses communication and social skills training means that many individuals with ASD can learn the skills necessary to lead full and productive lives.

Characteristics

  • The word spectrum means that any child’s problems may vary from mild to severe.
  • A child with ASD may be late in or may never acquire speech. However, they can learn to communicate.
  • A child with ASD may “echo” or repeat words or phrases. This may be an attempt to communicate.
  • Children with ASD often demonstrate a need for sameness and can be resistant to changes in routine.
  • Children with ASD often experience sensory processing difficulties. They may be over-reactive (hyper-sensitive) or under-reactive (hypo-sensitive) to sights, sounds, smell, touch, taste, movement or gravity.

Source:
Geneva Centre for Autism
112 Merton Street, Toronto, Ontario, M4S 2Z8
Tel: (416) 322-7877 – Toll Free: 1-866-Geneva-9 – Fax: (416) 322-5894
www.autism.net

Visual Schedule Tip Sheet

Many children with ASD are visual learners. This means they understand and remember information better when the see and hear it rather than just hearing it.

Visual Schedules

  • What is a visual schedule: A visual schedule shows what activity is currently happening and what activity will happen next. A schedule might show two events or it might show several. It is based on what the child can understand.
  • Why do visual schedules help: Visual schedules provide information that does not “go away” like words do. This allows the child a longer time to process and understand the information. Visual schedules highlight the important information and provide predictability and structure.
  • Where do I start: You need to teach the child to use the visual schedule starting with two symbols and showing the child that the symbol is related to the activity. Gradually increase the number of symbols. Once the child knows how the use the visual schedule, they may be able to use it independently without adult help.
  • Where should I keep it: Post the visual schedule in an area where all the children can see it and many children in the class will use it. The child with ASD may need to have the schedule brought to them or have a smaller version to keep with them.

Tips for Using a Visual Schedule

  • Visual schedules use a symbol to represent an event. The following symbols are listed in order from easiest (most concrete) to most difficult (most abstract).
    • Real objects
    • Miniature objects
    • Colour photographs
    • Black and white photographs
    • Colour picture drawings
    • Black and white drawings
    • Written words
  • Start with the most abstract symbol the child can understand (each child will be different). Once the child understands the schedule pair that symbol with the next, more difficult symbol and fade the easier symbol. Continue this as long as the child can understand the schedule.
  • Make the symbols on the visual symbol movable. This allows the child to remove the symbol when the activity is completed. It also allows the adult to show the child when a change in schedule has occurred by changing the symbols.

Source:
Geneva Centre for Autism
112 Merton Street, Toronto, Ontario, M4S 2Z8
Tel: (416) 322-7877 – Toll Free: 1-866-Geneva-9 – Fax: (416) 322-5894
www.autism.net

Vestibular Stimulation Tip Sheet

Vestibular stimulation is the input that your body receives when you experience movement or gravity. It can be mild; nodding your head or climbing stairs or it can be intense; skydiving or a rollercoaster

Characteristics of Vestibular Dysfunction

  • Vestibular input has an impact on arousal. Too much vestibular input may lead to overarousal and too little vestibular input may lead to underarousal.
  • Hypersensitive: The child who is hypersensitive to vestibular input is more responsive to sensory input and will avoid movement. The child might:
    • be fearful of moving equipment
    • be fearful of simple challenges to balance
    • may appear lethargic
    • may appear to have low muscle tone
    • may avoid active play
  • Hyposensitive: The child who is hyposensitive to vestibular input is less responsive to sensory input and will seek movement. The child might:
    • appear to need to move
    • enjoy busy, energetic activities
    • appear to be in constant motion
    • enjoy movement
    • spin, whirl, or bounce frequently

Tips for Providing Vestibular Input

  • Slow, rhythmical, predictable movement is calming. For example, swinging, rocking, walking, or slow, gentle spinning in one direction.
  • Quick, arrhythmical, unpredictable movement is arousing. For example, jumping, bouncing, running, playground activities like the teeter totter, slide or climber, sports and games like hopscotch, soccer, hockey or tag.
  • Supervise and monitor activities as “overload” of the nervous system can occur. Signs of overload include irregular breathing, colour change, sweating, pallor, increased anxiety, change in sleep patterns, etc.
  • An activity should be stopped immediately if the child shows any signs of distress and/or discomfort.
  • Consultation with an Occupational Therapist is recommended.

Source:
Geneva Centre for Autism
112 Merton Street, Toronto, Ontario, M4S 2Z8
Tel: (416) 322-7877 – Toll Free: 1-866-Geneva-9 – Fax: (416) 322-5894
www.autism.net

Understanding Early Childhood Placement Options

There are a multitude of child-care program choices for parents to select from and sometimes understanding the differences can be overwhelming. Depending on your daily schedule you may be able to attend more than one community program. Families should select settings with assistance from professionals according to the specific needs of their child and their needs.

The following are general descriptions of centre based programs;

  1. Drop-In Programs: Drop-in programs may be offered in the morning, afternoon or both. The program offers a number of activities such as arts and crafts, games, circle or music time and usually a snack. The parent is expected to remain at the program with their child for the duration of the program. The drop-in may be offered 2-5 days per week offering a two-two and half-hour program. There are no fees associated with these programs. The main philosophy of the program is for parents and caregivers in the community to meet one another and develop social networks and to provide a safe and nurturing environment for children to play and develop skills.
  2. Nursery Programs: Nursery programs may be offered in the morning or afternoon, most nursery programs operate in the morning. Nursery programs tend to follow a ten or eleven month schedule each year, closing for one or two months during the summer. The programs may be offered for 2-5 days per week, usually offering a three-hour program. There are fees associated with the program and can range from $100.00 to $325.00 per month depending on the program (subsidies available). The parent is not expected to remain with the child. The program will provide a range of activities such as arts and crafts, sensory, free play, gross motor and group games such as music.
  3. Day Care Centres: Day care environments provide a program for a full day, usually offering at least 9 hours of care. Day cares are open all year; some may close for a set two week period during the summer for vacation. There is a fee for the program and this can vary from day to day care however the norm is usually around $650.00 per month for a pre-school age child (subsidies available). The fees increase and decrease depending on the age of the child (care for infants is the most expensive). Many day cares offer before and after school care for children as well. Centre based programming for children will emphasize enhancement of skills in all areas of development and preparing children for school environments.

Transitions Tip Sheet

A transition occurs when a child is required to change location, activity, environment or position. Transitions are often difficult for many children with Autism Spectrum Disorder (ASD).

Why are transitions difficult?

Transitions are often difficult for children with ASD.

  • Due to their neurological differences, children with ASD have a hard time maintaining and shifting attention.
  • It may take them longer to physically move themselves from one activity to another.
  • It may be difficult for them to understand the need to change activities.
  • It may be difficult for them to manage their own behaviour during the transition.

Anxiety is often associated with transitions.

  • Anxiety may be a by-product of resistance to change.
  • Many children experience anxiety over the possibility that they will not be able to complete a routine.
  • Anxiety many take many forms. The child may ask perseverative questions about upcoming events or engage in other stereotypical behaviours.

Transition Tips

  • Prepare for all transitions ahead of time. Give ample warnings (i.e. 5 minutes left, 2 minutes left, 1 minute left, time to switch).
  • Once children are at the next activity, they should not have to wait for “setup”; circle time should begin as soon as the children are seated.
  • Use a transitional object to help the child remain calm during the transition. It may be a calming toy (squeeze ball) or an item related to the next activity (paint brush to move to the paint centre).
  • Use transitional signals such as a sign, a noise or song. Eventually the child will learn to associate the signal with change and will understand that the signal means to stop what they are doing.
  • Use a visual schedule to indicate what will happen next.
  • Give one clear direction at a time.
  • Use a specific relaxation strategy.
  • Remain calm even when the transition appears chaotic.

Source:
Geneva Centre for Autism
112 Merton Street, Toronto, Ontario, M4S 2Z8
Tel: (416) 322-7877 – Toll Free: 1-866-Geneva-9 – Fax: (416) 322-5894
www.autism.net

Sleep/Quiet Time Tip Sheet

40-70% of child with Autism Spectrum Disorder have sleep disturbances that negatively affect their functioning and the functioning of their families. If the child with ASD is sleep deprived, one or both of their parents are also sleep deprived.

Sleep Expectations

  • Most child care centres expect children who attend the centre to sleep for 1-1/2 to 2 hours each day after lunch. This is also the time that staff breaks are often scheduled so a child who does not sleep creates a scheduling problem.
  • The expectations for sleep vary considerably from centre to centre.
    • Some centres expect children to sleep with shoes on; others expect children to sleep with shoes off.
    • Some centres expect children to sleep on their stomachs; other centres allow children to sleep on either stomach or back.
    • Some centres play loud music to act as a sound filter; other centres insist upon total quiet.
    • In some centres the expectations meet the needs of the child with ASD; in other centres the expectations do not meet the needs of the child with ASD.

Sleep Tips

  • Consult a physician to rule out any physical problems that can interfere with sleep including ear infections, gastroesophageal reflux, sleep apnea, allergies, etc.
  • Try to provide a consistent and structured sleep time routine.
  • Provide visual cues and/or a visual schedule which explains the sleep routine or expectation.
  • Take into account sensory sensitivities: is the child too hot/cold, is it too noisy or quiet, are the blankets itchy or scratchy, is the bedding to light, is the clothing too tight, too itchy, to new, etc?
  • It may be unrealistic to expect a child with ASD to sleep during the day. For some children with ASD, a daytime nap will replace their nighttime sleep.
  • Explore alternative activities that provide quiet stimulation such as books, puzzles, books on tape, music with headphones, etc.
  • For the child who cannot stay quiet, explore alternative activities away from the sleep area such as a walk or playtime in the playground

Source:
Geneva Centre for Autism
112 Merton Street, Toronto, Ontario, M4S 2Z8
Tel: (416) 322-7877 – Toll Free: 1-866-Geneva-9 – Fax: (416) 322-5894
www.autism.net

Sensory Processing Tip Sheet

Many individuals with ASD have difficulties processing sensory information. Some or all of the child’s senses may be affected by this. Each child with ASD will have a unique sensory profile.

Sensory Processing Difficulties

  • Sensory systems: There are seven sensory systems and a child may be over or under reactive in one or more of these systems. Sometimes these are called sensitivities. The sensory systems are hearing, vision, touch, taste, smell, vestibular (movement) and proprioceptive (body awareness).
  • Sensory sensitivities: A child may be over-reactive in one sensory area and under-reactive in another. Over-reactive children are hyper-sensitive and may avoid some sensory input. Underreactive children hypo-sensitive to sensory input and may seek out sensory input.
  • Sensory Profile: The child’s sensory profile is based on an ongoing pattern of behaviour and consistent responses to specific sensory input. Each child’s sensory profile is unique. Some children have many sensory sensitivities, other children have few or none.
  • Sensory Diet: Providing appropriate opportunities for the sensory input the child is seeking while offering accommodations and adaptations for the sensory input the child is avoiding.

Sensory Diet Tips

  • Provide additional movement breaks throughout the day. These can be made purposeful by having the child take a message to another room or help carry items from one area to another.
  • Sitting at circle or on the floor can be very difficult for some children with ASD. Provide a small chair or beanbag chair or allow the child to sit near and lean against a wall or cupboard.
  • Some children can pay better attention when they have a “fidget toy”. Playing with the toy helps them stay focused and on task.
  • Effective fidget toys are small, quiet and do not distract the other children. Examples include squeezable foam balls or figures, Koosh balls, Silly Putty, Tangle rings, etc.
  • Some children have difficulty with noise especially during play time or group activities. Allow the child to sit on the edge of the group where the noise is lessened or provide earphones or ear plugs.
  • There are many other tips and tricks. Consult an Occupational Therapist for support.

Source:
Geneva Centre for Autism
112 Merton Street, Toronto, Ontario, M4S 2Z8
Tel: (416) 322-7877 – Toll Free: 1-866-Geneva-9 – Fax: (416) 322-5894
www.autism.net

Reinforcement Tip Sheet

Reinforcement provides external motivation when a child is learning a new skill or working hard at managing their behaviour. An event that follows behaviour and increases the probability of that behaviour occurring again is a reinforcer.

Types of Reinforcement

  • Social reinforcement: Praise, high fives, smiles and nods, any kind of social acknowledgement. Examples include “you did a good job”, “way to go”, “I’m proud of you”, “thanks”, etc.
  • Tangible reinforcement: Access to a preferred object or toy; the opportunity to participate in a preferred activity. Sometimes, these activities may have a sensory component. Examples include puzzles, videos, books, Thomas the Tank engine, water play, swinging, etc.
  • Primary reinforcement: Food and drink are primary reinforcers because they meet basic biological needs. Some children prefer sweets or treats but others may respond to unusual foods such as pickles, onions, or lemons
  • Token reinforcement: Tokens have no value by themselves. They are valuable because they can be collected and traded for another type of reinforcement. Examples include stickers, checkmarks, plastic disks, etc.
  • There is no one item that is a “universal” reinforcer. Reinforcers are determined by their impact on behaviour.

Reinforcement Tips

  • Reinforcement is not the same as bribery. Reinforcement is earned by the child. The newer the skill and the harder the task, the greater the reinforcement needs to be.
  • During initial teaching, reinforcement should be given every time the desired behaviour occurs.
  • Once the child begins to show mastery of the skill (80% success over 3 days with 3 different people) begin to slowly and gradually reduce the frequency of reinforcement.
  • Children with autism DO respond to social reinforcement, especially from parents and other significant people. They may still need a tangible or primary reinforcer when learning a new and challenging skill.
  • When choosing a reinforcer, pick something you are prepared to give every time you see the behaviour and are prepared to withhold when the behaviour does not occur. You cannot use lunch, snack or other necessities of life as reinforcers.

Source:
Geneva Centre for Autism
112 Merton Street, Toronto, Ontario, M4S 2Z8
Tel: (416) 322-7877 – Toll Free: 1-866-Geneva-9 – Fax: (416) 322-5894
www.autism.net

Proprioception Tip Sheet

Proprioception is the feedback you get from you joints, muscles and tendons that tells you where your body is in space and assists with motor control and motor planning.

Characteristics of Proprioceptive Dysfunction

  • Experiencing difficulties with touch, balance or movement.
  • Appear stiff, awkward, uncoordinated and clumsy. May fall and trip often.
  • Poor sense of body awareness
  • Lean on, bump into or crash against objects or other people. Frequently may invade other’s body space.
  • Have difficulty climbing up and down stairs.
  • Hold pencils, crayons or other objects extremely tightly or extremely loosely.
  • Pull on or twist clothing. Stretch shirts and sweaters. Chew sleeves or collars.
  • Have difficulty carrying out unfamiliar and complex motions, e.g. tying shoes or learning a new sport.
  • Difficulty doing familiar and simple motions without looking, e.g. pulling up pants, putting on socks
  • Manipulate hair clips, light switches and classroom tools so hard that they break or are damaged.

Activities to Enhance Proprioceptive Function

  • Pulling/pushing weighted wagon or cart (use library books, bean bags, etc.)
  • Wheel barrel walks
  • Rough and tumble play or wrestling
  • Digging in sand or dirt
  • Wiping windows, tables, whiteboards, chalkboards
  • Carrying heavy items
  • Pulling on elastics, theraband, etc.
  • Experiencing vibration
  • Deep pressure massage
  • Playing with Play-Doh, plasticine or modeling clay
  • Running, jumping, stretching
  • Pillow fights, falling into a pool of pillows, hiding under heavy pillows or blankets
  • Stirring cookie batter or liquids of other consistencies

Source:
Geneva Centre for Autism
112 Merton Street, Toronto, Ontario, M4S 2Z8
Tel: (416) 322-7877 – Toll Free: 1-866-Geneva-9 – Fax: (416) 322-5894
www.autism.net

Prompting Tip Sheet

Prompting is a way of assisting a child to perform a specific response after a given instruction. The instructor/teacher provides a cue to elicit a specific behaviour from a child/student.

There are 5 types of prompts.

  • Verbal Prompt: Providing verbal instruction or cue (emphasizing the correct response from a choice).
    A full verbal prompt may be providing the whole word or phrase, and a partial verbal prompt would be the first sound or syllable.
  • Physical prompt: Involves touching the child. Full physical prompt may be assisting the child through the whole response, partial physical prompt may be just touching their hand/shoulder to start the response.
    Before physically assisting the child to perform a task, ensure they are comfortable with being touched in that manner (hand over hand, touching shoulders)
  • Modeling: The adult or another child acts out the response, hoping that the individual will imitate.
  • Gestural prompt: Includes pointing to, looking at, moving, or touching an item or area to indicate a correct response.
  • Positional prompting: Involves arranging materials so that the correct item is in a position obvious to the child.

Prompting Tips

  • These prompts are listed from most to least intrusive (verbal/physical = most, positional = least)
  • When introducing a new skill you should start with the least instrusive level of prompting needed to help the child be successful with the task.
  • If prompting is required for a learned skill, you should start with the least amount of prompting necessary
  • Some children become dependent on prompts and wait for the adult to assist them before they make any type of response.
  • To avoid this, prompting should be faded as soon as soon as the child begins to demonstrate mastery.
  • All individuals supporting the child should be aware of their prompting levels, to avoid confusion.
  • Prompting should gradually fade until the child is performing the specific action/response on their own.

Source:
Geneva Centre for Autism
112 Merton Street, Toronto, Ontario, M4S 2Z8
Tel: (416) 322-7877 – Toll Free: 1-866-Geneva-9 – Fax: (416) 322-5894
www.autism.net

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