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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

Lunch/Snack Tip Sheet

“Food for Thought” 75% of children with Autism Spectrum Disorder experience atypical eating patterns and have limited food preferences.

Tips to support good eating

  • Routines: Establish clear routines around meals and snacks. Try to ensure that they occur at consistent times.Provide a setting with minimal distractions.
  • Seating: Ensure that the child is sitting in a chair that provides ample support (child size chairs/booster with foot rest) and provide modified dishes and utensils if necessary (for example, a weighted spoon).
  • Portion size: Small is better. Smaller portions allow the child to see results after taking a few bites and requesting more food is a communication opportunity.
  • Encourage food exploration: Provide opportunities for the child to play with and explore new foods. Be creative about games and activities that involve new foods.Use peers and yourself as a model to demonstrate exploring new foods.
  • Motivation: Use “First – Then” boards to show the reinforcement available after eating. (“First carrots – Then juice”).

Food Facts

  • Typically developing children need to see a food 10-15 times before they will taste it. A child with ASD is likely to need even more exposure before they will try the food.
  • A typically developing toddler will eat one “good” meal every 48 hours. This means 1 out of 6 meals are “good” and 5 out of 6 are not.Have realistic expectations about what the child with ASD will eat.
  • Typically developing children have food preferences. Not every child likes every food. This is true for children with ASD as well.
  • Some children become dependent on prompts and wait for the adult to assist them before they make any type of response.

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

Inclusion Tip Sheet

Inclusion is a set of practices and beliefs that involves educating all students, regardless of disability, in their neighbourhood daycare or preschool with appropriate supports and necessary services

Principles of Inclusion

  • Acceptance of diversity: Fairness is giving each student what they need, not just what everyone else has. Fair does not mean equal.
  • Willingness to address individual needs: Each student is working to his/her greatest potential regardless of what other students in the class are doing.
  • Use of reflective practice: The teacher is able to be flexible based on the needs of the day and recognize that these may change daily based on the individual student.
  • Encouragement of collaboration: The general education and special education teachers work collaboratively in the same classroom to meet the needs of all students.
  • Active development of a program that is inclusive of all children: Provide opportunities for both child-directed and teacher directed activities, use small and large group activities to build relationships and provide the supports and accommodations the child with ASD needs to be successful.

Inclusion Tips

  • Provide many opportunities for communication and accept whatever way the child is able to communicate at that moment.
  • Support communication by using visual schedules, labeling the environment with pictures and printed words, providing behavioural cue cards, choice boards, etc.
  • Provide opportunities for imitation including duplicate toys, books and activities and space for more than one child.
  • Support and encourage independence by offering choices, providing a visual schedule, using a timer, offering predictable routines and allowing the opportunity for independent exploration.
  • Involve instead of isolating by teaching skills and encouraging skill development within the child’s preschool grouping. For example, putting on shoes can be taught during the group dressing routine to provide opportunities to watch others.

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

The Diagnosis of Pervasive Developmental Disorder

To be diagnosed with one of the Pervasive Developmental Disorders including Autism Spectrum Disorder, the child must have a specific number of characteristics in 3 categories:

  1. Social Interaction
  2. Communication
  3. Behaviour

The specific diagnosis is based on the number of characteristics and the severity of those characteristics. Some of the possible characteristics may include:

  1. Social Interaction
    • Unusual eye contact
    • Different and/or decreased interaction
    • Relates better and more frequently to adults than children
    • Prefers to do things without seeking help from others
  2. Communication (verbal and nonverbal)
    • Delay in spoken language
    • Difficulty understanding directions
    • Difficulty starting and continuing a conversation
    • May repeat words/phrases that other people say
    • Limited pretend play
    • Gets needs met by taking an adult’s hand
    • Uses gestures to communicate
  3. Behaviour
    • Repeats actions e.g. often plays with fingers, rocks body, jumps
    • Unusual play e.g. puts toys in line, repeatedly spins toys
    • Difficulty with change. Prefers things to stay the same.
    • Unusual reactions to sound, smell, taste, touch or visual sensations

Note: This is a general overview and should be accompanied by more detailed information.

Structuring Activities for a Child with Autism Spectrum Disorder

General Programming Strategies for a Child with Autism/P.D.D.

When Interacting with a Child:

  1. Sit at the child’s eye level.
  2. Touch the child on the arm occasionally to refocus his/her attention.
  3. Say the child’s name, occasionally, throughout the task.
  4. Use 2-3 word sentences and focus on task-related or important words. i.e. “Ahmed, roll ball.”
  5. Continue to comment, label the child’s activities (and those of the other children around him/her.)
  6. Be positive. Emphasize the child’s strengths and reinforce all of his/her efforts. i.e. “Gevon, great puzzle making.”
  7. Reinforce the child’s communication be repeating what he/she says and then expand on it.
    i.e. child: “cah go”
    adult: “car go”
    adult: “red car go”
  8. When your child consistently repeats what you say (parrots / mimics,) this is called “echolalic speech,” or “echolalia.”
    i.e. adult: “Do you want more juice?”
    child: “Do you want more juice?”

    • Use simple phrases which sound appropriate when repeated.
      i.e. adult: “Want juice?”
      child: “Want juice.”
    • Ignore delayed echolalia.
  9. Exaggerate your facial expressions (wide eyes, raise eyebrows.)
  10. Use body cues (pointing, hand motions.)
  11. Use objects or pictures when they are available.
  12. Have fun.

Routines and Rituals, Tips for Early Childhood Educator

For most children in child care programs having a routine they can count on provides reassurance and a feeling of safety. For children who may have unpredictable lives outside of child care it is helpful to have a stable routine and classroom environment. You can create a sense of stability and security in your classroom in many ways. Having rituals for the children to follow daily is often a successful method in providing what children need to manage through the day. You may even consider giving children the power to help choose specific rituals for certain times of the day. This may help in the children following the rituals and understanding why they are in place. For example ask the children what they think the routine should be for transition from lunchtime to snack time – with your help they will probably come up with some great ideas.

For pre school children, transition times can often be the most difficult part of the day. Providing consistent rituals for transitions can often provide children with enough security to know what to expect at certain times. Here are some tips to help ease transitions time in your classroom:

  • Always provide a 1-3 minute warning and tailor the advance warning for individual children if needed. Because some children do not cope well with change in general, sudden changes can at times be
    traumatic and have negative affects in behaviour. If you have specific children in your program that do not handle change well approach these children in advance of the warning and provide an extra warning
    to them that there is going to be a change in what is happening. Sometimes even asking these children to help with transition chores can assist allowing them to make the transition with ease.
  • Have a chart of daily routines at the children’s eye level. If possible, use pictures of the children doing the specific activity beside the word or phrase it matches. This way children can easily identify each activity. Arranging these charts to read left from right means, you are also reinforcing a reading skill. Review the chart during circles and group times.
  • Review routines whenever possible to remind the children what to expect.
  • Have a bag of tricks. Having a bag of books a puppet or something the children will be attracted to will help if one staff is on the carpet receiving children while the other staff is assisting children in clean up. When you work as a team and divide the responsibility this way you may find that transitions become easier and children will have less negative behaviours.
  • Keep waiting times to a minimum. Sometimes the reason transitions are so traumatic for children, is that the wait time is too long . Divide and conquer! Divide the group if you can, to allow for easier supervisions and shorter wait times for things like washroom. And whenever possible, have one staff waiting to receive the children as this will alleviate many behaviours children get into when they are waiting for long periods on the carpet or in line during transition. For example after lunch instead of both staff trying to clean up and get bathroom routine finished, try having one staff on the carpet where the beds are and the other doing bathroom. Then, when bathroom routine is complete you can switch and get the lunch area cleaned up while still having one staff on the carpet.

During transition if the majority of the children are not able to keep on task, re evaluate the ritual ask your supervisor or a co worker to give you an outsiders opinion to help fill in any gaps that are keeping the ritual form being successful. If there is consistent chaos during certain rituals you may also want to “stop the world” and have all of the children gather around for an impromptu and quick circle time to review the ritual and its purpose. This can often give you insight as to why they children are not managing; they may not know what the expectations really are. It is important that when a transition time ritual is not working and there is chaos in the room, you remain calm and cool. The important thing is to get the children to relax and stop the chaos. Sometimes this can mean turning the lights off, ringing a small bell or clapping your hands until you have everyone’s attention. Non-verbal direction can work wonders. Lets say you are in the middle of clean up after a very active and full morning. There is paint and toys everywhere and it happens to be the one day that all of the children are in. Lets also say that typically most of the children are able to follow the routine or ritual of cleaning up however today the room seems out of control and chaotic and no one seems to be listening. What can you do to bring some order back to the room?

Nonverbal re-direction can work wonders. Plant yourself in the middle of the chaos, start clapping your hands in a rhythmic pattern or ring a bell – you will see the children will start responding by coming over to where you are. You can then address the room and help the children get back on track. This strategy works well with older pre school children. Younger children however may need a firmer form of re direction, where you may need to have one staff on the carpet and another physically brining the children over. The bottom line is sometimes you may have to stop the world in order to bring order back into the room.

Author: Sheela Visram, Child Care Consultation Program, Aisling Discoveries Child And Family Centre