Monday, May 30, 2011

“Encouraging Friendship Skills”

 “Encouraging Friendship Skills” Program for Children with Asperger’s Syndrome and their parents”

The Aims of the Study

Parents of children with an Autism Spectrum Disorder (ASD), including Asperger’s syndrome (AS), often report that they experience significant stress in their daily lives. In addition, many children with AS have difficulty with friendship skills in particular affectionate communication, which can lead to a number of difficulties in everyday life.

This study aims to evaluate the effectiveness of a newly developed stress management approach that has been adapted for parents of children with AS and a child program developed by Professor Tony Attwood to encourage friendship skills in children with AS.

Who can participate?
  • Children aged 7 to 12 years old with a diagnosis of Asperger syndrome or High Functioning Autism who have difficulties with friendship skills.
  • Parent/s of the child with AS who is/are experiencing parenting stress or distress.

The Study

First phase: both parent/s and child will be required to come to the University of Queensland, St Lucia Psychology Clinic for an assessment session. At this assessment session, the parent/s will be asked to complete a battery of questionnaires and answer questions about their child’s diagnosis, friendship difficulties and own stress levels. The child will complete a brief measure of intelligence and answer questions about a hypothetical situation designed to assess their friendship skills. This assessment session will take approximately 1.5 hours. Parents will be asked to complete the same battery of questionnaires at three different time points: at the assessment session, immediately following the program and 3 months following the program. These questionnaires take approximately 30 to 40 minutes to complete. The questionnaires are about parenting, stress, coping and your child’s affection and friendship skills.
Second phase: involves completing the 7 week intervention program. The program will be conducted at the UQ Psychology Clinic, St Lucia campus, for two hours each week on consecutive Saturday mornings. There are two groups planned: one to start the first weekend of School Term 3 and the second on to start the first weekend of School Term 4. To meet research requirements, parent/s and their child will be randomly allocated to one of two groups.

The first two weeks are for the parents only. These two weeks will cover the stress management techniques. During these two weeks, parents will work in large groups to learn stress management techniques specifically designed for parents of a child with AS.

The last five weeks are for both the parent/s and their child. These five weeks will cover the ‘Encouraging Friendship Skills’ program developed by Professor Tony Attwood. These sessions will focus on teaching the children friendship skills and the importance of affectionate communication for making and keeping friends. The children will be in groups of three with two therapists. The parents will cover the child content in a large group so they are able to support and help their children learn the skills and complete homework tasks.
The program will be conducted by Postgraduate Provisional Clinical Psychologists and supervised by Clinical Psychologist, Dr Kate Sofronoff. Please also note to participate in the program, $50 will be charged. This cost is to cover the program resources and facilities provided.

Joining the Study

If you would like to participate in this project or you would like more information, please contact a member of the research team:
Lize Andrews
Ph: 0432 438 600
Email: lize.andrews@uqconnect.edu.au
Celia Bird
Ph: 0430 179 174
Email: celia.bird@uqconnect.edu.au

Social Skills Interventions

B E YO N D  B E H A V I O R - Social Skills

Social Skills Interventions for Students With Asperger Syndrome and High-Functioning Autism: Research Findings and Implications for Teachers

CHRISTOPHER B. DENNING, UNIVERSITY OF VIRGINIA

More than a decade ago, Asperger syndrome (AS) was added to the Diagnostic and Statistical Manual – 4th Edition (DSMIV) (American Psychiatric Association [APA], 1994). Although there is much debate over the differentiation between high-functioning autism (HFA) and AS, social skills deficits are a hallmark of both disorders (Klin, 2000). These impairments have lifelong implications and have been linked to depression,
limited job success, and poor relationships (Bernard, Harvey, Potter, & Prior, 2001; Gutstein & Whitney,
2002; Klin, Volkmar, & Sparrow, 2000; Venter, Lord, & Schopler, 1992). There is a great need for   
research-based practices and for placing this research into the hands of educators. Guidelines are also needed to ensure that effective practices are used. According to the National Research Council (2001, as
cited in Sweeney & Hoffman, 2004), “Some approaches have been greeted with great enthusiasm initially, but have relatively quickly faded, in part because of their failure to demonstrate worthwhile effects” (p. 304). Numerous techniques have been shown to be effective for students with HFA and AS, and these studies begin to show teachers how to instruct students with HFA and AS in order to provide the best chance for social and lifelong success. This article examines the available research in social skills instruction as it relates to HFA and AS, and recommends practices to educators.

Overview Definition

The DSM-IV defines the social impairment for autism and AS in four different areas and requires that an individual exhibit two of these to qualify (APA, 1994). These include
  1. (a) a marked impairment in the use of multiple nonverbal behavior,
  2. (b) a failure to develop peer relationships,
  3. (c) a lack of spontaneous seeking to share enjoyment with other people, and
  4. (d) a lack of social or emotional reciprocity (APA, 1994, p. 77).
Characteristics Klin et al. (2000) noted that children with AS seem aware of and interested in other people, but have difficulties that result from “a constant, but inappropriate approach to others” (p. 38). Individuals struggle with many pragmatic language skills, including turn-taking, maintaining eye contact, initiating and ending conversations, and picking up on cues that the listener may not be engaged. Numerous other
difficulties include unusual voice— cadence, pitch, and volume; a tendency to discuss topics of interest without regard for the listener; difficulty following the rules of games or with losing games; and problems with
change or an insistence on routine.Finally, the “hidden curriculum” or the subtleties that other children seem to
pick up naturally can be problematic (Myles & Simpson, 2001). Students with AS or HFA may need to be explicitly taught many of the skills teachers or parents expect students to understand. All of these issues can create problems during general social engagement.

Recent Research

Recent research has focused obiological and cognitive differences in individuals with AS and HFA related to early social impairments (Dawson, Meltzoff, Osterling, Rinaldi, & Brown, 1998; Dawson et al., 2004),
joint attention (Mundy & Burnette, 2005; Mundy & Crowson, 1997), and theory of mind differences (Klin,
2000). Dawson et al. (2004) found that children with autism failed to orient to all stimuli and that their orientation to social stimuli was “much more extreme” (p. 479) when compared with typical peers or children with Down syndrome. Other signs that point to an early lack of social connectedness include
  • (a) a failure to smile by 6 months;
  • (b) a failure to share sounds or facial expressions by 9 months; and
  • (c) a failure to babble, point, show, wave, or reach by 12 months (Painter, 2003).
Although typical children are practicing these skills and becoming experts in social engagement through
repeated practice, children with AS or HFA can remain relatively isolated unless someone intervenes.

Outcomes

Although the outcomes for individuals with HFA and AS are generally considered more favorable than for individuals with more typical autism, there are still concerns with employment, personal relationships,and independence (Bernard et al., 2001; Gutstein & Whitney, 2002; Klinet al., 2000; Venter et al., 1992). Bernard et al. (2001) conducted a study in the United Kingdom that interviewed the parents of 450 individuals with autism spectrum disorders. More than 70% of the individuals were identified as medium to very high functioning and nearly 50% had a diagnosis of AS. The results showed that 70% of parents felt that their children would not be able to live independently without support, only 12% of high-functioning adults had full-time employment,  56% S P R I N G 2 0 07 17 BB BeyondBehavior B Social Skills had depression, “only 28% have had any access to social groups for people with autism or Asperger syndrome” (p. 7), and finally 82% of the parents “believed their children would benefit from social skills training, but only 44% had received any” (p. 21). Clearly, work is required to increase support and involvement for students before they enter adulthood to improve these outcomes.

Many parents notice signs of depression and withdrawal during the teenage years. It seems that adolescents
become more aware of their differences and their lack of friends, despite their repeated attempts at interaction, and become frustrated by this difficult reality. Others may struggle with instances of being picked on or being actively rejected by peers (Myles & Simpson, 2001).

Interventions - Social Stories

What does the research say?

The studies using Social Stories™ begin to illustrate that they can be used to increase appropriate behaviors
and decrease inappropriate behaviors. The advantage of Social Stories seems to be their ability to address
social understanding and to provide behavioral solutions to the student in a concrete and portable form. Some studies have examined ways for students to access them independently, and for the busy classroom teacher, they are relatively easy to implement. One limitation is that the research has not clearly shown the necessary components or that teachers need to follow the guidelines presented by Gray (1993, 2004).
Sansosti, Powell-Smith, and Kincaid (2004) performed a research synthesis of Social Stories and concluded that the empirical evidence was limited. The authors found that “due to a lack of experimental controls, weak treatment effects, and confounding treatment variables in the reviewed studies, it was difficult to determine if Social Stories alone were responsible for durable changes in important social behaviors” (p.200). Another area of concern was the fading of Social Stories. Since they are intended to produce long-term change, removing Social Stories should not result in a complete return to baseline levels for behaviors. More recently,
Reynhout and Carter (2006) conducted a meta-analytic review of Social Stories and found that the studies showed considerable variability, that the overall change in behavior did not indicate the intervention was effective, and that there was little evidence to indicate that Social Stories were more effective if they conformed to Gray’s (2004) guidelines (see below). In fact, Social Stories that included more control
sentences than recommended were more effective. Scattone, Wilczynski, Edwards, and Rabian (2002) developed a program for three participants and created a Social Story for each that was read before engaging in the target activity. The results showed that each participant had markedly reduced levels of inappropriate behaviors. Thiemann and Goldstein (2001) developed an intervention for five students that combined Social Stories, comic strip conversations, and video modeling. The intervention focusedon social communication skills such as “(a) securing attention, (b) initiating comments, (c) initiating requests, and
(d) contingent responses” (p. 429). Results showed increased and more consistent rates of the targeted social behaviors, but limited generalization and maintenance. The authors hypothesized that results might have
improved if training had continued for a longer time period and if prompts had been faded more gradually.
Another study that was implemented at home involved a single subject (Lorimer, Simpson, Myles, &
Ganz, 2002). Two Social Stories were written for the target behavior of tantrums: “talking with adults” to
address his need for attention when others are talking, and “waiting.” The behaviors decreased dramatically
during the intervention phase. Bledsoe, Myles, and Simpson (2003) developed a program to use with a 13-year-old subject and targeted his lunchtime behavior. The story addressed both using a napkin to wipe his face and spilling food and drink. Results showed that spills decreased and wipes increased. The authors hypothesized that the behaviors improved the longer the story was used, and that the participant may have required additional practice to master the skills. Some studies trained or involved parents in implementing Social Stories (Adams, Gouvousis, VanLue, & Waldron, 2004; Ivey, Heflin, & Alberto, 2004; Rogers & Myles, 2001; Smith, 2001; Sofronoff, Leslie, & Brown, 2004). Interventions occurred in both home
and school settings. Results showed that the majority of the participants reported that it was enjoyable, practical, and effective. Adams et al. (2004) noted that both parents and teachers reported that the Social
Stories seemed to reduce frustration of a 7-year-old participant and helped him understand how to ask for help. Finally, Ivey et al. (2004) reported that - The  advantage of  Social Stories seems to be their ability to address social understanding and to provide behavioral solutions to the student in
a concrete and portable form .

18 BEYOND BEHAVIOR all three participants said that they enjoyed the Social Stories and would like to use them again. In addition, the parents reported that the story created the opportunity for their children to
ask questions about and comment on the upcoming events.

How is it done?

Social Stories attempt to accurately describe the situation in which a behavior occurred, describe the perspective of those involved, and provide guidelines for what the student should do in the future (Gray
& Garand, 1993). They have been used to prepare students for a new activity, to teach appropriate behaviors, and to focus on inappropriate behaviors. The basic format can be implemented with minimal teacher effort. Based on the reviewed research, some components appear to make the technique more
effective; these include
  • (a) involving the parents,
  • (b) using the approach in multiple settings,
  • (c) receiving input from the student,
  • (d) focusing on a limited number of specific behaviors,
  • (e) using additional reinforcements with the story,
  • (f) writing on the students receptive language level,
  • (g) reading before engaging in the activity,and
  • (h) including comprehension questions to ensure that the student understands the expectations and alternative behaviors.
Gray (2004) directs writers to follow certain guidelines when writing Social Stories. These include six
different sentence types (descriptive, perspective, cooperative, directive, affirmative, and control) and a formula that states there should be twice as many descriptive sentences as directive or control sentences combined. The research, however, does not indicate whether this or any other formula is more effective. illustrations are also discussed in the guidelines (Gray, 2004), including the use of drawings, photographs, objects, and children’s illustrations, but again the research is unclear about what is more effective or whether pictures need to be used. Minimizing pictures may make it easier for teachers to use the technique quickly as the need arises. Another option is to have students create their own illustrations, which may help them connect more with the story. Prewritten stories are also available and may save teachers and parents time when addressing common concerns, such as raising your hand or getting ready for school (Gray, 1993;
2000). See Figure 1 for an example of a Social Story. Cue Card/Written Script

What does the research say?

A cue card or script is similar to a Social Story and may hold promise as an intervention because it is portable and concrete. Scripts have been used in two different ways: to teach appropriate conversational skills (Charlop & Milstein, 1989; Charlop-Christy & Kelso, 2003); and to teach appropriate behaviors (Keeling, Myles, Gagnon, & Simpson, 2003). Both methods have produced positive results. Charlop and Milstein (1989) and Charlop-Christy and Kelso (2003) used scripts and video-modeling to teach conversational skills to three boys. Scripted conversations were created that the boys practiced and then viewed on a video or had access to on a cue card. Results showed that the boys were able to learn the scripts and acquired subsequent scripts more rapidly. Generalization probes also showed success across
different persons, topics, settings, stimuli, abstract conversations, and maintenance at a 15-month follow-up.
Keeling et al. (2003) developed an intervention called a Power Card that combined elements of Social
Stories, special interests, reinforcement, scripts, and a portable card to teach appropriate social behaviors. They developed a script about playing games for one student that centered on her interest in the Power Puff
Girls, and created a card that listed how to act if she lost or won a game. Results showed that her screaming
and whining was reduced to near zero during the intervention and that she was able to generalize the skill to the playground when she had the Power Card with her. Because only one study has demonstrated the effectiveness of the Power Card strategy, additional research is needed to make a recommendation.

How is it done?

The use of a cue card or script may lend itself well as an addition to an existing social skill support plan. The
written format is concrete, portable, and relatively easy to implement. The above studies used scripts that were seven lines long, and generally included a statement and question within each response. Scripts could be practiced with a parent, teacher, or sibling, should focus on either an area of interest or a Social Skills

Figure 1 JOHN’S MORNING ROUTINE STORY

When I get to school in the morning there are many things I need to do. All of the children in my class need to do these things too. If I need help I can watch the other children or ask my teacher, Mrs. Smith. Sometimes it’s hard to remember what I need to do. I can use my schedule to help me remember. First I need to unpack my backpack. I put all my things where they belong. Then I give my journal to Mrs. Smith and move my lunch clip. This will let Mrs. Smith know what I want to eat. The last thing I do is hang up my backpack. Everyone will be happy when I get done and I will be ready for school. Yeah!!
S P R I N G 2 0 07 19 BB BeyondBehavior B topic that is typical for the age group, and should be written on the student’s reading level. Practice sessions could follow a sequence that includes practicing with the script present, practicing without the script, and then practicing the script in another setting with a different partner. Based on the criterion of Charlop-Christy and Kelso (2003) students should be able to complete the entire conversation in two consecutive trials before they would try the conversation in another setting or with another partner. Some students may need more time and as many as 20 trials to be successful (Charlop &
Milstein, 1989). Lastly, praise or small reinforcers such as stickers or food could be used in the initial training
stages to create motivation. See Figure 2 for an example of a social script.

Social Skills Groups

What does the research say?

Social skills groups are becoming more popular and recommended as a training tool for individuals both at schools and in private settings. Unfortunately, only two of the studies were conducted within a school setting
(Kamps et al., 1992; Williams, 1989), so it is difficult to make recommendations for school personnel. Although results from studies have generally been positive, the outcome data relied heavily on anecdotal information and should be interpreted with caution. The studies consistently reported concerns with generalization of skills to other settings, limited changes in interactions with peers, and limited or no improvement in understanding of how others may feel. Mesibov (1984) conducted a social skills group with 15 older adolescents and adults who ranged in age from 14 to 35. The group met for 10–12 weeks for 1 hour and had a 1:1 staff to participant ratio. Each meeting consisted of a group discussion, listening and talking, role-playing, and an appreciation of humor. The author felt that the group met the goal of providing positive peer-related social experiences, and there were anecdotal reports that skills had generalized back
to the home and community. Williams (1989) attempted to replicate Mesibov’s social skills group. The group consisted of 10 students between the ages of 9 and 15 who attended a separate school, and lasted for 4 years. Results of a social behavior questionnaire indicated that they all exhibited gains in social skills, and anecdotal reports showed the participants were more likely to volunteer in groups, talk to peers, and use appropriate facial expressions. The lack of a control, lack of entry data, and extended length of the intervention make it difficult to pinpoint specific causes of improvement. Kamps et al. (1992) assessed the
effects of a classwide social skills group on three participants. Groups contained four peers and one student with HFA. The class was instructed in areas such as initiating an interaction, giving compliments, helping others, and including others in activities. During free time students received stars on a monitoring form when they were engaged in a social interaction at 1- minute checks. The results showed that social interaction increased in duration and frequency, and that appropriate behaviors occurred more frequently.The authors felt that training the whole class was effective and that “the groups were more successful when focusing on fewer behaviors with more practice opportunities for those basic skills” (p. 287). Barry et al. (2003) created an outpatient clinic-based group with four elementary students that lasted for eight sessions. Seven typically
developing peers were taught about autism and were trained to use strategies, such as ignoring inappropriate
behaviors and providing a suggestion during a monologue, to assess whether the students could apply the skills they had learned. Weekly groups used a structured format, behavior chart, an assessment period, and parent training to review skills and make suggestions for use at home, and taught new skills through scripts and role-play. Results showed that participants had significant improvements in greetings and play, and showed a trend for improvement in conversation. Skills that were not targeted did not increase and there was
limited generalization to other settings, according to parent reports. Webb, Miller, Pierce, Strawser, and
Jones (2004) created a social skills group that focused on teaching adolescents to use the SCORE Skills Strategy.
In the program, students needed to
  • (a) share ideas,
  • (b) compliment others,
  • (c) offer help or encouragement,
  • (d) recommend changes nicely, and
  • (e) exercise selfcontrol.
Ten students participated and were randomly assigned to groups to practice the skills. Results showed that performance improved by at least 10% for all areas and was statistically significant for each focus area except Social Skills Figure 2

SAMPLE CONVERSATION

Teacher: What did you do over the weekend?
Student: I went swimming. What did you do?
Teacher: I went for a walk in the woods. What else did you do?
Student: I ate pizza at a restaurant. Do you like pizza?
Teacher: I do. What’s you favorite topping?
Student: I like cheese. What do you like?
Teacher: Everything!

20 B E YO N D B E H A V I O R for “share ideas.” Working in the study did not change the participants’
opinion about working in small groups with classmates at school. The authors also expressed concerns
that the students would not be able to generalize the skills, and additional research may need to focus on this area. Finally, Solomon, Goodlin-Jones, and Anders (2004) created a group that trained parents to use problem-solving strategies to deal with inappropriate behaviors and taught skills to students with autism spectrum disorders. Eighteen boys were in the group, and a control group was used to compare results. Parents were taught how temperament and intelligence interact with core autism deficits to create problem behaviors, and used a behavior log to brainstorm problemsolving strategies. Mothers reported statistically fewer problems and increased satisfaction in their dealing with these behaviors. Two groups developed in the social skills group and differences were noted in how each responded to information. Boys with higher verbal skills seemed to rely more on verbal information, and those with higher visual-spatial skills relied more on nonverbal skills to gain information. This suggests that there may be a difference in how children respond to
information. As with other studies, the participants failed to achieve significant gains in their ability to understand others’ perspective or in generalizing skills to other settings.

How is it done?

The best results were achieved when the lessons focused on teaching specific skills for the students to use,
involved modeling and role-play, were connected with home so the skills could be practiced in multiple settings, and involved the participation of peers.

Peer Coaching/Tutoring

What does the research say?

Involving peers in the process of teaching social skills has produced positive results in a variety of studies.
Kamps et al., (1998) conducted a study measuring the social validity of peermediated programs by assessing peer opinions after participating in these interventions. Their findings suggest that these programs can make a
difference in active social participation as long as the programs include peer training and are structured by the
teacher or parent. Peers generally reported positive comments about the programs and were excited to participate. Handlan and Bloom (1993) trained peers through two phases: the first provided education about disabilities, and the second provided modeling to assist with interactions. Minimal change was noted in peer interactions after the education phase; however, peer interactions increased from an average of 2 or 3 per class to as many as 18 after they received support through modeling and coaching. In addition, parents reported increased contact with peers, and the parents of the nondisabled students reported that they were more likely to talk about their peers with disabilities. Kamps, Barbetta, Leonard, and Delquadri (1994) used a classwide peer tutoring (Greenwood, Delquadri, & Carta, 1988) program in a second grade classroom. All students were trained for three 45-minute sessions. Components included reading of passages, feedback
from peers, correction of errors, and a public posting. Tutors were instructed to provide positive and corrective feedback, were monitored by teachers, and received bonus points for appropriate interactions.
Results showed that all 3 students with HFA and 11 out of 13 of the peers had significant improvements in
reading comprehension during both intervention phases when compared to baseline. Although social interactions increased, there are two main limitations. The authors assessed the length of the interactions, but not the quality. In addition, these interactions account for only between 10% and 16% of the total free time. To be truly integrated in the class, these students need to engage more frequently. Barry et al. (2003) recruited and trained peers to interact with students with autism during a social skills group. Finally, Bauminger (2002) developed a program that used aspects of other previously discussed techniques (i.e., training and modeling for peers, teachers, and parents). The intervention involved 15 participants with a mean age of 11 and included
  • (a) instruction in prerequisite concepts such as what a friend is or how we listen to a friend,
  • (b) affective education in teaching emotions, and
  • (c) social–interpersonal problemsolving.
Participants met with peers twice weekly to practice learned skills and were required to call peers from
home. In addition, parents helped students meet with peers at home, suggested social activities, and assisted
with phone calls. Results showed that participants demonstrated growth in positive social interactions through
interest in other students, improved eye contact, an increase in sharing experiences, an increase in functional
behavior, and a reduction in repetitive or ritualistic behavior. Although it was difficult to assess whether this
translated into interactions with other peers, parent and teacher reports showed improvements in overall social skills, assertiveness, interactions with peers, and the ability to cooperate in a group. The study shows promise in its ability to integrate the program across settings, intimately involve parents as agents of change, and connect the participants closely with another peer. It also provided ongoing times to practice the skill that may be much more effective than the isolation seen from a social skills group or another intervention that is only connected with a single setting.

How is it done?

Peer coaching and training has been effective on both an individual and classwide basis. The research seems to show that interactions increase Social Skills S P R I N G 2 0 07 21 BB BeyondBehavior B between students with disabilities and peers when a structured activity is created, such as tutoring or a structured
play time. Peers should be trained in specific techniques, such as positive reinforcement through modeling,
and be provided information about disabilities and differences. More research is needed to isolate how
specific components affect results, and teachers would benefit from the use of protocols that outline how to create peer tutoring programs.

Parent Training

What does the research say?

Parental involvement has been examined in eight studies and consistently correlated with improved outcomes. Results showed improved outcomes and generalization to other settings when parents were involved in the process and when the activities were used in the home (Adams et al., 2004; Bauminger, 2002; Charlop-Christy & Kelso, 2003; Ivey et al., 2004; Lorimer et al., 2002; Smith, 2001; Sofronoff et al.,2004; Solomon et al., 2004). Sofronoff et al. (2004) developed a controlled study to assess the effects of parent training. Fifty-one parents with children recently diagnosed with AS were instructed in Social Stories, comic strip conversations, behavior management techniques, anxiety management, and educated about the disability. Parents involved in either training session group reported significant improvement in number of problem behaviors, intensity of problem behaviors, and social skills. Parents from the individual session group reported greater use of strategies, while those in the waitlist control group did not report a significant improvement on any outcome measure.

How is it done?

Based on the available research, teachers should actively seek ways to involve parents through training in
both understanding the characteristics of the disorder and implementing the interventions, encourage parents to provide support and motivation to their children, and provide weekly updates on the status of the program. Parents are able to follow up on strategies and plans outside of the school to ensure their use in multiple settings. In addition, the added knowledge may be helpful in areas other than social skills, and may positively affect the overall atmosphere of the home.

Conclusion

According to the research reviewed, seven components are common across successful social interventions for students with AS or HFA:
  1. teaching specific skills, such as how to initiate a conversation;
  2. modeling skills demonstrated by the interventionist, using a scripted conversation or scripted lines, or by presenting an example of a response to a situation (e.g., asking to play a game);
  3. practicing the skills after observing a demonstration; 
  4. using positive reinforcement, such as praise, food, or stickers;
  5. involving parents in the intervention and giving specific responsibilities so that the student could continue to practice the skills at home;
  6. involving peers as the intervention agents or in the practice and play sessions; and
  7. including written information and pictures to create a readily accessible and more concrete format.
Future research will be necessary to ensure that including these “common components” results in better social outcomes. Research will need to continue to focus on the quality of social interactions and the potential for
interventions to create long-term change. Table 1 lists the studies analyzed and illustrates whether the
interventions were effective. Scripts, peer support, and parental involvement appeared to produce the best results in generalizing behaviors to other settings. Future research should also focus on ways to improve the quality and frequency of interactions. The research also illustrates the benefits for individuals with HFA and AS when effective instructional techniques are used. Since social skills deficits create lifelong difficulties related to employment, independence, and personal happiness, it is crucial that teachers find ways to improve the social interactions and social behavior of students with AS and HFA.

REFERENCES

Adams, L., Gouvousis, A., VanLue,M., & Waldron, C. (2004). Social story intervention: Improving
communication skills in a child with an autism spectrum disorder. Focus on Autism and Other Developmental
Disabilities, 19, 87–94.
American Psychiatric Association. (1994).Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Barry, T. D., Klinger, L. G., Lee, J. M., Palardy,N., Gilmore, T., & Bodin, S. D. (2003). Examining the effectiveness of an outpatient clinic-based social skills group for high-functioning children with autism. Journal of Autism and Developmental Disorders, 33, 685–701.
Bauminger, N. (2002). The facilitation of social-emotional understanding and social interaction in high-functioning children with autism: Interventionoutcomes. Journal of Autism and Developmental Disorders, 32, 283–298.
Bernard, J., Harvey, V., Potter, D., & Prior, A. (2001). Ignored or ineligible? The reality for adults with autism spectrum disorders. London: The National Autistic Society.
Bledsoe, R., Myles, B. S., & Simpson, R. L. (2003). Use of a social story intervention to improve mealtime skills of an adolescent with Asperger syndrome. Autism, 7, 289–295.
Charlop, M. H., & Milstein, J. P. (1989). Teaching autistic children conversational speech using video
modeling. Journal of Applied Behavior Analysis, 22, 275–285.
Charlop-Christy, M. H., & Kelso, S. E. (2003). Teaching children with autism conversational speech using a cue card/ Social Skills 22 B E YO N D B E H A V I O R written script program. Education & Treatment of Children, 26, 108–127.
Dawson, G., Meltzoff, A. N., Osterling, J., Rinaldi, J., & Brown, E. (1998). Children with autism fail to orient to naturally occurring social stimuli. Journal of Autism and Developmental Disorders, 28, 479–485.
Dawson, G., Toth, K., Abbott, R., Osterling, J., Munson, J., Estes, A., et. al. (2004). Early social attention impairments in autism: Social orienting, joint attention, and attention to distress. Developmental Psychology, 40, 271–283.
Gray, C. (1993). The original social story book. Arlington, TX: Future Horizons.
Gray, C. (2000). The new social stories book: Illustrated edition. Arlington, TX: Future Horizons.
Gray, C. (2004). Social stories 10.0: The new defining criteria and guidelines. Jenison,MI: Jenison Public Schools.
Gray, C. A., & Garand, J. D. (1993). Social stories: Improving responses of students with autism with accurate social information. Focus on Autistic Behavior, 8, 1–10.
Greenwood, C. R., Delquadri, J., & Carta, J. (1988). Classwide peer tutoring. Seattle,WA: Educational Achievement Services.
Gutstein, S. E., & Whitney, T. (2002). Asperger syndrome and the development of social competence.
Focus on Autism and Other Developmental Disabilities, 17, 161–171.
Handlan, S., & Bloom, L. A. (1993). The effect of educational curricula and modeling/coaching on the interactions of kindergarten children with their peers with autism. Focus on Autistic Behavior, 8, 1–11.
Ivey, M. L., Heflin, L. J., & Alberto, P. (2004). The use of social stories to promote independent behaviors in novel events for children with PDD-NOS. Focus on Autism and Other Developmental Disabilities, 19, 164–176.
Kamps, D. M., Barbetta, P. M., Leonard, B. R., & Delquadri, J. (1994). Classwide peer tutoring: An integration strategy to improve reading skills and promote peer interactions among students with autism and general education peers. Journal of Applied Behavior Analysis, 27,49–61.
Table 1 PUBLISHED RESEARCH ON SOCIAL SKILLS INTERVENTIONS FOR
HFA AND ASPERGER SYNDROME
Author Year N Design Intervention(s) Results Adams et al. 2004 1 ABAB Social storiesParent training Behaviors improved Ivey et al. 2004 3 ABAB Social stories Parent training Increased participation
skills
Solomon et al. 2004 18 Pre-post Social skills group Parent training Parent reported success, but limited
generalization
Webb et al. 2004 10 Multiplebaseline Social skills group Skills improved, but not generalized to school
Barry et al. 2003 4 Pre-post Social skills group Peer coaching Skills improved, but limited generalization
Bledsoe et al. 2003 1 ABAB Social stories Decreased spills and increased mouth wipes Charlop- Christy &
Kelso 2003 3 Multiple baseline Cue card Parent training Improved conversational speech Keeling et al. 2003 1 Multiple baseline Cue card Reduced inappropriate behaviors and results generalized Bauminger 2002 15 Pre-post Social skills group Peer coaching Parent training Skills improved; parents and teachers noted social skills gains Lorimer et al. 2002 1 ABAB Social stories Parent training Reduced tantrums and
interruptions Scattone et al. 2002 3 Multiple baseline Social stories Reduced levels of inappropriate behaviors Rogers & Myles 2001 1 Case study Social stories Anecdotal reports of improved behaviors Smith 2001 15 Case study Social stories Parent training Parent reports positive,results anecdotal
Thiemann & Goldstein 2001 5 Multiple baseline Social stories Targeted behaviorsimproved
Kamps et al. 1998 2 ABAB Peer tutoring Increased interactions,but quality not assessed
Kamps et al. 1994 3 Multiple baseline Peer coaching Interactions increased,but quality not assessed
Handlan & Bloom 1993 3 Multiple baseline Peer coaching Increased interactions and positive parent report
Kamps et al. 1992 3 Multiple baseline Social skills group Peer coaching Social interactions and behavior improved
Charlop & Milstein 1989 3 Multiple baseline Written script Conversations improved and results generalized
Williams 1989 10 Pre-post Social skills group Positive anecdotal reports
Mesibov 1984 15 Pre-post Social skills group Positive anecdotal reportsSocial Skills S P R I N G 2 0 07 23 BB BeyondBehavior B
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Treatment of Children, 21, 107–134.
Kamps, D. M., Leonard, B. R., Vernon, S., Dugan, E. P., Delquadri, J. C., Gershon, B., et. al. (1992). Teaching social skills to students with autism to increase peer interactions in an integrated first-grade
classroom.
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Simpson, R. L. (2003). Using the power card strategy to teach sportsmanship skills to a child with autism. Focus on Autism and Other Developmental Disabilities, 18, 105–111.
Klin, A. (2000). Attributing social meaning to ambiguous visual stimuli in higherfunctioning autism and Asperger syndrome: The social attribution task. Journal of Child Psychiatry and Psychology, 41, 831–846.
Klin, A., Volkmar, F. R., & Sparrow, S. S. (2000). Asperger syndrome. New York: The Guilford Press.
Lorimer, P. A., Simpson, R. L., Myles, B. S., & Ganz, J. B. (2002). The use of social stories as a reventative behavioral intervention in a home setting with a child with autism. Journal of Positive Behavioral Interventions, 4, 53–60.
Mesibov, G. (1984). Social skills training with verbal autistic adolescents and adults: A program model. Journal of Autism and Developmental Disorders, 14, 395–404.
Mundy, P., & Burnette, C. (2005). Joint attention and neurodevelopmental models of autism. In Volkmar, F.
(Ed.), Handbook of autism and pervasivedevelopmental disorders (pp. 650–681).
Hoboken, NJ: John Wiley. Mundy, P., & Crowson, M. (1997). Joint attention and early social communication: Implications for research on intervention with autism.Journal of Autism and Developmental
Disorders, 27, 653–656.
Myles, B. S., & Simpson, R. L. (2001). Understanding the hidden curriculum: An essential social skill for children and youth with Asperger syndrome. Intervention in School and Clinic, 36, 279–286.
National Research Council. (2001). Educating children with autism. Washington, DC: National Academic Press.
Painter, K. (2003, June 18). Autism now diagnosed early. USA Today. Retrieved December 12, 2004, from http://www.usatoday.com/news/health/2003-06-18-autism-usat_x.htm.
Rogers, M. F., & Myles, B. S. (2001). Using social stories and comic strip conversations to interpret social
situations for an adolescent with Asperger syndrome. Intervention in School and Clinic, 36, 310–313.
Reynhout, G., & Carter, M. (2006). Social Stories™ for children with disabilities. Journal of Autism and Developmental Disorders, 36, 445–469.
Sansosti, F. J., Powell-Smith, K. A., & Kincaid, D. (2004). A research synthesis of social story interventions for children with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 19, 194–204.
Scattone, D., Wilczynski, S. M., Edwards, R. P., & Rabian, B. (2002). Decreasing disruptive behaviors of children with autism using social stories. Journal of Autism and Developmental Disorders, 32,535–543.
Smith, C. (2001). Using social stories to enhance behaviour in children with autism spectrum difficulties.
Educational Psychology in Practice, 17, 337–345.
Sofronoff, K., Leslie, A., & Brown, W. (2004). Parent management training and Asperger syndrome: A randomized controlled trial to evaluate a parent based intervention. Autism, 8, 301–317.
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for high-functioning autism, Asperger’s syndrome, and pervasive developmental disorder NOS. Journal of
Autism and Developmental Disorders, 34,649–668.
Sweeney, D. P., & Hoffman, C. D. (2004). Research issues in autism spectrum disorders. In R. B. therford, Jr., M. M.Quinn, & S. R. Mathur (Eds.). Handbook of research in emotional and behavioral disorders (pp. 302–317). New York: The Guilford Press.
Thiemann, K. S., & Goldstein, H. (2001). Social stories, written text cues, and video feedback: Effects on social communication of children with autism. Journal of Applied Behavior Analysis, 34(4), 425–446.
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Webb, B. J., Miller, S. P., Pierce, T. B., Strawser, S., & Jones, W. P. (2004). Effects of social skills instruction for high-functioning adolescents with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 19, 53–62.
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TOUGH LOVE PROGRAM

TOUGH LOVE PROGRAM FOR PARENTS TROUBLED BY UNACCEPTABLE ADOLESCENT BEHAVIOUR

TOUGHLOVE philosophy is explained in the Parent Manual, which every parent receives when they become a member of a TOUGHLOVE group.

How we work
  • We are a parent support group – parents meet for peer support.
  • We deal in behaviour, not in emotions, even though emotions are considered and respected.
  • We do not act as professional counsellors - each group can recommend helpful professionals from their own resource lists.
  • We have no affiliations with any religious, or political groups.
  • We can give you no immediate answers to your problems, what we can do is show you that you are not alone, that and you have rights and worth and deserve to be treated with respect.
  • We have a “process for change” that you can use as a guide. We offer supportive confrontation and selective support to help you to make changes - first for yourself and your wellbeing - then for your teenager. We give no guarantees.
  • We do not tell you what to do. We can give suggestions, hope and sharing. There are no prescriptions: you make your own plans and get support from the group to follow through with your decisions. If you don't know what to do we can help brainstorm and provide our collective experience.
We ask three things of you
  1. That you use the TOUGHLOVE materials so we are all speaking the same language.
  2. That you allow yourself time to see how TOUGHLOVE works. Please plan, initially, to come to at least six consecutive weekly session.
  3. And because we are a support group, not a service, that you give back support to others when you can.
What is TOUGHLOVE?
  • TOUGHLOVE is a non-profit, educational organisation offering self-help materials to parents, kids in trouble and the professionals working for them... it works!
  • TOUGHLOVE is an effective self-help program for the parents of unruly young people.
  • We empower parents and young people to accept responsibility for their actions and to stop destructive behaviours.
  • We help parents to regain control of homes and lives, making communities safer places in which to live.
  • TOUGHLOVE is a combination of philosophy and action which, together, can help you gain positive control of your home again.
  • TOUGHLOVE is a network of parents helping kids – of parents and professionals working together – to bring change into the lives of young people.
What TOUGHLOVE is not
  • TOUGHLOVE does not advocate or support physical or verbal abuse.
  • TOUGHLOVE does not advocate or support kicking kids out – we give our kids options that protect their safety and our responsibility, even though the reality is that they may not choose our options.

Assessing your situation
Look at the following issues, or printout and fill in one of the Crisis Assessment forms, below.

AT HOME
  • You and your spouse argue about your teenager’s behaviour
  • You have withdrawn from your spouse
  • Your spouse has withdrawn from you
  • You have not recently had a peaceful nights sleep
  • You hate to hear the phone ring when your teenager is not home
  • You or your spouse lost time from work because of your teenager
Has your teenager come home and missed dinner:
  • High?
  • Unreasonably late?
  • Drunk?

Has your teenager run away
  • Overnight?
  • For two days?
  • For a week?
  • For more than a week?
Has your teenager been violent:
  • Verbally?
  • Physically to the house or furniture?
  • Physically to anyone in the family?
  • Physically to other people in the community?
  • In school?
  • With the police?
AT SCHOOL Has your teenager:
  • Been lazy?
  • Absent without your knowledge?
  • Missed classes?
  • Been suspended?
  • Have you been called by the school?
WITH THE LAW Has your teenager:
  • Received a summons?
  • Received fines or tickets?
  • Been involved in accidents?
  • Been charged with drug incidents?
  • Been charged with drinking incidents?
  • Been arrested?

What is your assessment?
Do you want things to stay as they are, or are you ready to change?!


How many items have you ticked?

Are you satisfied with the way things are?

Do you believe that a crisis may be developing?

Do you believe that you are in crisis now?


We believe that if you have ticked two areas in the home category, two areas in the school category and one area in the legal category then YOUR CRISIS IS BUILDING.

If you have ticked more areas then YOU ARE ALREADY IN CRISIS.

DON’T FEEL BAD, GET MAD!
THEN USE YOUR ANGER TO MAKE CONSTRUCTIVE CHANGES.

http://toughlove.org.au/index.htm

(07)3856 3211

Sensory systems differences

Hypersensitivity and Hyposensitivity (back) Autistic people can either be hypersensitive or hyposensitive to stimuli in any of the sensory systems. Many autistic people experience both extremes in the same sense - they may be hypersensitive at one point in time and then hyposensitive at another - this is known as inconsistency of perception.

hyper-sensitivity( high)

Tactile (touch) - Refusal to do p.e in the hall as the sensation of bare feet on the wooden floor is to over whelming----

Visual (sight) unable to take part in an art lesson as the bright colors are "hurting my eyes"

Auditory(hearing) concentration is affected because the ticking of the clock is distracting,

Gustatory( taste) Serverly limited diet as many foods have an over powering flavor and are rigorously avoided

Olfactory (smell) Being unable to sit next to a particular child because of the smell of the shampoo is distracting

Vestibular( balance)  Finds it difficult to make some movents in p.e and sports

Proprioception (body awareness) Difficulty with some fine motor skills eg, buttons

HYPO-sensitivity (low)

Tactile (touch) -Stabs any object with a sharp end repeatedly into own arm but appears to feel no pain

Visual (sight) Looks sideways at objects with peripheral vision and complains that central vision"makes it blurred"'

Auditory(hearing) not responding to the whistle to signal the end of play as he dose not
acknowledge certain sounds despite normal hearing

Gustatory( taste)Eats anything- soil,grass,paper,his pencil ect.

Olfactory (smell) Licks things that are new to him

Vestibular( balance) needs to rock spins or swing his body frequently

Proprioception (body awareness) often bumps into people and furniture

PDD-NOS Symptoms

Nov 11th, 2009

PDD-NOS belongs is a type of autism spectrum disorder. Pervasive Developmental Disorder Not Otherwise Specified is a disorder that looks like autism but does not fit all the symptoms. Although this disorder can be seen at e very young age, most often it is diagnosed in toddlers. PDD-NOS symptoms are much a like autism but come in a milder form. You could say that Pervasive Developmental Disorder Not Otherwise Specified is a form of mild autism.

Because it is also a spectrum disorder, all children diagnosed will show different PDD-NOS symptoms. The two symptoms that brings the most problems in social functioning are social interaction with other children and communicating problems with parents.

Autistic traits are noticeable at a very young age. It is aid that even babies show some symptoms of autistic traits. It is not always noticeable but they often do not like to be cuddles and don’t make eye contact. This can be very frustrating for young parents. However, the diagnosis is mostly made when toddlers are 3 or 4 years old. Strange behavior is not always apparent visible. They could play normally with other children and like to play on their own. However, they also don’t have any trouble being separated from their parents or talking to strangers.

DD-NOS comes in a severe form and in a milder form. Children with milder PPD-NOS symptoms often want to make friends or interact with them. However, they often act a bit strange compared to their peers and do not know how to make new friends. When they grow older they often stay close to their parents and other people that are around but they are not well able to make other friends.

Communication is frequent the biggest problem for children with PDD-NOS. It already starts when they were babies and were not able to babble and when they grow older they speak less often than is considered normal. Because of this they have troubles learning new words and their vocabulary is not as large as in a normal development.

Besides communication they could also have problems with recognizing facial expressions and emotions. They don’t know how to act when someone is laughing or crying because they don’t fully understand the meaning of that behavior. Another problem is that they do not understand figural speech. They think rationally and don’t understand jokes or sarcastic remarks.

Just like in autism, children with PDD-NOS symptoms often stick to one topic when they are communicating. They will speak of a topic that they know off.

Although these children have difficulties adapting and grow up normally, a lot is achievable with proper education and  treatment. Therefore it is important that if you recognize these symptoms to talk to a doctor and ask for advice.

MELATONIN

Melatonin and sleep

Melatonin (5-methoxy-N-acetyltryptamine) is a hormone that occurs naturally in human body.
At night, when we are sleeping, melatonin is secreted by a tiny, pea-sized organ at the centre of our brains called the pineal gland to help our bodies regulate our sleep-wake cycles.
Melatonin regulates the body's circadian rhythm, our internal 24-hour time-keeping system which plays an important role in controlling when we fall asleep and when we wake up.
Melatonin has been used successfully in the treatment of many sleep related disorders.
Darkness, stimulates the release of melatonin and light suppresses its activity in our nervous system. See also Sleeping Conditions.

Melatonin, sleep and age

While our pineal gland is capable of producing melatonin for the entirety of our lives, scientists have observed evidence which suggests melatonin production slows down as we age.
Scientists believe this is why younger people tend to have less difficulty with sleeping than older people.

Melatonin as a supplement

In addition to occurring naturally in the body, melatonin has also been synthesized in the laboratory and is available as a supplement without a prescription in health food and drug stores in the United States for several years, but Melatonin is not regulated by any government agency.
Because Melatonin is contained naturally in some foods, the U.S. Dietary Supplement Health and Education Act of 1994 allows Melatonin to be sold as a dietary supplement, which do not need to be approved by the Food and Drug Administration (FDA) or controlled in the same way as drugs.
However, since melatonin products have not been approved by the FDA, their safety, purity and effectiveness can't be guaranteed.

Melatonin as a sleep aid

When thinking about using melatonin as a sleep aid there are several issues that everyone should be aware of.
First, although Melatonin is available over the counter and has been used for several years without instances of severe side effects, the use of melatonin has not yet been confirmed to be safe by a regulatory body authorized to do so.

Of particular concern is the lack of information regarding melatonin's interaction with other medications.

Melatonin dosage

The proper dosage varies greatly from person to person. Pills are available in a range of doses (commonly from 1mg to 3mg). It is typically suggested to begin with a small dose (around 1mg) and work your way up to larger doses if necessary.

When taking Melatonin to assist with the quality of your sleep, Melatonin should be taken at nighttimes. It is usually most effective when taken about thirty minutes prior to going to sleep.

Melatonin - a treatment for jet lag?

Melatonin is particularly effective in treating delayed sleep-phase disorders, and has also been very useful in treating and preventing jet lag and jet lag's resulting insomnia.

If you are travelling across multiple time zones and wish to use melatonin to counteract the effects of jet lag, you may want to take a dosage prior to getting on your flight and a higher dosage prior to going to bed.
If you commonly sleep during the night, melatonin should not normally be taken during the day, and vice versa, due to melatonin's role in adjusting the body's internal clock.

Melatonin warning

Melatonin is for adult use only. Do not use Melatonin for children, teenagers, or pregnant or lactating women. If you have an auto-immune disease, diabetes, a depressive disorder, epilepsy, leukaemia or a lymphoproliferate disorder, or are taking an MAO inhibitor, consult a physician before taking Melatonin.

Coloured light and sleep - Blue Light Treatment

Researchers Use Blue Light to Treat Sleep Disturbances in the Elderly Seniors receive the experimental light treatment while playing cards in the residence dining room.

In a recent pilot study, scientists at the Lighting Research Center demonstrated how exposure to blue light can reduce sleep disturbances and increase the likelihood of stable, consolidated sleep in seniors. The study included subjects with Alzheimer’s disease (AD), an illness often accompanied by severely irregular sleep/wake patterns, as well as those without dementia who simply have trouble sleeping.
The occurrence of sleep disturbances increases as we age. Researchers have long believed the disturbances often result from a disruption of the body’s circadian rhythms—biological cycles that repeat approximately every 24 hours, including the sleep/wake cycle.

“Our circadian rhythms are synchronized by the 24-hour light/dark cycle, and exposure to light and dark stimuli help to set the body’s internal ‘master clock’ to match the solar day,” says LRC light and health researcher Mariana Figueiro, Ph.D., principal investigator of the sleep study. “Light stimulus travels through the retina, the light-sensitive nerve tissue lining the back wall of the eye, to reach the master clock in the brain. However, a combination of age-related changes may influence the amount and magnitude of light/dark stimulus affecting the circadian system.”

The LRC designed the luminaires for the study using LEDs donated by Nichia.
Age-related influences on the circadian system

As we age, the lens in the eye thickens and the pupil shrinks, reducing the amount of light passing through to the retina. Moreover, as we age, the circadian system may require a stronger light/dark stimulus due to deteriorating neural processes in the brain. Finally, adoption of an indoor lifestyle can create an environment with little variation in light/dark intensity, resulting in a weak light/dark stimulus to the circadian system.
“Physical changes to the eye, neural changes in the brain, and lifestyle changes can mute the light/dark signal sent to the body’s master clock, presumably contributing to major sleep disturbances in seniors,” said Mark Rea, Ph.D., LRC director and co-principal investigator on the pilot study. “There needs to be a distinct, repeated pattern of light and dark to tell the circadian system the solar time.”

The power of blue

Daylight is a mixture of wavelengths dominated by short, visible wavelength light that, in isolation, gives a blue visual sensation, like the blue sky. In fact, according to Rea, blue sky is the best stimulus for the circadian system.

“Blue sky is ideal for stimulating the circadian system because it’s the right color and intensity, and it’s ‘on’ at the correct time for the right duration—the entire day,” said Rea.
Figueiro agrees that blue light is the most effective and efficient at stimulating the circadian system. However, she explains that it isn’t just the color that is important, but rather the entire 24-hour pattern of light intensity, spatial distribution, timing, and duration, all in combination with the color.

Exposure to other light colors, as well as exposure to white light, can stimulate the circadian system, but it may take longer to get the desired response and the intensity required may cause visual discomfort, according to Figueiro.

The LRC research team set out to demonstrate that exposure to blue light, followed by darkness at bedtime, would create a light/dark pattern that the circadian system would recognize and react to.

Details of the pilot study

The research team studied the effects of blue-light treatment on seniors at a skilled nursing facility in upstate New York. In the four-week study, the residents were exposed to tabletop LED luminaires for two hours every day from 6:30 p.m. to 8:30 p.m.

For the first two weeks, one group composed of both AD and non-AD residents was exposed to blue LEDs, while another group of both AD and non-AD residents was exposed to red LEDs, a condition introduced as a placebo control. While the circadian system responds best to blue light, it is essentially non-responsive to long-wavelength radiation (red light), according to Figueiro.

After a short break, the second two-week phase of the experiment began. The residents exposed to blue light in the first phase were exposed to red light in the second phase, and vice versa.

Blue-light treatment results in longer sleep intervals

Over the course of the experimental light treatment, the research team analyzed the percentage of time the subjects slept between midnight and 6 a.m. The study showed statistically significant increases in sleep after blue-light treatment during this period for all subjects.

The non-AD subjects were found asleep 90 percent of the time between midnight and 6:00 a.m. after blue light exposure and only 67 percent of the time after red light (placebo) exposure. The AD subjects exposed to the blue-light treatment were found asleep 67 percent of the time compared to AD subjects exposed to the placebo treatment who were found asleep only 54 percent of the time.

The non-AD subjects’ stronger response to the blue-light treatment was expected, according to Figueiro, as AD patients have more fragmented sleep patterns than healthy older adults.

Next steps

Figueiro had previously studied the effects of blue light exposure on the sleep efficiency of AD subjects in 2002, but this recent pilot study was the first time she tested the theory on non-AD subjects having sleep problems.

“It was exciting to replicate our earlier study and expand our research to include non-AD subjects in order to demonstrate that blue-light treatment can have a significant, positive effect on the sleep efficiency of older adults,” said Figueiro. “The consistencies in our research support the theory that blue light can be a powerful, non-pharmacological treatment for sleep disorders in seniors and should be considered in the design and operation of senior housing.”

The LRC is pursuing additional funding for further research on the subject and hopes to motivate manufacturers to design luminaires that can be attached to glasses, television sets, or computer screens for the purpose of providing light treatment for those with sleep disorders, according to Rea.

The study was sponsored by the Alliance for Solid-State Illumination Systems and Technologies (ASSIST). The LEDs were provided by Nichia America Corp., and the luminaires were custom-built by the LRC.

About the LRC

The Lighting Research Center (LRC) is part of Rensselaer Polytechnic Institute and is the leading university-based research center devoted to lighting. Founded in 1988, the Lighting Research Center has built an international reputation as a trusted and reliable source for objective information about lighting technologies, applications, and products. Its mission is to advance the effective use of light and create a positive legacy of change for society and the environment.

Interview with Temple Grandin

by Joan Raymond
Articles ► Education
Posted by Kelly Green on March 18, 2011

Temple Grandin on her struggles and stardom
Msnbc.com talks to autism advocate about a different kind of life

Author, scientist and professor Temple Grandin is portrayed by actress Claire Danes in the upcoming HBO film, “Temple Grandin.” (Chris Pizzello / AP)

By Joan Raymond | MSNBC

Temple Grandin knows she’s different. But she wouldn’t have it any other way. In 1950, Grandin was diagnosed with autism. The disorder, seen in about 1 in 110 U.S. kids, spans a range of complex neurodevelopmental problems: an inability to make social connections, language difficulties and bizarre, repetitive behaviors. There is no known cause or cure. Some children may have a mild form of the disorder, yet have difficulties holding down a job in adulthood. Others may never be able to live on their own.
And some, like Grandin, defy the odds.

Grandin is a professor of animal science at Colorado State University, a noted lecturer, best-selling author and an autism advocate. Her designs for creating a more humane livestock slaughter process earned her recognition from People for the Ethical Treatment of Animals.

Now actress Claire Danes is playing Grandin in an HBO movie airing on Saturday. The film “Temple Grandin” is based upon Grandin’s memoirs, “Emergence” and “Thinking in Pictures.” That’s heady stuff for a woman who admits that at age 62 she still relates better to animals than she does to humans. She talks to msnbc.com about how autism affects her life, a life that she believes is different, but not less.

Msnbc.com: Where do you fall on the autism spectrum?

Temple Grandin: I am much less autistic now, compared to when I was young. I remember some behaviors like picking carpet fuzz and watching spinning plates for hours. I didn’t want to be touched. I couldn’t shut out background noise. I didn’t talk until I was about 4 years old. I screamed. I hummed. But as I grew up, I improved.

What made the difference for you?

I had people in my life who didn’t give up on me: my mother, my aunt, my science teacher. I had one-on-one speech therapy. I had a nanny who spent all day playing turn-taking games with me. For the last 30 years I’ve been on a low-dose antidepressant. I’ll never give it up. It helps with the panic attacks. The most important thing people did for me was to expose me to new things. I was so afraid to go out west to my aunt’s ranch. But the only choice my mother gave me was to go for two weeks or all summer. I wound up staying all summer. And that’s where I learned about cattle. I could relate to their behavior, their fears.

Why do you think that is?

I’m a visual thinker, not a language-based thinker. My brain is like Google Images. If someone says the word factory, most people think of a vague place. I think in detail of every factory I ever saw, like the John Deere plant in Moline. Animals are sensory thinkers, thinking in pictures, smells, sounds. They don’t think in terms of language. I don’t either.

Didn’t observing cattle give you your idea for the “squeeze machine” you developed to help autistics reduce stress?

I saw cattle held in a squeeze chute while they were waiting to get some veterinary attention. Some of the animals relaxed once pressure was applied to their bodies. I built a prototype for myself when I was 18, and found that if I used it for about 15 minutes I would feel better, calmer. Now a lot of people and programs use the machine.

What help do you think most people with autism need?

Little kids, especially ages 2 through 5, need one-on-one interaction with an effective teacher. I don’t care who that teacher is. It could be the mother, an aunt, a grandma, someone from a church, a synagogue, maybe a student. You just need someone who clicks with that kid. The worst thing you can do is nothing. You can’t let these kids sit and watch TV all day.


Actress Claire Danes in the HBO film “Temple Grandin.” (HBO)


The other thing is, teach these kids manners. I was raised in the ‘50s and ‘60s, and manners were drilled into me. I see kids [on the spectrum] today that have no manners. That’s going to hurt them. You can’t punish a child who is acting out because of sensory overload. But it’s unacceptable to see kids throwing things and slapping people. I see kids with Asperger’s [a mild form of autism] who can’t hold a job because they are constantly late. Teach kids to use an alarm clock. This is common sense and sometimes we forget about common sense. Autism is used too much as an excuse for bad behavior.

Cases of autism are rising. Why do you think that is?

Some of it is probably due to the way autism is diagnosed. I saw people on the HBO lot that probably have Asperger’s but never got a diagnosis as a child. There has been an increase in regressive autism, children who develop normally, have speech, and then lose it. I think there’s something going on with some type of environmental contaminant. Some insult is getting to the child whose genes are susceptible to autism. I think we are going to be hearing more about epigenetics and autism. With epigenetics you look at how the genome responds to the environment. How things like toxins and diet and other things turn on the switches that regulate how certain genes are expressed.

“Autism pride” or neurodiversity is a growing movement. Do you think there needs to be a “cure” for autism?

I believe there’s a point where mild autistic traits are just normal human variation. Mild autism can give you a genius like Einstein. If you have severe autism, you could remain nonverbal. You don’t want people to be on the severe end of the spectrum. But if you got rid of all the autism genetics, you wouldn’t have science or art. All you would have is a bunch of social ‘yak yaks.’

Have you gotten more social as you’ve gotten older?

I have friends now. But it’s about shared interests. We talk about engineering or animal behavior. Chit-chat bores me. I’m always sure about science. I had to learn about social cues. But I’ve learned to talk about the weather a little bit.

What was it like to see someone portray you?

It was like going in a weird time machine. The movie was set in the ‘60s and ‘70s, and I was very severe back then, very anxious. This was before I went on antidepressants for the panic. Puberty and high school were horrible for me. I spent time with Claire [Danes], and her portrayal of me back then is very authentic. She was me.

You are well known within the autism community. Are you worried about becoming a celebrity, more of a household name?

No. I think about the responsibility. There was a responsibility to get this right. I’m very pleased. The things I do, my work, it gives meaning to my life. I don’t understand people’s fascination with celebrity and all the psychodrama. What turns me on is helping a parent of an autistic child, or having someone say my work [with animals] helped them understand their dog better. Something that makes a beneficial change is what turns me on. But I did meet Steven Spielberg. He was nice. He told me he liked my book. That made me happy.

Joan Raymond is a freelance journalist whose work has appeared in Newsweek, the New York Times, MORE and Woman’s Day.
Source: http://www.msnbc.msn.com/id/35150832/ns/health-mental_health

Social Story for insects

Flying insects can look a bit weird.
When I see flying insects, sometimes I feel scared.
It's ok to feel scared. Everyone is scared of something.

When I see flying insects, I need to remember that they don’t want to hurt me.
All bugs are good for the environment and are food for other animals.
Without these bugs, some animals might die from not having anything to eat.

All insects are good.
Lady-beetles help keep our plants clean so the flowers can grow.
Ants can let us know when there is rain coming!
And stick insects eat other bugs that might annoy us like mosquitoes :)

All insects and bugs have a job to do.
My job is to remember that no insects are bad and they don’t want to hurt me.
This will help me not be so scared of them.
They are probably more scared of me because I am so big and they are so little!

Bees are even good - they collect nectar from the flowers to make honey.
I like honey.
When I eat honey or see honey, I am reminded that an insect made this and it was nice of a bee to make honey for me to eat :)

My Declaration of Self-Esteem I AM ME

by Virginia Satir

In all the world, there is no one else exactly like me
Everything that comes out of me is authentically me
Because I alone chose it - I own everything about me
My body, my feelings, my mouth, my voice, all my actions,
Whether they be to others or to myself - I own my fanatasies,
My dreams, my hopes, my fears - I own all my triumphs and
Successes, all my failures and mistakes
Because I own all of Me,
I can become intimately acquainted with me - by so doing
I can love me and be friendly with me in all my parts -I know
There are aspects about myself that puzzle me, and other
Aspects that I do not know - but as long as I am
Friendly and loving to myself, I can courageously
And hopefully look for solutions to the puzzles
And for ways to find out more about me -
However I Look and sound, whatever I say and do, and whatever
I think and feel at a given moment in time is authentically Me -
If later some parts of how I looked, sounded, thought
And felt turn out to be unfitting, I can discard that which is
Unfitting, keep the rest, and invent something new for that
Which I discarded - I can see, hear, feel, think, say, and do
I have the tools to survive, to be close to others, to be
Productive to make sense and order out of the world of
People and things outside of me - I own me, and therefore I can engineer me - I am me and
I AM OKAY

10 Things Every Child With Autism Wishes You Knew

by Ellen Notbohm

  1. I am a child with autism. I am not "autistic." My autism is one aspect of my total character. It does not define me as a person. Are you a person with thoughts, feelings and many talents, or are you just fat (overweight), myopic (wear glasses) or klutzy (uncoordinated, not good at sports)?
  2. My sensory perceptions are disordered. This means the ordinary sights, sounds, smells, tastes and touches of everyday life that you may not even notice can be downright painful for me. The very environment in which I have to live often seems hostile. I may appear withdrawn or belligerent to you, but I am really just trying to defend myself. A "simple" trip to the grocery store may be hell for me. My hearing may be hyperacute. Dozens of people are talking at once. The loudspeaker booms today's special. Muzak whines from the sound system. Cash registers beep and cough. A coffee grinder is chugging. The meat cutter screeches, babies wail, carts creak, the fluorescent lighting hums. My brain can't filter all the input, and I'm in overload! My sense of smell may be highly sensitive. The fish at the meat counter isn't quite fresh, the guy standing next to us hasn't showered today, the deli is handing out sausage samples, the baby in line ahead of us has a poopy diaper, and they’re mopping up pickles on Aisle 3 with ammonia. ... I can't sort it all out, I'm too nauseous. Because I am visually oriented, this may be my first sense to become over stimulated. The fluorescent light is too bright. It makes the room pulsate and hurts my eyes. Sometimes the pulsating light bounces off everything and distorts what I am seeing. The space seems to be constantly changing. There's glare from windows, moving fans on the ceiling, so many bodies in constant motion, too many items for me to be able to focus - and I may compensate with tunnel vision. All this affects my vestibular sense, and now I can't even tell where my body is in space. I may stumble, bump into things, or simply lay down to try and regroup.
  3.  Please remember to distinguish between won't (I choose not to) and can't (I'm not able to). Receptive and expressive language are both difficult for me. It isn't that I don't listen to instructions. It's that I can't understand you. When you call to me from across the room, this is what I hear: "*&^%$#@, Billy. #$%^*&^%$&*" Instead, come speak directly to me in plain words: "Please put your book in your desk, Billy. It's time to go to lunch." This tells me what you want me to do and what is going to happen next. Now it's much easier for me to comply.
  4. I am a concrete thinker. I interpret language literally. It's very confusing for me when you say, "Hold your horses, cowboy!" when what you really mean is "Please stop running." Don't tell me something is a "piece of cake" when there is no dessert in sight and what you really mean is, "This will be easy for you to do." When you say, "It's pouring cats and dogs," I see pets coming out of a pitcher. Please just tell me, "It's raining very hard." Idioms, puns, nuances, double entendres and sarcasm are lost on me.
  5. Be patient with my limited vocabulary. It's hard for me to tell you what I need when I don't know the words to describe my feelings. I may be hungry, frustrated, frightened or confused, but right now those words are beyond my ability to express. Be alert for body language, withdrawal, agitation, or other signs that something is wrong. There's a flip side to this: I may sound like a little professor or a movie star, rattling off words or whole scripts well beyond my developmental age. These are messages I have memorized from the world around me to compensate for my language deficits, because I know I am expected to respond when spoken to. They may come from books, television or the speech of other people. It's called echolalia. I don't necessarily understand the context or the terminology I'm using, I just know it gets me off the hook for coming up with a reply.
  6. Because language is so difficult for me, I am very visually oriented. Show me how to do something rather than just telling me. And please be prepared to show me many times. Lots of patient repetition helps me learn. A visual schedule is extremely helpful as I move through my day. Like your day planner, it relieves me of the stress of having to remember what comes next, makes for smooth transitions between activities, and helps me manage my time and meet your expectations.
  7. Focus and build on what I can do rather than what I can't do. Like any other human, I can't learn in an environment where I'm constantly made to feel that I'm not good enough or that I need fixing. Trying anything new when I am almost sure to be met with criticism, however constructive, becomes something to be avoided. Look for my strengths and you'll find them. There's more than one right way to do most things.
  8. Help me with social interactions. It may look like I don't want to play with the other kids on the playground, but sometimes it's just that I simply don't know how to start a conversation or enter a play situation. If you can encourage other children to invite me to join them at kickball or shooting baskets, I may be delighted to be included.
  9. Try to identify what triggers my meltdowns. This is termed "the antecedent." Meltdowns, blowups, tantrums or whatever you want to call them are even more horrid for me than they are for you. They occur because one or more of my senses has gone into overload. If you can figure out why my meltdowns occur, they can be prevented.
  10. If you are a family member, please love me unconditionally. Banish thoughts such as, "If he would just ..." and "Why can't she ...?" You didn't fulfill every last expectation your parents had for you, and you wouldn't like being constantly reminded of it. I didn't choose to have autism. Remember that it's happening to me, not you. Without your support, my chances of successful, self-reliant adulthood are slim. With your support and guidance, the possibilities are broader than you might think. I promise you I'm worth it.
It all comes down to three words: Patience. Patience. Patience.

Work to view my autism as a different ability rather than a disability. Look past what you may see as limitations and see the gifts autism has given me. I may not be good at eye contact or conversation, but have you noticed I don't lie, cheat at games, tattle on my classmates, or pass judgment on other people?
 You are my foundation. Think through some of those societal rules, and if they don't make sense for me, let them go. Be my advocate, be my friend, and we'll see just how far I can go.

Freelance writer and consultant Ellen Notbohm is a columnist for Autism/Asperger's Digest and co-author of 1001 Great Ideas for Teaching and Raising Children With Autism Spectrum Disorders (Future Horizons). She favors "common sense" approaches to raising her sons with autism and ADHD. She lives in Oregon.

Transition Information Check List

Transition Information Check List
Support the Student’s Transition to Primary, High School, Post School Education and Work Location

Refer to the individual student’s transition needs when considering the following - individualise:

General
1.        Plan in advance: time to get to know location, people, routines etc.
2.       Visual schedules for student
3.        Photos of new environment & key people
4.        Purposeful visits to new environment
5.        Create list & video of success strategies
6.        Social Stories regarding new locations
7.        ‘Hot Tips’ document
8.        Safety awareness
9.        Student Profile
10.     All student information passed to next setting

Home to Kindi
11.     Communication between Mum/caregiver & education staff
12.     Arrange for purposeful visits for initially short durations to the new environment. Gradually extend the duration of the visits, the locations visited and numbers of people involved in the visits.
13.     Identify the teaching staff and where applicable the teaching assistant(s) well in advance of the end of the current school year, and prior to the move to the new environment.
14.     Mum speak positive of Kindi
15.     Photos of Kindi and activities, review the photos with the student on a regular basis
16.     Uniform practice
17.     Planned structured short visits to Kindi
18.     Photos of child in Kindi & activities
19.     Photos of key education staff
20.     Visual schedule favorite activities (symbol set)
21.     Social story of Kindi (activities)
22.     Favourite tangible items (toy, sheet, pillow, food)
23.     Buddy system
24.     Identify and determine concerns team members have and determine the action plans to satisfy those concerns

Kindi to Prep/Primary
25.     Communication between Mum/caregiver & education staff
26.     Mum speak positive of Kindi
27.     Photos of Kindi
28.     Uniform practice
29.     Planned structured short visits to Kindi
30.     Photos of child in Kindi & activities
31.     Photos of key education staff
32.     Visual schedule favourite activities (symbol set)
33.     Social story of Kindi (activities)
34.     Favourite tangible items (toy, sheet, pillow, food)
35.     Photo of family members (laminated & available)
36.     Consider individualized staggered start & time reduction
37.     Reinforcement plan
38.     Student Profile: ‘Hot Tips’ & Preference Profile completed
39.     Buddy systems
40.     Develop a positive and trusting relationship between the student and individuals from the new team.
41.     New team members to visit the current environment to see modelled support strategies, as well as be coached in implementation of those strategies. This time period will allow the new environment staff to become familiar with the focus student.
42.     Current team members could create a video of a ‘day in the life’ of the student. The new team members will need to view the videos and have time to discuss the significance of the entered video segments with the current team members.
43.     Provide the new team members and ensure they are familiar with all support plans, positive behaviour strategies and crisis management plans along with clear observable and measurable definitions of behaviour of concern where needed
44.     Provide the student visual support of successful behaviour strategies e.g. ‘Good Plans’ reference
45.     Classroom environments are to be prepared as much as possible in support of the student’s best learning and working environments and with consideration of the student’s sensory needs
46.     Provide the student with a photographic and written step-by-step descriptive story of his/her ride to the new environment.

Primary to Secondary High School
47.     Team updates and confirms the education priorities and goals for the student
48.     Identify the best educational situations/environments which will support the student’s ability to successfully reach his/her education al goals
49.     Identify ASAP the student’s classrooms, plus any other location which will support his/her education as determined by the team
50.     Involve the new team members from the new classroom, or new school, or new work site location during the transition planning meeting, ensuring communication and input from those team members in addition to the present team members
51.     Identify what needs to be done as a part of the student’s transition plan, by what date and who is responsible to complete the identified task

Secondary High School
52.     Provide transition opportunities for Student e.g. structured exploration of the school, unstructured exploration of the school, discuss which classes occur in which buildings.
53.     Identify where the student will store his/her personal items (jacket, lunch bag etc.)
54.     Provide the student a school map and how to navigate through the school website
55.     Provide a colour-coded/visual timetable for Student and talk through which classes he will be attending. Later years negotiated timetables.
56.     Discuss the purpose of the SEU and provide clear information about where it is, when Student can access it and what he is able to do in the unit. Meet with SEU case managers to discuss priorities.
57.     Provide Student with simple and concise information regarding school rules (possibly with visual cues) and behavioural expectations (possibly with visual cues).  This should be provided in an easy to access format for Student’ own use.
58.     Provide Student with an opportunity to meet all of his teachers (one-on-one) to discuss what he will be learning in their class.  Encourage discussion regarding `break’ strategies for Student in each classroom.  Support Student’ understanding of classroom expectations by looking at the books he will require for each class with each teacher.  Identify the teacher’s and their classes on Student’ timetable.
59.     Provide Student with support to attend his first classes.  Provide him with de-briefing opportunities.
60.     Provide all teacher’s working with Student, with information about ASD.
61.     Provide Student with digital camera to take `walk through’ his timetable and take photographs of classes.  Using these visuals a social story could be created to help Student feel more confident about where he needs to be and when.  (This has been initiated by AVT’s).
62.     Use copies of the photographs and easel paper for Student to make a large visual timetable overview of his week.
63.     Use the photos to create a social story to support Student’ understanding of the school expectations.
64.     Provide all teachers working with Student with copies of his IEP and Risk management documents.
65.     Encourage teacher’s not to ask Student questions when he is first attending class (as this will increase his stress levels), and to provide him with unobtrusive support throughout the lessons.  Student should also be given a choice of where to sit initially (although it may be beneficial to encourage him to sit beside a quiet, helpful student if possible).  Teacher’s should not highlight what work Student is/is not completing initially.
66.     Student should be provided with appropriate strategies of what to do if he is feeling stressed.  (If possible a quiet permanent place should be arranged for Student to move to at these times – adult supervision will be necessary).
67.     Use the timetable to encourage Student to verbally identify what is coming next.
68.     Implement a mentor/buddy to support Student’ progress.
69.     Implement a friendship program for Student.
70.     Explore potential job interests: Supported employment, internships, job shadowing, volunteer work
71.     Plan course work to meet job interests

Secondary High School – Higher Education
72.     Communication between work site/post secondary high school and higher education is essential
73.     Bring the student to visit the new environment with a motivating activity purpose e.g. visit the music room, oval, tuck shop with a specific purpose/mission, which s/he likes and knows what is coming
74.     Identify accommodation needs for tertiary education
75.     Consider funding sources
76.     Explore potential job interests: Supported employment, internships, job shadowing, volunteer work
77.     Plan course work to meet job interests

Secondary High School/Higher Education – Work/Adult Life
78.     Contact as needed with employment support agencies
79.     Plan course work if applicable to meet job interests
80.     Organize accommodation if outside family home
81.     Contact supported living accommodation agencies if required
82.     Record on visual schedule appointments & function of appointments
83.     Resume & job interview support & practice

Outside of School Hours
84.     Identify student’s interests & match with recreational, after school hours and graduation/school leaving
85.     Contact recreation organizations & community group options
86.     Support  buddy/friendship groups formally and/or informally organized

Visual Examples
87.     Time table/schedule
88.     Day Planner
89.     Calendar
90.     Home/school communication book
91.     Classroom rules
92.     Equipment lists
93.     tangible item(s) representing next activity/environment to take from one
environment to next
94.     visual timer, watch, clock
95.     ‘5. 4. 3. 2. 1’ / green, yellow red cards
96.     School map
97.     Photos of key people
98.     Success rules
99.     Many more visual supports – individualize for your student

General Life Issues
100.  Moving home
101.  Changes in family dynamics
102.  Death

Reminder
103.  Visual supports
104.  Plan ahead