Thursday, March 29, 2007
Regardless of the cause(s) of autism spectrum disorder, its behavioral symptoms have many common components, which all interfere with effective learning.
Five main types of maladaptive behavior performed by those with autism spectrum disorder are stereotypical, ritualistic, self-injurious, tantrum, and aggressive behaviors.
Stereotypical behavior, is defined as repetitive movement of the body or objects , and can involve any of the sensory pathways. Examples of stereotypical behavior are hand flapping, tapping ears, scratching, rocking, mouthing, sniffing, and other such behaviors.
Stereotypical behavior stimulates the senses while causing feelings of internal pleasure, due to a simultaneous release of beta-endorphins in the brain. It serves to calm the individual, but focuses his or her attention inwardly and away from attention to learning.
Student E does hand movements( like that of "Incy Wincy Spider" hand movement when singing the song),tongue rolling,feet shaking one after the other when he listens to the teachers.Specially during Math Subject,when I first came in.I taught him to sit on his hands to avoid the hand movement and it makes him focus on listening.When it doesnt help I ask him if he wants "time out".When he says "yes" I bring him to an adjacent room until he calms down.I tell him "tell me when you are ready to go back and join your classmates".
After some time when I see him starting to get restless,I pull him out before he starts the behavior.bring him to another room and he tells me when he wants to go back to join the whole class.But during this time I do not allow him to do anything but sit and relax until he is ready to go back to classroom.When I first came in I when he is not ready to join the class which is most of the day,he would get a book to read while in another room.He would of course get a book of his choice.This did not help even a bit.It encouraged him to go on with the behaviors because he would be able to choose a book and read it.No need to work.This is what we call stereotypical behavior.
To stop this I gave him a choice on listening to the teacher and no hand movements or unnecessary noise or movement or go to the other room and calm down.Later on he would choose to stay with the rest of the group and avoid going to the other room.
Ritualistic behavior is an attempt to regulate something concrete and controllable because the person cannot identify and control some real psychological problem...way of subduing ideas or feelings that seem too hideous to be accepted...symbolically removing something that is experienced as a dire threat.
Essentially, it is an "act of terror".It interrupts life with compulsions to act in maladaptive ways, and creates feelings of helplessness and anxiety. Compulsions may be caused by a lack of serotonin in the brain. People engaging in ritualistic behavior show indifference to others’ needs, going to great lengths to perform rituals in a maladaptive attempt to control both their environment and the actions of others within it.
Self-injurious behavior is "any behavior that can cause tissue damage, such as bruises, redness, and open wounds", for example, head banging, self biting, or hand scratching or "any behavior that results in physical injury to a child’s own body".Causational theories include the seeking of internal pleasure and release of beta-endorphins as also seen in stereotypical behavior, sub-clinical seizures, middle ear infections, or hypersensitivity to sound.
Based on my experience I have observed,that children with Autism who are not "Accepted" by the families,most have this self-injurious behaviors.One of them,I will call him "D" used to put his arms outside the jalousy window of the school when I was not looking then he would bang the window to hurt himself.His arms have calousies all over on both right and left arms,signs of former injuries he sustained.He would also bite himself until there was blood.This student has no father figure.He is not recognized by the father.He is brought up by the working mom and grandparents.
Adnan would also bang his head on the wall,and scratch himself.He is rejected by the mom herself.Its the father who loves him a lot.His mom is not at all bothered when people tell her she favors daughter over Adnan and would let him cry his heart out and not be bothered by it when she buys something for her daughter and Adnan wants one for himself.She would rather buy things for her nephews and nieces,and would let him cry because he sees them buying things and nothing for him.
Tantrum behavior is usually defined as a combination of two or more maladaptive behaviors, such as screaming, aggression, crying, dropping to the ground, and self-injurious behavior. Often, tantrums can be attributed to sensory overload, anxiety, anger, or frustration. Tantrums are often crisis-level behaviors and can be dangerous for all involved.
Student E throws a tantrum after Outdoor play which if based here and in the other articles I have read is due to sensory overload.The sun's glare hurts his eyes that causes the sensory overload.He would run and jump and scream and cry out loud after each outdoor play which made me suggest he not be allowed to go out and play after snacks.It helped as I have written in the past articles.
Adnan would curl like a fetus and cover both his ears when he is starting to have sensory overload in the malls where there is a theme park inside for children to play with.Then he would cry out loud.After awhile when i see him cover his ears,I would bring him out of the place and wait inside the car for the others.
He would also cover his ears when his sister tries to get his toy from him.Then he would cry aloud.
Aggression is an act of violence to another person or object, including hitting, kicking, biting, slapping, pinching, grabbing, and pushing. Again, often this maladaptive behavior is triggered by painful sensory stimuli, anger, frustration, or anxiety. Another factor may be extreme exhaustion. Aggression can also be a learned behavior expressed in a pattern. The key to improving classroom learning for those with autistic spectrum disorder is decoding the communicative message of maladaptive behavior, and then adapting the treatment and setting accordingly.
Adnan kicks,hits,bites and scratches when I first came in.His Ethiopian nanny had marks on her shoulders of his bites,and scratch marks on her arms.After awhile I found out a lot of these are all learned behaviors from his sister who would hit him,kick him,push,and grab his toys for no reason.The mom lets her do it so she does for fun.He also bangs his head on the nanny when he gets frustrated.At one point he learned to fight back by pushing his sister or hitting when he gets threatened.
I have never seen an Autistic child wanting to hurt anybody intentionally unless they are threatened in the case of Adnan.Most get bullied because they do not know how to fight back as doing this has to be taught to them as well.And no teacher will teach them to hurt anybody.I used to tell Adnan,"tell Baba sister hit you".
All the maladaptive behaviors described above can be an attempt to communicate discomfort or stress. Stressors may be internal, sensory, or external in nature.
Lacking the ability to use conventional signals and to consider what the listener needs to know to understand them, they instead use maladaptive behaviors, such as self-injurious behavior or echolalia to express themselves .
In addition, autism spectrum disorder can cause severe sensitivity to environmental disturbances that may seem minor to others, for example, the sound of a phone, a change in place or routine, or a change in temperature. Since they lack a more effective, reliable means of communication, those with autism may use maladaptive behavior to try to change their environment.
Maladaptive behavior may also be an attempt to draw attention to themselves or something in the environment. People with autistic spectrum disorder have difficulty using language for socialization purposes, such as social interactions, establishing joint attention, and establishing social connections Requesting an item, greeting a person, asking or answering questions, commenting, conversation, and expression of feelings all become difficult.
Monday, March 26, 2007
As they were practising today for the program,I kept on talking to him and telling him "No talking","Sit on your hands" ..this is to stop him from playing with his hands when excited.I also prepared him for whats going to happen on Wednesday.I told him "Parents will be watching all of you,your mom and dad and your classmates (I gave names) mom and dad are also coming""They will be watching you".
At one point,one of his classmates who is hyperactive started making noise,he told this classmate "L,they are watching us,dont be noisy".I was laughing when I heard what he said.
His classmates were all applauding him when he read the story he wrote about his Batangas trip with his family.Its heartwarming to see these children appreciate the effort student E has exerted for this story.Its the only story he made that is based on personal experience.They have a Writers Workshop for Literacy that made them think of a story they can write to be published at the end of the schoolyear.Before I came in as his shadow teacher I was told that he always writes stories about the books he loved to read,"Snow White" and "Cinderella".
It took quite a lot of prompting to make him write the story but he did quite well when he started writing.
Summer is coming,student E has improved a lot.Thanks to our heavenly father.Without Him I know I cannot be as effective as I am to all my students.
Thank you God!Thanks for the gift of teaching you gave me.
Today I will share with you a poem I saw about Autism.
Here it goes:
Words and Music by Elizabeth King Gerlach and Leslie King
Hidden by his face,full of ideas or just empty space
He cannot speak what’s on his mind.
Reflections in his eyes
Do they even stop to question whyI just don’t know about his kind.
Should I take his hand or should I walk away
Does he even want me to be part of his world
Where’s the lightIs there longingFor belonging?I’ll try.
Inside white rooms,knowing faces staring into the look
That they cannot understand
They want to see him smile
They want to put him into their files but He holds out against their plans.
Searching every glance
I don’t want to miss a single chance to find a path into his heart.
There’s a part of me that just see what it wants to see but I have to have a place to start.
If a wrong turn’s taken we may never know
What was hidden away on the alternate road
Where’s the lightIs there longing for belonging? I’ll try.
So put your hand in mine
You can even put your fears aside
We’ve got to find a new direction
Just give me one chanceI want to teach you how to dance
I want to make the connectionThe connectionThe connection.
Sunday, March 25, 2007
Subject: Two Choices
What would you do?
You make the choice! Don't look for a punch line; There isn't one!
Read it anyway.
My question to all of you is: Would you have made the same choice?
At a fundraising dinner for a school that serves learning disabled children,the father of one of the students delivered a speech that would never be forgotten by all who attended.
After extolling the school and its dedicated staff, he offered a question:
"When not interfered with by outside influences, everything nature does is done with perfection. Yet my son, Shay, cannot learn things as other children do. He cannot understand things as other children do. Where is the natural order of things in my son?"
The audience was stilled by the query.
The father continued. "I believe,that when a child like Shay, physically and mentally handicapped comes into the world, an opportunity to realize true human nature presents itself, and it comes, in the way other people treat that child."
Then he told the following story:
Shay and his father had walked past a park where some boys Shay knew were playing baseball. Shay asked,"Do you think they'll let me play?" Shay's father knew that most of the boys would not want someone like Shay on their team, but the father also understood that if his son were allowed to play, it would give him a much-needed sense of belonging and some confidence to be accepted by others in spite of his handicaps.
Shay's father approached one of the boys on the field and asked if Shay could play, not expecting much. The boy looked around for guidance and said, "We're losing by six runs and the game is in the eighth inning. I guess he can be on our team and we'll try to put him in to bat in the ninth inning."
Shay struggled over to the team's bench put on a team shirt with a broad smile and his Father had a small tear in his eye and warmth in his heart. The boys saw the father's joy at his son being accepted. In the bottom of the eighth inning, Shay's team scored a few runs but was still behind by three. In the top of the ninth inning, Shay put on a glove and played in the right field.
Even though no hits came his way, he was obviously ecstatic just to be in the game and on the field, grinning from ear to ear as his father waved to him from the stands. In the bottom of the ninth inning, Shay's team scored again. Now, with two outs and the bases loaded, the potential winning run was on base and Shay was scheduled to be next at bat.
At this juncture, do they let Shay bat and give away their chance to win the game?
Surprisingly, Shay was given the bat. Everyone knew that a hit was all but impossible 'cause Shay didn't even know how to hold the bat properly, much less connect with the ball.
However, as Shay stepped up to the plate, the pitcher, recognizing the other team putting winning aside for this moment in Shay's life, moved in a few steps to lob the ball in softly so Shay could at least be able to make contact.
The first pitch came and Shay swung clumsily and missed. The pitcher again took a few steps forward to toss the ball softly towards Shay. As the pitch came in, Shay swung at the ball and hit a slow ground ball right back to the pitcher.
The game would now be over, but the pitcher picked up the soft grounder and could have easily thrown the ball to the first baseman. Shay would have been out and that would have been the end of the game.
Instead, the pitcher threw the ball right over the head of the first baseman, out of reach of all team mates.
Everyone from the stands and both teams started yelling, "Shay, run to first! Run to first!"
Never in his life had Shay ever ran that far but made it to first base. He scampered down the baseline, wide-eyed and startled. Everyone yelled, "Run to second, run to second!"
Catching his breath, Shay awkwardly ran towards second, gleaming and struggling to make it to second base. By the time Shay rounded towards second base, the right fielder had the ball, the smallest guy on their team, who had a chance to be the hero for his team for the first time. He could have thrown the ball to the second-baseman for the tag, but he understood the pitcher's intentions and he too intentionally threw the ball high and far over the third-baseman's head.
Shay ran toward third base deliriously as the runners ahead of him circled the bases toward home. All were screaming, "Shay, Shay, Shay, all the Way Shay" Shay reached third base, the opposing shortstop ran to help him and turned him in the direction of third base, and shouted, "Run to third! Shay, run to third"
As Shay rounded third, the boys from both teams and those watching were on their feet were screaming, "Shay, run home! Shay ran to home, stepped on the plate, and was cheered as the hero who hit the "grand slam" and won the game for his team.
That day, said the father softly with tears now rolling down his face, the boys from both teams helped bring a piece of true love and humanity into this world.
Shay didn't make it to another summer and died that winter, having never forgotten being the hero and making his Father so happy and coming home and seeing his Mother tearfully embrace her little hero of the day!
We all have thousands of opportunities every single day to help realize the "natural order of things." So many seemingly trivial interactions between two people present us with a choice:
Do we pass along a little spark of love and humanity or do we pass up that opportunity to brighten the day of those with us the least able, and leave the world a little bit colder in the process?
A wise man once said every society is judged by how it treats it's least fortunate amongst them.
Today while I was in a friends house,we were in their patio,a 4 year old Autistic boy and his father passed by.The boy kept on pulling his fathers hands because his father was pulling him away from where we were.My friend called my attention and pointed on this boy.I looked and saw him looking at the television which at the moment is being used for sing-a-long by my friends visitors.The lyrics of the song being sang is flashed in the screen.i know this boy is non-verbal.I told the father "He is reading".Father said no,he is looking at how the words are coming out.But I do know he was reading.It has been my experience that a lot of non-verbal children with Autism can read.I'm planning to talk to the mother to tell her my observation.
Friday, March 23, 2007
Student E,I was told by regular teachers is hardest to manage after outdoor play.We have outdoor play after snacks.E would ride a favorite trike(bike with seat for passengers) during this time.He would either ride it alone or ask somebody to ride with him or ask a classmate to drive for him.
I observed what the teachers told me and yes,they were right.He would run inside after outdoor play,wash hands,drink water with much prompting because here is where he starts making noise,doing self-stimulation activities like playing with his fingers alone while grinding his teeth or making this unusual sound and/or put his fingers under his shirt while he was playing with his hands,and jumping up and down.This has accompanying tongue rolling and shoulder movements most of the time.He would also laugh out loud or cry out loud.All these comes one after the other when he is stimulated.
When I see him do these things I wonder what is causing them because after these episodes he would start shouting at the top of his voice and wont stop until after a few minutes.I try to stop him but its useless because he would do the same thing all over again.
Since this happens after outdoor,I suggested to the regular teachers that he should not be allowed to go out with the other students and see what will happen.
Whenever I see something unusual about my students behavior I try to look for answers,sometimes its a family issue,but sometimes its something about Autism that manifests which is causing the behavior.
I came accross Visual- Perceptual Processing Problem while researching on E's behaviors.
Irlen Syndrome is a type of visual-perceptual processing problem.
Most people are unaware that they have a perceptual problem.
Some of the symptoms are:
(1) Sensory Overload caused by bright lights, florescent lights, and sunlight. Lighting is stressful. The body reacts as if it is being attacked or bombarded, resulting in negative
biochemical changes. These may result in headaches, anxiety, and other physical symptoms.
(2) Environmental Distortions where the individual sees the world in a distorted fashion so that objects appear as blurry, moving, shifting, changing, or even disappearing. People may look frightening, stairs may be seen as a slide without steps, and walls and floors may swing and sway. This creates problems with sustained attention, eye contact, gross and small motor coordination, ability to interpret facial expressions, and poor social skills.
(3) Print Distortions which make learning or reading difficult. The individual may have good or even advanced reading skills but has trouble with reading comprehension, attention, strain or fatigue. Other visual activities besides reading, such as copying, handwriting and using the computer, can also cause strain or fatigue.
In most instances, this type of perceptual processing problem has a hereditary component.
Therefore, it may be possible to determine if your child has Irlen Syndrome by asking other family members if they have any of the problems listed below. Remember, most people are not aware that they have this problem or think that everyone sees things like they do.
Light Sensitivity. These individuals usually wear sunglasses, prefer dim lighting and may find fluorescent lighting and glare to be bothersome. They may find night driving to be difficult because of the brightness of the highlights from oncoming traffic.
Problems with Attention or Concentration.
There are two different reading styles.
One group prefers to read for two hours, three hours, or until they finish the book.
Individuals with Irlen Syndrome prefer to build breaks into reading. They may not read for pleasure, avoid textbook reading, or prefer to read magazines or short articles rather than books.
Experience Physical Symptoms. Those individuals who have Irlen Syndrome may become tired or sleepy and feel strain, headaches dizziness, stomachaches, or other physical symptoms. Lighting or reading, using the computer, or performing other visually-intensive activities may be causing this problem.
Many Autistic children cannot report or tell you how they feel. You may need to watch for behaviors to tell you that they are uncomfortable. Some behaviors which may alert you to this problem are rubbing eyes, squinting, looking down, looking away, or closing one or both eyes.
Has Difficulty in the Area of Depth Perception.
Problems in this area can be experienced while driving, especially changing lanes or turning left in front of oncoming traffic. Other individuals think of themselves as clumsy or uncoordinated because they bump into things, knock things over, or cannot easily catch a small ball or do other such activities.
Today I started the "no outdoor play" day.And it helped.He did not do any distracting behavior after snacks which is the time he usually does all these distracting behaviors,and was cooperative and joined his partner in finishing up a project they are preparing to present for the program on the last day of school.
His behavior is far from perfect but I think I was able to pinpoint here the reason for his most distracting behavior.This will make him work more and participate on the activities of the class for the rest of the day.
Friday, March 16, 2007
Adnan is the name of boy from Saudi. He has curly brown hair and deep brown eyes. When we first met he had with him a bag full of animal toys.
The mom and nanny later told me he would throw a tantrum if the animals were not brought with them when they go out.
Slowly I removed this by bringing lesser and lesser number of the animals until finally I told him the animals will stay in the house and he can only play with them in the house. It wasn't easy. He would cry when the animals are not in the car when he looks for them but eventually he got used to the idea and stopped looking for them in the car. Sometimes though he would put animals in his bag when he knows he is going somewhere...Children with Autism can be manipulative and stubborn just like any other kid. I would put away the animals when I see him putting them in his bag. Later on when I see him try bringing toys along with him I would ask him to put them back inthe playroom. He would smile and put the toys where they belong.
Autistic children knows when they can get away with something and knows who they can get away things with and who they will follow. Hats why with them there should be consistency with discipline
When I tried talking to him he avoided my eyes and said hi as coached by the mom. He tried handing over to me a few of the animal toys he had with him in his hands. The mom went down to fetch her 5 year old daughter in the school and Tarek cried out loud. He wanted to go with his mom. But the mom said no. I saw bruises and cuts on Tarek's face. When I asked the mom she could not say where the marks came from. She said when she came home one day it was already there...one after the other.
Autistic children do not know how to tell what happened to them or who hurt them or where they get hurt unless u teaches them how. I taught Tarek how to say how he got hurt. How? On one occasion he was running inside the house fast from one room to another without looking where he was going...he was looking on his side and looking back. He did not see the door going to another room and hit his cheek on the door. He cried. I went up to him and asked him what happened. He was crying and couldn't say what happened.
This is one problem of children with ASD (Autistic Spectrum Disorder) have...Communication.
I held his face with my two hands and made him look at me. I said u hit your face in the door because you're not looking where you're going. I showed him by pointing where he hit his face. (Be specific and clear...shorten sentence)Then I said next time look where you re going. And then I said...say “I hit my face on the door.".He did not follow me right away. I had to repeat it 3 times... (Sometimes more on different occassions) until he follows and says what I'm saying. Then I said look where you're going okay? He answered with "okay".
(I observed that when any of my students says "OK" or "YES"...they mean it...they would not do the action or behavior again or the behavior will be minimized until its gone).
I repeat asking 3 times and wait for him to answer then I stop. After a few minutes I asked him while pointing to his cheek...What happened to your cheek? I kept asking until he answered me. Then I tell mom or dad to ask him what happened to his cheek. And coach them to keep asking until he answers back. This is Expressive and Receptive Language.