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4/20/2017 Myles, 2017 [email protected] CREATING A PSYCHOLOGICALLY SAFE ENVIRONMENT FOR STUDENTS WITH HF-ASD Brenda Smith Myles, Ph.D. www.ocali.org www.texasautism.org CREATE A PSYCHOLOGICALLY SAFE ENVIRONMENT FITS WITHIN THESE EBP: Behavioral package, Modeling, Multi-component package, Naturalistic Interventions, Social interventions, Social narratives, Task analysis, Schedules Learning: What to Teach Research shows that … Individuals with “soft skills”, including good social skills, sociability, good work habits, punctuality, conscientiousness and those who participated in extra curricular activities are more likely to make more money, be employed, and attain high levels of education than those with good grades and high standardized test scores. University of Illinois at Urbana-Champaign (2009, March 26). Social Skills, Extracurricular Activities In High School Pay Off Later In Life.

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Page 1: CREATING A PSYCHOLOGICALLY SAFE ENVIRONMENT FOR STUDENTS …idahotc.com/Portals/57/Course Files/ASDNBI... · 4/20/2017 Myles, 2017 brenda_myles@mac.com PREDICTABILITY: PRIMING Priming

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Myles, 2017 [email protected]

CREATING A PSYCHOLOGICALLY SAFE ENVIRONMENT FOR STUDENTS WITH HF-ASD

Brenda Smith Myles, Ph.D.

www.ocali.org

www.texasautism.org

CREATE A PSYCHOLOGICALLY SAFE ENVIRONMENTFITS WITHIN THESE EBP: Behavioral package, Modeling, Multi-component package, Naturalistic Interventions, Social interventions, Social narratives, Task analysis, Schedules

Learning: What to Teach

• Research shows that …• Individuals with “soft skills”, including good social skills,

sociability, good work habits, punctuality, conscientiousness and those who participated in extra curricular activities are more likely to make more money, be employed, and attain high levels of education than those with good grades and high standardized test scores.

University of Illinois at Urbana-Champaign (2009, March 26). Social Skills, Extracurricular Activities In High School Pay Off Later In Life.

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Create a Psychologically Safe Environment

PredictabilityPredictability

Communication demandsCommunication demands

Sensory factorsSensory factors

Physiological factorsPhysiological factors

Adapted from Loomis

PREDICTABILITY

Predictability

• The more predictable, the easier the interaction

• Routines and regularly occurring events• Circle time

• Martial arts lesson

• Math cooperative group

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Myles, 2017 [email protected]

Predictability

• The learner with ASD must know answers to questions, such as:• What is the schedule?

• What am I expected to do?

• How much am I expected to do?

• What will other people be doing?

• How will I know when I am finished?

• What will I do next?

• What should I do if I don’t know what to do?

• Can I tell when I become overwhelmed, anxious, or upset?

• What should I do if I become overwhelmed, anxious, or upset?

Bolded items from Project TEACCH

Predictability

• One of the best ways to provide clear explanations is to make:

• The unfamiliar Familiar

• The unpredictable Predictable

• Unclear expectations Clear

Predictability: Tools

• Priming

• Video modeling

• Social narratives

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Myles, 2017 [email protected]

PREDICTABILITY: PRIMING

Priming• Preparing the student for daily activities

• Can occur • At home for the next day

• The morning of in school

• At the end of the school day for the next day

• Overview of schedule changes, assignments and activities

Sample Priming Activities

• Look at a grocery list

• Look at a to-do list

• Look at a worksheet

• Look through a book

• Overview a test

• Show the visual schedule

• Practice with art supplies

• Talk about and show a finished project

• Show a work sample

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Myles, 2017 [email protected]

PRIME FOR TESTS!!!!!!

You can call them study guides, if it makes you more comfortable.

Priming Considerations: Explanation• Get the child’s attention

• Tell the child what is going to happen

• Be brief yet thorough

• Show no panic or fear!

Sakai, 2005

Priming Considerations: Schedule• Use a timeline

• Stick to it

• No last minute changes

• Consider this step as a trust-builder

Sakai, 2005

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Priming Considerations: Reward• Tell or negotiate

• Expect and communicate reasonable compliance

• “Going with the program”

Sakai, 2005

Priming Considerations: Predicting

• Make the schedule clear

• What might happen?

• Examine all variables

• What has happened in the past

• Ask the child questions to check for comprehension

• With the child, think of possible alternatives … just in case

Sakai, 2005

Priming Considerations: Predicting• Brainstorm and include the child in the process

• Ask “What if”?

• Write it down• Paper

• Post-It

Sakai, 2005

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Priming Considerations: Countdown

• Time needed varies by activity and location

• Be prepared• Do not use seconds• Don’t say “just a

minute” unless you mean 60 seconds

Sakai, 2005

Priming Considerations: Wrap-Up• Present the facts

• Not a time for scolding or making judgments

• A play-by-play listing of what occurred

• Make sure the child is calm before you wrap-up

Sakai, 2005

PREDICTABILITY: VIDEO MODELING

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Myles, 2017 [email protected]

PREDICTABILITY:SOCIAL NARRATIVES

Rule Cards

Proper Greeting Behaviors for an Adolescent in a New Situation With Peers

1. Make eye contact.

2. Say, “Hey, great to meet.”

3. Say, “What are we supposed to be doing?

Loomis, 2012

Conversation Starter Cards

Things to Talk About

1. Yesterday’s snowstorm.

2. The joke about the horse that dad told. Remember each person should only hear the joke one time

3. The baseball game on television tonight.

Loomis, 2012

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Myles, 2017 [email protected]

Scripts

Marty’s Script

• Hi (peer’s name). How are you?

• Did you see (television show) last night?

• What did you think was funny.

• I liked it when everybody fell into the swimming pool.

Loomis, 2012

Situational Fact Cards

Dinner at Restaurant

• Who will be there: Aunt Donna, Uncle John, Mark, Missy, dad, mom, you

• What will you have to do beyond general ordering and eating: (a) hug aunt and uncle hello and goodbye; (b) talk with Mark and Missy about their interests: hockey and American Idol; (c) it is appropriate for you to talk with Mark and Missy while the adults are talking with each other

• After we leave the restaurant, you can de-stress with a favorite video game

Loomis, 2012

Descriptive Stories

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Descriptive Stories

COMMUNICATION DEMANDS

Communication Demands

• Verbal communication

• Nonverbal communication

• Problem solving

• Hidden curriculum

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SIMPLIFY THE LANGUAGE

EXPRESSIVE LANGUAGE DOES NOT EQUAL COMPREHENSION

Simplify the Language• Students with ASD often appear to understand than they

actually do• Many students can repeat back what they hear without

understanding• Verbalization does not equal comprehension• The answer to “Do you understand what you are

supposed to do?” is almost always, “Yes”. The meaning may be “No”.

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Communication• Use student’s name to obtain attention

• Ask questions in different ways

• Have student paraphrase

• Tape gently on the desk prior to asking a question

• Have student demonstrate understanding

• Teach new vocabulary

• Explain that words have more than one meaning

COMMUNICATE VISUALLY

Cartooning

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Graphic Organizer

The human body

Respiratory system

Skeleton

Circulatory system

Digestive system

Reproductive system

The human body

Nervous system

Respiratory system

The human body

Nervous system

Skeleton

Circulatory system

Respiratory system

The human body

Nervous system

Insect Report Due Next FridayTimeline Task Details

Monday Read at least 2 sources to learn more about insects

Can be on internet or information from books

Tuesday Create outline 5-10 facts people should know about insects

Wednesday Write 1st draft. Use information from research to add details to outline

IntroductionBodyConclusion

Thursday Edit report (Ask your teacher to read it and make suggestions)

Read and look for errorsCorrect errorsMake changes based on suggestions

Friday Read paper again. Check for spelling errors. TURN IN PAPER

Look for spelling errorsCorrect spelling errors

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Lofland, 2010

USE SOCIAL AUTOPSIESBieber, 1994

PROMPTING, SET-UP, NARRATION

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Prompting

• Providing the subtle “nudge” to help the learner get started or to provide direction• Verbal

• Nonverbal

The Set-up

• Providing a brief introduction to help the learner get started• “John has something to say.”

• “We are going to the store and there is something that John would like to ask you before we go.”

Narration

Her mouth is turned down and her arms are crossed. I think she is mad and is waiting for the students to stop talking.

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CREATE PRACTICE OPPORTUNITIES

HELP STUDENTS CREATE A COMMUNICATION PLANBefore approaching a social situation

Gardella, A. (2015, April). How to network as an introvert. Real Simple. Retrieved from http://realsimple.com/work-life.

Make a To-Do List

• Jot down what you want to accomplish prior to attending a social situation

• Make one or two goals• Learn about a specific topic

• Listen to a speaker

• Meet an individual

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Myles, 2017 [email protected]

Stay Only a Short While (20 Min)

• It is usually acceptable to leave after your goals are accomplished

• Check with a mentor to see how long it is necessary to stay

• If you are having a good time, stay longer

Think Quality, Quantity

• Try to make one or two meaningful connections with people you might enjoy

• In a group setting, strive NOT to be the person who talks the most

Script Your Introduction

• Develop a three-to-five second ‘elevator pitch”• Unique talents

• Professional background

• What you enjoy (in a sentence)

• Write them out so that the words sound natural, not forced

• Practice in front of a mirror and trusted people

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Learn to Ask Meaningful Questions

• If you ask questions, other people do the talking

• Don’t interrupt

• Come armed with questions• People

• News

• Locale

Answering Questions

• Respond to “What do you do” with something you actually did• Previously identified and practiced

• Answer the question; ask a question

Duck Out Now and Then

• Take brief breaks to recharge• Walk

• Go to hotel room

• Duck into the restroom

• Find a quiet spot

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NONVERBAL COMMUNICATION

Teach Nonverbal Language

TEACH NONVERBAL COMMUNICATION BODY LANGUAGEBody Language Cheat Sheet for Writers

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ANGER

Anger

• Balling the fists

• Crossing the arms tightly

• Clenching the fists once arms are crossed

• Tight-lipped smile

• Clenched teeth

• Shaking a finger like a club

• Firmly pointing a finger at someone

Body Language: Cheat Sheet for Writers

CLOSED TO CONVERSATION

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Closed to Conversation

• Keeping hands in the pockets• Especially men

• Arms crossed

• Sitting back

• Folding hands together on a table to create a barrier

• “Figure-four” leg cross

Body Language: Cheat Sheet for Writers cont

Closed to Conversation: Figure Four Leg Cross

DISTRESS

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Distress

• Stroking or rubbing neck (especially men)• Think “pain in the neck”

• Crossed arms• Self-hugging

• One-arm cross

• Clutching a purse, briefcase, or bag with both arms

Body Language: Cheat Sheet for Writers cont

Distress

• Adjusting cuffs or cuff-links

• Folding the hands together in front of the crotch (men)

Body Language: Cheat Sheet for Writers

LYING

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Lying

• Covering the mouth• Shhh gesture

• Covering mouth similar to coughing

• Touching or rubbing the noise or just below the nose• Quick, small gesture; not a scratch

• Rubbing the eyes (especially men)

• Scratching the neck with the index finger

• Averting gaze

Body Language: Cheat Sheet for Writers

OPENNESS AND HONEST

Openness and Honesty

• Exposure of the palms

• Arms and legs unfolded

• Leaning forward

Body Language: Cheat Sheet for Writers

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SUBMISSIVE

Submissive

• Smiling• Some people smile when they are upset or afraid

• Slumping the shoulders

• Doing anything to appear smaller

Body Language: Cheat Sheet for Writers

SUPERIORITY, CONFIDENCE, POWER AND DOMINANCE

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Superiority, Confidence, Power and Dominance• Steepling the fingers (setting the tips of fingers together)

• Folding hands behind the back

• Thumbs sticking out of pockets (front OR back pockets)

• Hands on hips

• Straddling a chair

• Hands folded behind head while sitting up (in men)

• Rolling eyes

Body Language: Cheat Sheet for Writers

THE INCREDIBLE 5-POINT SCALEMatching emotions to actions and identifying interventions

Buron & Curtis, 2013

Rating Feeling What It Looks Like

What I Should Do

I have to leave; it is time to be alone

Fast rocking; loud voice

Use the secret signal with the adult you trust and leave the room when the adult acknowledges you.

I need to move to a differentplace in the room

Rocking back and forth; picking on my fingernails

Say, “Excuse me”, if you can. If you can’t, just walk to a quiet part of the room and put on your headphones. Think about using your secret signal with an adult.

I need to stop talking with this person or I might need help telling someone to be quiet

Feeling like I want to flapmy hands and cover my ears

Think about saying one of these things, “I’ll talk with you later”, “I’m going to get a drink”, “I need to get some work done”. If that is not going to work, say “Gotta go!” And go stand by an adult you like and know. Ask the adult for help.

I can do this by myself

Starting to tap my foot

Taking a deep breath and count to 10Think about saying one of these things, “I’ll talk with you later”, “I’m going to get a drink”, “I need to get some work done”.

I am good. Nothing is really bothering me.

Smiling, talking

Keep doing what I am doing.

1. Make a table

2. Label the top columns

3. Write numbers down the side

4. Write in your feelings for each number.

5. Write down what each feeling looks like for you.

6. Write what you should do for each number.

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Buron & Curtis, 2012

Buron & Curtis, 2012

Buron, 2011

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Buron & Curtis, 2012

Buron & Curtis, 2012

LEARN TO SOLVE PROBLEMSEfficiently and Calmly

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Problem Solving

Channon, 2004

ALL PROBLEMS HAVE A SOLUTION --But you might not always get the solution you want.

This is called life!

1. Figure out what the problem is.

2. Look at the four choices.

3. For each choice ask, “What would happen if I did that?” It is best to do this with an adult you trust.

4. Choose the best one; practice how to do it with an adult. Then do it!

Mataya & Owen, 2012

Talk it out and compromise

Seek help from an adult

Ignore and move on

Let it bother you

Problem________

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Mataya & Owens, 2013

Looks Like Feels Like What to Do

ScreamingStomping feet

Very embarrassedVery frustrated

Go to home base

Getting quietSaying “bad words”

A bit frustratedA bit embarrassed

Folding armsRefusing to work

Confused

Making excuses“I don’t want to …”

Uncomfortable

Trying thingsGood attitude

HappyContent

Be proud of myself

Buron & Curtis, 2014 Mataya & Owens, 2013

Hidden Curriculum

• The set of unwritten rules that no one has been directly taught, but everyone knows. Violations of these rules can make an individual a social outcast.

• Phrase associated with hidden curriculum:• “I shouldn’t have to tell you but … “

• “Everyone knows that … “

• “It’s obvious … “

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Hidden Curriculum Includes

Hidden Curriculum Includes

Hidden Curriculum Includes

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Hidden Curriculum Includes

Hidden Curriculum

Differs Across

• Age

• Who you are with

• Culture

• Gender

Impacts

• Home

• Community

• School

• Workplace

• Legal system

EVERYWHERE!!!

THE HIDDEN CURRICULUM AND CULTURE

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British and American EnglishWhat the British Say What the British Mean What Americans

Understand

I hear what you say I disagree and do not want to discuss it further

He accepts my point of view

With the greatest respect You are an idiot He is listening to me

I’m sure it’s my fault It’s your fault Why do their think it is their fault?

You must come to dinner It’s not an invitation, I’m just being polite

I will get an invitation soon

Hidden Curriculum

Differs Across

• Age

• Who you are with

• Culture

• Gender

Impacts

• Home

• Community

• School

• Workplace

• Legal system

EVERYWHERE!!!

One-a-Day Method

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Resources to Teach the Hidden Curriculum

Resources to Teach the Hidden Curriculum

SENSORY DEMANDSANTECEDENT-BASED INTERVENTIONS

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Sensory Demands

• Some experiences are experienced too intensely and others are not intense enough

Coulter Video

Sensory Demands

Relaxers/Fidgets

PHYSIOLOGICAL FACTORS

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Physiological Factors …

That Impede Interactions

• Fatigue

• Hunger

• Thirst

• IllnessPain

Are Important

• Individuals with ASD often have to use energy to “block out” extraneous stimuli

• Social processing requires concentration, focus, balanced energy levelBe interoception aware!!

PAIN SENSITIVITY IS HIGHER THAN AVERAGEOr lower than average

Chen, Hung, Fan, Tan Hong, Chang, 2016

CONSIDER STRUCTURAL FACTORS

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Structural Factors

Number of peopleNumber of people

Types of peopleTypes of people

Relationships: Peers and adultsRelationships: Peers and adults

TimeTime

Physical spacePhysical space

Adapted from Loomis

NUMBER OF PEOPLE

Number of People

• The fewer people involved, the lower the social challenge

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TYPES OF PEOPLE

Types of PeoplePeople Who Are Easy to Socialize With

• Speak slowly

• Listen carefully

• Articulate well

• Express themselves directly

• Communicate feelings

• Are entertaining and fun

• Are reinforcing

• Who genuinely like the child

• Who send clear messages of support

• Who minimize figurative language or explain it

PEERS

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Peer Buddies

• Can be coached to provide clear, straight forward communication

• Can act as translators

• Can support the use of cartooning, social narratives

Teach Peer Buddies

• To initiate interactions

• To understand “unusual” behavior

• To interpret the intentions of the person on the spectrum

• To accept different preferences for levels of engagement

Peer Buddies • Find common interests

• Find something you appreciate about the individual

• Like the individual

• Enjoy each other’s company

• Let the individual know that • You are happy to be with them

• You value them

• You know that they have something to contribute

We should do this also!

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ADULTS

STUDIES OF TEACHER-STUDENT RELATIONSHIPSOver 350,000 students

Over 12,000 teachers

Behaviors of Teachers in Positive Relationships• Engages in little conflict

• Is supportive of student needs

• Is empathetic

• Supports independence

• Is trustworthy

• Feels close to students

• Accepts student ides

• Praises/reinforces

• Accepts student feelings

• Is sensitive to individual differences

• Involves students in decision making

• Is warm

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Behaviors of Teachers in Positive Relationships• Is respectful

• Encourages higher-level thinking

• Is responsive to learner developmental, social and personal needs

• Promotes student success

• Is genuine

Student Outcomes

• Has better social skills

• Accepts peers

• Develops social connections

• Follows rules

• Has higher academic performance

• Attends school regularly

• Is self-directed

• Participates in class

• Has better mental health

• Explores higher education

• Exhibits less defiant behavior

LENGTH OF TIME

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Length of Times

• The longer it lasts, the more tired the learner becomes, and the more taxing it becomes

• Social processing is exhausting!

PHYSICAL SPACE

Physical Space

Less Exhausting

• Well organized

• Clearly defined boundaries

• Enough space for the activity

• Reasonable sound level

More Exhausting

• Crowed spaces

• Large, open areas

• Noisy environments

• Echoing environments

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Myles, 2017 [email protected]

BE KINDAn evidence-based practice, according to me!

Kindness

• Use the golden rule +• Do unto others what they need

• Assume that the individual is doing her best

• Assume that the behavior makes sense even if you don’t understand it

• Understand the “refusal” is probably “can’t in the moment”

Aspy & Myles, 2016; Endow, 2016

THE POTENTIAL OF INDIVIDUALS WITH AUTISM IS LIMITLESS!