overview of kennedy krieger school programs · pdf file ·...

Patricia O’Malley, Ph.D. Project Director, School-Based Support Services

[email protected]

Overview of Kennedy Krieger School Programs

October 9, 2014

www.kennedykrieger.org


Kennedy Krieger Institute

An internationally recognized institution dedicated to improving the

lives of children and adolescents with pediatric developmental

disabilities and disorders of the brain, spinal cord and musculoskeletal

system, through patient care, special education, research, and

professional training.


Kennedy Krieger School Programs

Kennedy Krieger School Programs is a non-public

school serving over 430 students with complex

learning and behavior problems from 13 different

Maryland school systems.

Disabilities served: Autism, Intellectual Disability, Specific Learning Disabilities,

Speech or Language Impairment, Emotional Disability, Orthopedic

Impairment, Other Health Impairments, Multiple Disabilities,

and Traumatic Brain Injury.


Kennedy Krieger School Programs

Has an extensive history of consultative service, including:

Operating a self-contained school for students with severe

and profound disabilities for Baltimore City

Operating Type 2 school program (Anne Arundel & Prince

George’s Counties)

Facilitating services for girls charter school in the city

Provided a full-time special education consultant to a charter

school for Baltimore County for two years

Operated the special education

component of a school for

Baltimore City


Kennedy Krieger High School

The focus of the school is the

preparation of students for employment

and continued educational opportunities

and training, using a model of five

career clusters:

Information Technology and Office Skills,

Hospitality and Tourism,

Retail and Consumer Services,

Construction/Manufacturing Trades and

Horticulture.


How Does Your Brain Work?

Reading is a complex process.

One must scan from left to right

Quickly be able to appreciate the small

differences which distinguish letters

Automatically translate groups of these

visual images (graphemes) into their

auditory representations (phonemes).

Efficiently blend phonemes into words so

that they can be recognized and

understood.

Visual clues indicating where words and

sentences start and stop must be

processed.

Rules of grammar must also be

understood for accurate comprehension.

Normal

Dyslexic


Identify the Colors You See


Read the Words You See


Say the Color in Which the Word is Printed


Understanding Autism: One family’s perspective

Maria’s Journey

http://www.youtube.com/watch?v=qDjx2poDS_E





Now share something about you….

Do you have someone close to you who is diagnosed

with autism?

What do you know about autism?

What would you like to learn?


If you know one person with autism,

you know one person with autism.

There is…..

An innumerable combination of possible symptoms.

No single behavior that is always typical or present

in every individual.

Understanding Autism


What is Autism?

Autism spectrum disorder (ASD) and autism are both

general terms for a group of complex disorders of brain

development. These disorders are characterized, in

varying degrees, by difficulties in social interaction, verbal

and nonverbal communication and repetitive behaviors.


Changes to the Diagnosis of Autism Spectrum Disorder

With the May 2013 publication of the DSM-V, the five disorders

previously classified as ASDs

now fall under the umbrella of autism.


What is Autism?

Criteria for Diagnosis

Person must demonstrate (either in the past or in the present) deficits in:

Social-emotional reciprocity

Nonverbal communicative behaviors used for social interaction, and

Developing maintaining and understanding relationships.

In addition, they must show at least two types of repetitive patterns of

behavior including stereotyped or repetitive motor movements, insistence on

sameness or inflexible adherence to routines, highly restricted, fixated

interests or hyper or hyper reactivity to sensory input or unusual interest in

sensory aspects of the environment.


A.Persistent deficits in social communication and social

interaction across

contexts


Dr. Rebecca Landa

Director, CARD, KKI


Autism is not….

• A disease

• Bad behavior

• Mental illness

• Poor parenting

• Lack of intelligence

• A disorder of childhood only

• Limited to any one race or socioeconomic group

Dr. Rebecca Landa

Director, CARD, KKI


What causes autism?

The causes of autism and the other disorders on the

spectrum are not known.

Many studies have examined the relationship between

vaccines and autism spectrum disorders. To date, the

studies continue to show that vaccines are not

associated with autism spectrum disorders.

Researchers are currently studying such

areas as neurological damage and

chemical imbalances within the brain.

(CDC, 2012)

Centers for Disease Control and Prevention (2012)


Prevalence

According to the CDC (2012):

Rates have increased 10 to 17% annually in recent years.

About 1 in 88 children has been identified with ASD.

1.5 million Americans today are believed to have an ASD

600% increase since 1975

Autism is reported to occur in all racial, ethnic,

and socioeconomic groups.

Autism is 4 to 5 times more common among boys than girls.

In the United States, approximately:

1 out of 54 boys

1 in 252 girls


Prevalence

Research has shown that a diagnosis of autism at

age 2 can be reliable, valid, and stable.

More children are being diagnosed at earlier ages—a

growing number (18%) of them by age 3.

Still, most children are not diagnosed until after they reach

age 4.

(CDC, 2012)


Prevalence in Maryland

The overall rate in Maryland is 1 in 80 children;

1 in 49 boys

1 in 256 girls

Prevalence has increased 85% from 2002 to 2008.

The increase was 41% between 2004 and 2008

35% between 2006 and 2008

(CDC, 2012)

Characteristics of Autism

Characteristics of Autism


Characteristics of Social Interaction Impairments

Avoids eye-contact

Prefers to play alone

Does not share interests with others

Only interacts to achieve a desired goal

Has flat or inappropriate facial expressions

Does not understand personal space boundaries

Avoids or resists physical contact

Is not comforted by others during distress

Has trouble understanding other people's feelings or

talking about own feelings

(CDC, 2012)


Characteristics of Communication Impairments

Delayed speech and language skills

Reverses pronouns

Gives unrelated answers to questions

Does not point or respond to pointing

Uses few or no gestures

Repeats words or phrases over and over (echolalia)

Talks in a flat, robot-like, or sing-song voice

Does not pretend in play

Does not understand jokes, sarcasm, or teasing

(CDC, 2012)


Characteristics of Behavior Issues

Plays with toys the same way every time

Gets upset by minor changes

Has obsessive interests

Temper tantrums

Self injury

Unusual eating and sleeping habits

Unusual mood or emotional reactions

Persistent preoccupation with parts of objects (e.g., wheels)

Inflexible adherence to certain routines or rituals

Flaps hands, rocks body, or spins self in circles

(CDC, 2012)


What are the implications for school?

• Short attention span for most lessons.

• Prone to sensory overload.

• Resistance or inability to follow directions.

• Exceptionally high skills in some areas

and very low in others.

• Excellent rote memory in some areas.

• Difficulty with reading comprehension.

• Difficulty completing work.

• Difficulty with fine motor activities (coloring, printing, gluing).

• Difficulty transitioning from one activity to another in school.

Dr. Rebecca Landa

Director, CARD, KKI

Strategies to Try with Students on the Autism Spectrum

One size does not fit all


Consider the strengths…

Good rule learner

Likes predictability

Detail oriented

Rarely judge others

Sustained attention

Enjoy constructive play (but not symbolic or imaginative)

Solitary and limited nature of imaginative play

Very large rote memory

Unique/original problem solving Dr. Rebecca Landa

Director, CARD, KKI

.


Strategies to Try…

To promote success, find ways to provide…

Predictable and Structured Environment

Visual Supports

Decreased Verbal Interactions

Sensory Supports

Positive Behavioral Support

Kadie Miller

Principal, Kennedy Krieger High School


Provide a Predictable & Structured Environment

Strive for predictability, Prepare for the unexpected.

Minimize distractions.

Physical Space/Work Space

Personal work space

Visual boundaries

Work Space

Left to right

Tailored to Interests of the student

Breaking tasks down into smaller steps


Example of Structured Environment


Provide Visual Support

Visuals help children who have difficulties with:

• Listening and attending

• Understanding and responding

• Processing sequenced information

• Motivation and play

• Following instructions and routines

• Anxiety and resistance to change

• Memory


Provide Visual Support

Therefore, it is important to utilize….

Schedules

Checklists

Color Coding

Graphic Organizers

Pictures

Social Stories/Video Modeling

Choice Boards


This activity illustrates what it might be like to try to concentrate on a set of oral

instructions amidst a variety of classroom distractions. http://www.pbs.org/wgbh/misunderstoodminds/experiences/attexp2b.html

http://www.pbs.org/wgbh/misunderstoodminds/experiences/attexp2b.html


Modify Verbal Interactions

Suggestions to avoid confusion…

Keep your language simple and concrete

Avoid idioms (e.g., “Open your ears”)

Avoid using sarcasm

Give very clear choices

Decrease speed of verbal directions

Support verbal with visual cue

Gestures

Pictures

Sign Language


Where to Learn More

http://www.autisminternetmodules.org/

http://autism.kennedykrieger.org/

http://www.autismspeaks.org/








Always Unique Totally Interesting Sometimes Mysterious

The End


References

Autism Internet Modules (2014) http://www.autisminternetmodules.org/

Carr, E. G., Horner, R. H., Turnbull, A. P., Marquis, J. G., McLaughlin, D. M.,

McAtee, M. L., Smith, C. E., Ryan, K. A., Ruef, M. B., Doolabh, A., & Braddock,

D. (1999). Positive behavior support for people with developmental disabilities:

A research synthesis. American Association on Mental Retardation.

Centers for Disease Control and Prevention (2012) Autism Spectrum Disorders

http://www.cdc.gov/NCBDDD/autism/research.html

Council for Exceptional Children (1999). Teaching Students with Autism

http://www.cec.sped.org/AM/Template.cfm?Section=Home&CONTENTID=418

5&TEMPLATE=/CM/ContentDisplay.cfm&CAT=none

Kennedy Krieger Institute (2014) Autism Initiatives


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