Social Communication Disorder vs. Autistic Spectrum Disorder

Children who are experiencing social problems may appear to have Autistic  Spectrum Disorder (ASD), but some of these children fit the criteria for Social (pragmatic) Communication Disorder (SCD). Children with either ASD or SCD often have a corresponding Developmental Language Disorder, which also needs to be considered during the diagnosis and treatment process.

The most clearly defining factor between ASD and SCD is that those children who receive the Autistic Spectrum diagnosis show or have a history of restricted and repetitive patterns of behaviors, activities or interests. These might include having difficulty with transitions, lining up toys, extreme focus on a specific topics, etc. Children with SCD have social interaction and language difficulties that are similar to those that kids in the spectrum have without the restricted and repetitive patterns of behavior.

The approach to treatment can be similar and should support the social communication challenges of the children in varied situations. It is important to include peer opportunities and teach the peers how to initiate and maintain interaction with children who have social communication difficulties. This provides an opportunity to understand the strengths of friends with ASD and SCD and appreciate them.

(For more information see the article in the ASHA Leader magazine date April 2018)

Emotional Regulation/Dysregulation

Emotional regulation refers to the response to ongoing demands of experience with a range of emotions that is socially acceptable and flexible. Emotional regulation is a complex process and something many of our students work on daily in the Rock Brook School Community. When our students are more emotionally regulated, they are better able to engage with other people and are more available for learning. Sometimes they are tired and hungry or not feeling well which we can take care of. Other times they are upset about something they can or cannot express and we try to figure it out and talk about it. Sometimes it is due to internal responses that result from their own neurological make-up with no clear antecedent.

We work on emotional regulation and working through situations at school in a variety of ways, and three main approaches include: 1) Provide processing time; 2) Use simplified language; and 3) Provide visuals. Here are some specific strategies that are in no specific order:

1) Model what is expected as it decreases anxiety and increases predictability.

2) Use the phrase “First…then….. (“First finish writing three sentences…then take a break”).

3) Give a choice “Now or one minute…” (Usually the kids pick one minute…)

4) Show how many (egg, math problems to complete”) or how long (“Work for five more minutes”) and use a timer

5) Use the phrase “I start…you finish…”

6) Verbalize the rule for the situation.

7) Use Video modeling.

8) Simple tasks : give the child something to do when they are upset to calm them down that is an easy task such as sorting objects, squeezing play dough etc.

9) Use Incentive/Token Charts

10) Visual Schedules and Social stories. We find some strategies work better with specific students and then we have to switch them around and try something new. We have learned what works and what doesn’t and when we have to make changes and we keep trying!

Benefits of Joint Reading

Parental involvement in children’s academics has proven to be very beneficial to their success in school. Children’s early reading experiences with their parents prepare them for formal instruction in literacy. Being involved in your child’s reading directly influences their language and literacy skills. Specifically, positive impacts on their compression and expressive language skills have been reported. Parental involvement in children’s reading is more impactful to their literacy development than is family background, social class, and parental education. Although the most beneficial joint reading starts when your child is young, it can be beneficial at any age, such as elementary and high school. It’s never too late to engage your child in literacy practice. During joint reading, parents and children take turns reading from the pages with whatever language skills and imaginary skills are available to them. Usually parents take the lead in reading the story, pausing for their child to fill in an idea, and encourage them to take over the story whenever they wish to. Often times, the parents allow the child to take the lead and scaffold as needed.

Here are some examples/ideas to help promote joint reading with your child:

  • Ask your child questions. For example, for a beginner reader, ask simple “wh”- questions (e.g., what, where, when, why). For a more advanced reader, ask your child to make predictions, ask how the characters feel, and ask what your child has learned.
  • Identify and discuss new vocabulary words.
  • Choose themed books to elaborate on words from a particular category.
  • Play games with words, such as a synonym or antonym game.
  • Make a word web by writing or use picture symbols (whatever is applicable).
  • Hone in on prepositions and play a “Simon Says” game and have your child work on following directions (e.g., Simon says put the ball under your chair) and link these ideas to the book.
  • Have your child retell the story (using the pictures to help if needed). Story retelling is a very beneficial skill which helps your child demonstrate comprehension, fosters imagination, and helps make connections to their world.

Appreciating Our Children’s Teachers, by Lisa Patterson

 

This week is teacher/staff appreciation week. For students with special needs, qualified, dedicated staff is a critical component to the development and overall well -being of the child and the family. This week, we have a special guest blogger. One of our Rock Brook parents shares her appreciation of the staff who works with her child. 

See if you can follow this: I have a friend here where I live, in Princeton, whose sister has a friend who lives in Australia.  My friend told me that, immediately after her sister’s friend gave birth to a child with special needs, a check from the Australian government arrived in the mail.  No forms to fill out.  No evaluations to schedule.  The Australian government understood that there would be extraordinary expenses associated with having a child with special needs, and they were pro-active and generous.

Not so here in the US.  Ask any parent about his/her experience in raising a child with special needs, and you will hear one harrowing tale after another.  (Given the reading audience of this blog, I guess I’m preaching to the choir.  Sorry.)  My husband and I had our daughter Audrey evaluated when she was still a baby, and she starting receiving Early Intervention services by her first birthday.  But we discovered rather late in the game that these public services (speech therapy, occupational therapy, physical therapy and cognitive therapy) were generally inferior to those offered by expensive private practitioners.  So, we shelled out some big bucks for supplemental “out-of-network” services.

When Audrey was three, Early Intervention ended, and she was enrolled in Special Education through our public school system.  The teachers there didn’t know what to do with her.  In our efforts to have her placed in a “least restrictive environment,” we ended up with teachers and administrators who were clueless about how to help a child as severely disabled as Audrey is.  I spent a stressful and depressing year meeting, arguing, cajoling, and fighting.  It was awful.  The next year, we placed Audrey in a more restrictive environment, where she was surrounded by other severely disabled kids, and where she was generally ignored for two academic years.

Enter the Rock Brook School.  Actually, Audrey’s class pictures tell the whole story best.  When she was three and in a district school, the school photo came home of her crying, and a teacher’s arm was in the frame trying to keep her from bolting off the stool.  The next two years’ photos weren’t much better.  Then – and I still thank God regularly for this – Audrey was moved to the Rock Brook School.  Here is her 2011-12 school picture:

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What a smile.  And as we are completing our fifth year at Rock Brook, the photos still tell the story through her broad smiles.  Not that it’s all about the school pictures.  Audrey loves Rock Brook, her friends there, and her teachers.  Plus, she’s learning!

At every Rock Brook parent-teacher conference and IEP meeting, I thank Audrey’s teachers and therapists, and the school’s administrators.  I say something along the lines of, “We are so fortunate to have you and this school in our lives.  I don’t know what we’d do without you.”  And my eyes well up.  Even as I write this, I’m tearing up again.

The Rock Brook team is knowledgeable, loving, patient, generous, dedicated, selfless, and nothing short of a blessing to our family and to all the families it serves.  During Staff Appreciation Week, we can’t show our appreciation enough for all that they do, and the peace of mind that they give us beleaguered parents, who can rest assured that our children are being given superlative educations.  Imagine my elation when the school announced its expansion into high school last year.  What a relief to know that Audrey can have the benefit of staying at Rock Brook for ten more years.

THANK YOU, everyone, for all you do for our precious children!!!!!!

Changing the Conversation About Autism

Barry Prizant, Director of Childhood Communication Services in Cranston, Rhode Island and an adjunct professor at Brown University has published a new book, “Uniquely Human.” The book is about changing the conversation about autism. It is often referred to in conjunction with Steve Silberman’s New York Times bestselling “NeuroTribes: The Legacy of Autism and the Future of Neurodiversity” which provides neurotypical people practical strategies for understanding and supporting people with ASD.

In the late 70’s, Rock Brook hosted a conference on a new area of focus in the field of speech pathology, called Pragmatics i.e. understanding the function or use of language for communication. Dr. Prizant was one of the key note speakers and helped us understand that looking at how we use language to communicate was as important as how we produce speech sounds to communicate. He also did a lot of work with echolalia and documented that it is a strategy for acquiring language.

Overtime this area of focus on use of language became more important as the number of students in the autistic spectrum grew. For individuals in the spectrum communicating to other people does not come easily especially if you don’t want to talk about the same things they do and if social interactions in themselves are difficult and overwhelming. In the book Dr. Prizant encourages all of us to try to understand behaviors and how they are communicative events and not just “non-compliant” or manipulative behaviors. The approach is a compassionate one as we problem solve situations as language difficulties impact the ability to express feelings or needs. We try to do this for all our students regardless of their diagnosis and we all need to humanize people with autism and all disabilities. Behavioral reactions are often as a result of people who are more vulnerable, more sensitive and have difficulties communicating and seeking support.

My Child has an Augmentative Alternative Communication (AAC) device…now what?

You’ve got the communication boards, picture symbols and/or voice output device, but how do you put all of it into action? Here are some helpful strategies:

  • Once your child has learned to communicate using a symbol, require that s/he continue to use that symbol during each communicative attempt for that particular idea.
  • Sabotage situations through controlling and manipulating the environment so as to increase opportunities for communication (e.g., keep highly preferred items out of reach, give a fork to eat soup with, hide a broken toy with others and encourage your child to comment about it).
  • Teach, model, and encourage use of communication symbols during real-life, meaningful activities. Pick specific activities or times of the day to incorporate communication practice into your daily life (e.g., Involve your child in snack prep where s/he has to request items or tell you what ingredient goes in next and what action needs to take place (i.e., pour the milk, scoop the flour, stir the mix).
  • Prior to engaging in a new activity, review vocabulary that will be used on the communication board/device pointing to each symbol while you talk about its meaning.
  • Create scripts for the communicative exchange. For example, when planning a bubble blowing activity, you may have a bubbles activity page where there are the pronouns (you, I, it), actions (blow, catch, pop, wipe), more again, all done, descriptive words (up, down, high, low, big, little) to direct and describe. You may say, “blow bubbles” while you point to the symbols for “blow” and “bubbles”. Next you could say, “blow, bubbles, up” while pointing to those symbols.
  • Notice what your child is trying to communicate, interpret his/her actions into words, and add to what s/he is saying both verbally and by using the AAC system.
  • Most importantly, do not dismiss or ignore gestures and vocalizations. ALL communication is important. Children can still be re-directed to use their device after the initial communication is validated.

Happy New Year and Farewell to No Child Left Behind!

In early December, the US Senate voted on an overhaul of the controversial federal education law known as No Child Left Behind, which officially expired in 2007. The “Every Student Succeeds Act”, its replacement, passed the House and was signed by President Obama on December 10, 2015. The President called it, in reference to the bipartisan support, a “Christmas miracle.”This new law scales back federal oversight of schools and makes dramatic changes in that regard.

No Child Left Behind established high goals that all students achieve proficiency on state tests by 2014. Schools faced stiff sanctions if they failed to make “adequate yearly progress” toward that goal. The “Every Student Succeeds Act”, gives states the right to decide what constitutes adequate performance and how to intervene with schools that don’t measure up.

Schools would still be required to test students in English and Math every year from third to eighth grade and once in high school. States would still be required to intervene in the lowest-performing schools. However, in addition to test scores, schools will be judged on measures like graduation rates, student and teacher engagement and student participation in advanced coursework. It will leave it up to state and local officials to see their own performance goals, rate schools and determine what to do when they fail to meet their objectives.

Hopefully, this new approach will shift accountability away from naming and blaming schools to providing schools information they need to improve.

Making the Most of Holiday Traditions with a Child with Special Needs

The holiday season is here, and few activities are as meaningful to children as holiday traditions. Embedding your child’s speech and language goals in enjoyable, real-life tasks is a wonderful way to make the work they are doing in therapy as meaningful as possible. And research has shown that, the more meaningful the activity, the more likely your child’s speech and language is to grow from the experience!

Here are some ideas for how to make the most of these meaningful holiday traditions:

  • Target sequencing and following directions by having kids help prepare holiday meals.
  • Target categorization by having children sort holiday gifts.
  • Target spatial concepts while decorating the house (e.g., put the gifts under the tree; put the candle on the menorah, etc.).
  • Embed articulation targets in fun holiday activities (e.g., target “L” sounds while “Lighting candeLs” on the menorah; target consonant clusters while “trimming the tree”).
  • Reinforce parts of speech (nouns/verbs/adjectives) throughout vacation (e.g., “Look at the pretty, white, cold snow”; “Eat the yummy Christmas cookies”).

From all of us at Rock Brook – Happy Holidays to you and your family. We hope you will come visit our blog in the New Year!

Including Your Child in Thanksgiving Preparations

November is always a very special time of year. No matter how busy we are we take time to stop and be with friends and family for Thanksgiving.

At Thanksgiving time, families have the opportunity to make traditions and do fun things together that are so important for strengthening bonds between parents, children and grandchildren. We all enjoy routines and memorable events. For students with special needs, rituals and routines become especially important! Think about what you enjoy doing with your children at Thanksgiving and during the month of November. If you always make certain foods for the holiday, include your children in the preparation. For children who read, they can help tell you what is next in the recipe or what else needs to be purchased when shopping with you at the grocery store. For non-readers, you can make a word document shopping list or recipe with clipart images for your child to “read.” Augmentative communication devices can be programmed to have the desired items listed and catch phrases such as “We need…” “Let’s get…” or “Next add…” can be used before selecting a food item when shopping or making the recipe. AAC devices can be taken to the grocery store. Students learn that their device is their voice and that it can be used in all areas of their lives. It is powerful for children to be able to order what they want at a fast food restaurant all by themselves! These events build memories that they can talk about later.

Remember to take photos of special family events and family members. The whole family will enjoy sitting down together and looking at the pictures from time to time. Encourage your child to tell about what he likes to do with Grandma, Uncle Pete, or Cousin Sam. Help them to express feelings about events. “It was fun playing Uno with Pop-Pop on Saturday. I won!”

This time of year is truly special. All of us at Rock Brook School wish you and your family a very Happy Thanksgiving.

Top 10 Most Overlooked Legal Entitlements When Advocating For Your Child

Freemanby: Hillary Freeman, Esq. of Freeman Law Offices, LLC

1)  FAPE:  District’s have an obligation to develop an IEP that addresses the student’s individualized needs. Districts will often try to deny services to a student by saying “we don’t offer that here” or “this is all we offer.” They may also state that the child’s grades are fine so the student is not eligible for a particular program. However, if the student has academic, social/emotional or behavioral needs that impact his/her educational performance, the student is entitled to services and supports to meet that particular need. This may include but may not be limited to speech/language instruction; social skills instruction; occupational therapy for handwriting, sensory needs and/or life skills; physical therapy; behavioral support; counseling; assistive technology and/or augmentative communication.

2) Stay Put:  A Child Study Team may not change a child’s program if the parents or guardians request a Mediation with the Office of Special Education Programs (“OSEP”) within 15 calendar days of receipt of the final written notice (in an IEP or otherwise). Notifying the district of your disagreement is not sufficient unless the district is giving you a draft IEP. If the IEP is final, then parents MUST file a Petition for Mediation with OSEP to prevent the proposed IEP from going into effect. This most frequently applies to (but is not limited to) (a) changes in placements/programs; (b) related services being reduced or eliminated; (c) the duration of the “extended school year” program is reduced; and/or (d) eliminating or changing “extended school day” programs.

3) Unilateral Placements or Retaining Private Services :  When parents do not believe their son or daughter is making progress (ex. education, social/emotional; behavior; life skills), they often hire private agencies to supplement their child’s educational program or place their child in a private school to compensate or supplement what the district is offering through the IEP. Parents may have a right to seek reimbursement from the local school district for providing those services. Unless there is an emergent situation, parents MUST provide the district with written notice of their intent to privately retain services 10 (business) days in advance of hiring the outside provider. Otherwise, reimbursement may be reduced or denied.

4) Independent Educational Evaluations (“IEE”):  Once a student has been classified, the district’s Child Study Team has a legal obligation to administer a reevaluation every three years or more often if deemed necessary. Upon completion of an evaluation, parents may request an IEE at public expense if they disagree with the results of the district’s evaluation. Districts however, may no longer limit the parents’ right to an IEE by insisting that it first be permitted to conduct the evaluation in an area not already assessed by the initial evaluation or reevaluation. The district must pay for the IEE unless it requests a Due Process hearing within 20 calendar days and is able to prove that its evaluation is appropriate.

5) Observations by Independent/Private Evaluators:  For any independent evaluation, whether purchased at public or private expense, the school district must allow the evaluator to observe the student in the classroom or other educational setting upon request. The district may impose reasonable limitations with respect to the duration and scope of an observation by an independent or private evaluator. However, such limitations must also be imposed on the district when the district conducts its own evaluation. The district’s policy may not be limited to outside evaluators only.

6) Goals:  It is very important that your child’s IEP goals and objectives are measurable. It is very difficult to establish that a child has not made progress with vague wording. When the goals are specific, observable and measurable, the IEP team (which includes the parents and/or guardians) to measure the student’s progress. The IEP must also state how the child’s parents will be informed of their child’s progress towards the annual goals and what criteria will be set for the child to have “mastered” each goal by the end of the year.

A) Vague Goal:  Johnny will act in a socially appropriate manner.
B) Measurable Goal:  Johnny will initiate a conversation with a same aged peer in the classroom setting three out of five opportunities to do so as measured by collected data.

7)  Transition Services:  IEPs must include transition services when the student reaches age 16 or younger as deemed appropriate by the IEP team. Appropriate transitions plans are designed to help the student learn academic and functional skills that they will need to be successful in the post secondary environment (such as college, vocational program, the account for the student’s strengths, preferences and interests after high school and then address the student’s academic and functional achievement to help the student be successful in the postsecondary environment. The plan should include instruction, related services, community experiences, the development of employment and other post-school adult living objectives, and, when appropriate, acquisition of daily living skills and functional vocational evaluation.

8)  Length of School Day and/or School Year:  The length of school day and/or school year shall be offered for the same length of time as established for non-disabled students. However, the IEP team may extend or shorten the length of the school day or year based on the needs of the student.

9) Graduation:  Graduation is considered a “change in placement” that triggers the 15 day clock to contest the IEP. If your child is (a) under the age of 21; (2) has not mastered all of his or her IEP goals; or (c) still has functional/academic needs that have not been addressed, the student may be entitled to continued services from the school district either in the school environment or another setting.

10) Partial Agreement with IEP:  Parents may consent to implement part of the proposed program without waiving their rights to contest the balance of the proposed program. If that situation arises, parents and/or guardians should ask the Child Study Team would continue working with them to reach a resolution. If not, then the parents should request a Mediation from OSEP (not the district) within 15 calendar days to invoke their “stay put” rights and maintain the IEP that is currently in effect until the dispute can be resolved. (See above).

Thank you Hillary Freeman for serving as guest blogger.
You can contact Hillary by visiting www.freemanlawoffices.com