Intervention Strategies in ASD: Skills needed to be addressed in preventing school failure and absenteeism - Module 3

1. EDUCATIONAL STRATEGIES

1.1. MAIN NEEDS TO BE ADDRESSED WITH ASD STUDENTS TO PREVENT SCHOOL FAILURE

Teaching strategies with students with ASD has its own basis in the education principle of learning from success. For this, we need to use behaviour modification techniques such as those explained below:

• Backward chaining: consisting of segmenting learning into small steps to give support in all of them and gradually withdrawing it from the last step to the first, provided that the previous one is successful.
• Token economy: a desirable behaviour that is intended to be achieved is established and in which the child can have control on his own or with the support that we plan to achieve it and reinforces are proposed (stickers, stickers ...) that accumulates or exchanges to achieve a previously established reward. You can set three goals, two that are very easy to achieve and will act as reinforces, or just one. In any case, it is important that the child participates in the construction to see it attractive. You can work together with the whole class. It is also known as the point system.
• Reinforcements: any stimulus that increases the probability that a behaviour will be repeated in the future.
• Extinction: it is based on the principle of reinforcement. Any behaviour that is followed from a reinforce will tend to recur, any behaviour after which the reinforces disappear will tend to disappear.
• Success from learning: promoting that learning is carried out based on the student's knowledge and sequencing the task in small steps so that they acquire the skills to solve it successfully.
• Strength focus: skills, interests and needs as a vehicle of learning
•  Individualised assessments: each student has its own needs and supports
•  Visual aids: organise the environment and tasks with clarity, colours or pictures 
•  Being broad-based, i.e. support people at their natural contexts
• Structuring:
• Physical spaces (classroom layout, control of sensory stimuli, space-temporal markers, visual aids, specific areas for relaxation, notice boards, traveling agendas in which social information is provided ...).
• Agenda and organization of school materials, notes, notifications: monitoring of academic agenda with support through support circles, or teachers.
• Organization of the distribution of students and tasks in group work.
• Highly unstructured spaces and moments (class changes, entrances and exits, breaks, ac-novel activities ...).
• Support in the sequential structuring of learning (following sequential teaching strategies: step by step) and establishing reinforcements for the achievement of the task.
• Sequenced support in the learning of physical skills, evaluating the motor, vestibular and executive capacity of the student.
• Anticipation and objective explanation of changes (absence of a teacher, surprise exams, introduction or exclusion of subjects, new learning formats, room changes ...).
• Curriculum accessibility:

• Adaptation of exams (specific questions, avoid double negation, previous training in the model).
• Time extension.
• Distribution of space and time with visual aids.
• Facilitation of notes.
• Course splitting.
• Visual aids (e.g., signalling when to turn the sheet because the exam continues with an arrow, use of coloured cards that indicate the time remaining for the student).
• Explicit training in self-instructions.
• Coordination with the environment through digital platforms, meetings, agendas.
• Enhancement of personal development in the area of ​​physical education vs competitive models.
• Support for the differentiation and delimitation of relevant aspects of the subjects.

1.2. SPECIFIC EFFECTIVE STRATEGIES FOR STUDENTS WITH ASD

Circle of trust

It is an activity to teach in an explicit and personalized way the different types of personal relationships that one has. It is important to do it visually for your better understanding, and thus be able to work with examples of excessive behaviours, or overly conservative behaviours, or even appropriate and inappropriate behaviours in public or private.

For example, to help identify who you should tell about health problems and who you shouldn't. In this way, different levels of support and intimacy can be established.

Social stories are a very effective working tool with students with ASD, for example, when we observe that they do not understand a situation. The thought that usually comes to mind is that it is a wake-up call or that they do not want to carry out what has been commanded, but there is usually a more accurate interpretation and that is that they have not understood something, and not having the ability to ask for internalized help, they find it difficult to resolve the doubts that have arisen and for this reason, they sometimes show this behaviour.

Social scripts or social stories are short narratives, accompanied by visual support, which explain information from the context and rules of conduct of a specific social situation. They include important information about why it occurs, who is related to it, and exactly how its protagonist should act.

Teach basic rules to the student with ASD

Every year when the school year begins, it can be difficult to manage the amount of important and new information that has to be attended to: names of new teachers, people of reference, important or reference places in the school, important dates, instructions, rules behaviour....

Therefore, in the transitions between primary and secondary school, it is even more important to consider strategies that can help to manage the anxiety that excess information can cause to students with ASD.

2. SOCIAL AREA. HOW TO PREVENT BULLYING?

Social skills are important because they allow us to interact with each other with predictability, so that we can more readily understand each other and be understood. Social skills such as helping, demanding help or information, thanking, apologizing, initiating a conversation in any subject, answering the questions, following the rules, awaiting his turn, collaborating, accepting critics, demanding feedback for the work he has done, introducing himself provides his adaptation to the society, his integration in society, his communication and interaction with his peers and others (Çifci and Sucuoglu, 2004). 

Social skills which are one of the tools to enable social adaptation, to create social relations and to maintain existing social relations during social development are learned during the first years of the life and leads to important long and short term effects over the life of the individual. (Gülay and Akman, 2009). Within this context, it is important to improve and support social skills of children which determine life quality and enable their adaptation to the 

environment beginning from the school period.   

On the other hand, bullying is unwanted, aggressive behaviour among school aged children that involves a real or perceived power imbalance. The behaviour is repeated, or has the potential to be repeated, over time. 

2.1. TYPES OF BULLYING

• Exclusion: involves leaving someone out, or just not selected or joint in games or work teams
• Verbal bullying: saying or writing mean things. It includes: teasing, name-calling, inappropriate sexual comments, taunting, threatening to cause harm. 
• Relational bullying involves hurting someone’s reputation or relationships. It includes: leaving someone out on purpose, telling other children not to be friends with someone, spreading rumours about someone
• Physical bullying: involves hurting a person’s body or possessions. It includes: hitting, kicking, pinching, spitting, tripping, pushing, taking or breaking someone’s things, making mean or rude hand gestures.
• Cyberbullying: is bullying that takes place over digital devices like cell phones, computers, and tablets. It includes sending, posting, or sharing negative, harmful, false, or mean content about someone else. It can include sharing personal or private information about someone else causing embarrassment or humiliation.

2.2. WHY IS BULLYING MORE FREQUENT IN AUTISM?

Studies speak of a 44% prevalence of bullying in students with ASD (Montes and Halterman, 2007), while in other studies it is said that 77% of the sample has been a victim (Cappadocia and Weiss, 2011).

Bullying and cyberbullying is somewhat difficult to handle for people with ASD due to the variety of behaviours that may be involved and the variables that affect those behaviours, which sometimes go unnoticed by boys and girls with ASD (such as it could be, the tone of voice, the context ...). Often people with ASD are not aware that they are being victimized (Dubin, 2007)

Autistic children and young people can be more at risk of being bullied than their peers because of the different ways they communicate and interact with others. Their peer group will often notice these differences more and more as they get older.  

It is also hard to read facial expressions and body language, and they cannot tell when someone is being friendly or if they are trying to hurt them. This means they may misunderstand the intentions of their peers. They can also be easy targets in the playground as they sometimes prefer to play alone. 

As a result, other children find it easy to pick on them as they do not have a support structure around them. Other children may also pick on them if they see them doing 'odd' things such as hand flapping or making inappropriate comments. 

Autistic children and young people can also display some bullying behaviours. They may become aggressive when a game is not being played the way they want and then try to control the situation. They may also become frustrated at being 'left out' in the playground and try to 'make' children become friends with them.

2.3. RED FLAGS TO SUSPECT ABOUT POSSIBLE BULLYING OR ABUSE

There are many warning signs that may indicate that someone is affected by bullying—either being bullied or bullying others. Recognizing the warning signs is an important first step in taking action against bullying. Not all children who are bullied or are bullying others ask for help.

It is important to talk with children who show signs of being bullied or bullying others. These warning signs can also point to other issues or problems, such as depression or substance abuse. Talking to the child can help identify the root of the problem.

Look for changes in the child. However, be aware that not all children who are bullied exhibit warning signs.

Some signs that may point to a bullying problem are: 

• Unexplainable injuries
• Lost or destroyed clothing, books, electronics, or jewellery
• Frequent headaches or stomach aches, feeling sick or faking illness
• Changes in eating habits, like suddenly skipping meals or binge eating. Kids may come home from school hungry because they did not eat lunch.
• Difficulty sleeping or frequent nightmares
• Declining grades, loss of interest in schoolwork, or not wanting to go to school
• Sudden loss of friends or avoidance of social situations
• Feelings of helplessness or decreased self esteem
• Self-destructive behaviours such as running away from home, harming themselves, or talking about suicide
• Come home with dirty, damaged or missing clothes, bags or books, with bruises or scratches, without money they should have or asking for more money the next day 
• Arrive at school or get home late because they have changed their route to or from school 
• Be reluctant to go to school and make excuses to miss attending  
• Seem to be stressed, depressed, unhappy or unwell  
• Show a deterioration in concentration or the standard of schoolwork 
• Show an increase or change in obsessional/repetitive behaviour

2.4. PREVENTION AND ACTING IN THE SCHOOLS

We can affirm that when there is no good classroom climate, students have difficulties to achieve the learning, since they have little willingness to learn and manifest attitudes such as: boredom, tiredness, low participation and indiscipline.

It is convenient that as teachers and technicians in education be aware of being “leaders and models” for the students, and it requires the deployment of communication and social rapport skills that promote trust, dialogue, respect and inclusion in the classroom, being aware of the fact that we do not understand and express them with the same actions and skills with which they are capable of being able and expressing them with the same actions and skills.

It is necessary: respect, which is achieved with the following strategies: always respectful the behaviour: in the classroom, at school, and in the community; the authority is accompanied by respect and forms of social relations that do not mean humiliation to anyone; get respect is not the same as fear; practice tolerance and acceptance of everyone in the classroom, considering that diversity is present in it. It is also necessary to develop confidence, being useful the following strategies: assess mistakes as part of learning and take advantage of them to improve, recognize that everyone has the potential to learn, have high expectations of the achievements of others. Trust is the basis of any affective bond.

In addition, some recommendations to achieve a good climate in the classroom are:

• Consider discipline, applied with firmness, fairness and responsibility.
• To ensure that respect, solidarity and mutual support are lived at all times.
• Propose stimulating activities, where all students feel important.
• Actively assess all students. Achieve during learning activities that they experience positive emotions.

• If they need tranquillity, it is better not to go to quiet corners, quiet and isolated during breaks; it is better to look for places safe as can be the library.
• If they stay in the yard, look for places where there are a lot of people or where they have close to the people who guard the playground (Jakson, 2002).
• If bullies are approaching, they could get out of that situation. If not possible, is useful to attract an adult (Jakson, 2002).
• Talk to a good friend or teacher about what is happening and ask for advice (Gray, 2004).
• If they doubt the intention of any behaviour, ask someone they trust. It is important that they count from the beginning all that has happened (Gray, 2004).
• It may be useful if at home they make a map of the school where they indicate the classes which ones are the most conflictive moments in each place, in which and in what moments they will find a reference to help them, where and in which moments we can find the stalkers ... (Gray, 2004).
• Make it clear that they are not to blame for being bullied (Gray, 2004; Jakson, 2002).
• Find some way not to lose control when they are being harassed; something that can work is to think of an image of tranquillity and that of security (Gray, 2004).
• Practice with them a phrase to say the moment they get into with them; keep it simple and as true as possible (for example, “already I have heard you "," I need you to stop "or" I don't like this, for now ").
• Teach them to try to stay in calm, but serious, with the right body and the head up, keep a safe distance, and then contact a trusted person who can help them (Gray, 2004).
• Develop assertive strategies and prioritize them over strategies avoidant or aggressive. In this sense, it is important to teach them to detect some short phrases that generate in the aggressor the sensation of being unmasked, from respect.

• Facilitate the gradual integration of the student with ASD in the group, proposing works in small groups, in which the what and how of their participation are specifically defined, as well as the deadlines to do so, encouraging them to develop their source points in the share activity.
• Practice social and emotional skills with the student with ASD, such as the use of reciprocal conversation, providing written scripts of questions or topics that they can share with their classmates.
• Prioritizing responsibility, anticipating consequences and promoting respect for diversity and promoting inclusion by example.
• Be consistent and act with authority and a sense of justice in the classroom.

3. EMOTIONAL REGULATION STRATEGIES

3.1. EMOTIONAL INTELLIGENCE

Emotional intelligence describes the ability, capacity, skill, or self-perceived ability to identify, assess, and manage the emotions of one’s self, of others, and of groups. People who possess a high degree of emotional intelligence know themselves very well and are also able to sense the emotions of others. They are affable, resilient, and optimistic.

Emotional intelligence (EI) describes the ability, capacity, skill, or self-perceived ability to identify, assess, and manage the emotions of one’s self, of others, and of groups. People who possess a high degree of emotional intelligence know themselves very well and are also able to sense the emotions of others.

3.2. HELP TO REGULATE YOURSELF EMOTIONALLY

Self-regulation can be defined in various ways. In the most basic sense, it involves controlling one's behaviour, emotions, and thoughts in the pursuit of long-term goals. More specifically, emotional self-regulation refers to the ability to manage disruptive emotions and impulses. In other words, to think before acting. It also reflects the ability to cheer yourself up after disappointments and to act in a way consistent with your deepest held values.

Self-regulation involves taking a pause between a feeling and an action—taking the time to think things through, make a plan, wait patiently. Children often struggle with these behaviours, and adults may as well.

Self-regulation is also important in that it allows you to act in accordance with your deeply held values or social conscience and to express yourself appropriately. If you value academic achievement, it will allow you to study instead of slack off before a test. If you value helping others, it will allow you to help a co-worker with a project, even if you are on a tight deadline yourself.

• Create an emotional levels chart: create a visual aid that depicts the different levels of emotions that a child may feel, allowing the student to create their own labels for each level.
• Teach the students to assign emotional levels to certain situations.
• Talk about what appropriate reactions should be to different scenarios.
• Teach to coping strategies and be a model
• Mindfulness skills: encourages core mindfulness techniques—learning to accept life as it is in the moment. These skills use all the senses to pay attention to and participate fully in the present, are practiced non-judgmentally, and focus on what is necessary to be successful.
• Distress tolerance skills: recognize when urges to do ineffective things, such as to threaten suicide or self-harm or to act impulsively. It also focuses on skills necessary to cope with stressful situations, tolerate and survive crises, and consciously control problematic urges and re-frame thoughts.
• Interpersonal effectiveness skills: tools to assess need from a relationship; to establish and sustain healthy relationships; to maintain self-respect (e.g., being able to say, “No,” assertively); and to learn to cope with inevitable loss and interpersonal conflict.
• Walking the middle path skill: learns to see other sides of the story, how to negotiate and compromise, and how to validate others.

3.3. CALMING STRATEGIES FOR STUDENTS WITH AUTISM

In ASD socio-emotional regulation is affected by the difficulties to lead with hypersensitivity and context blindness, also executive functioning that leads the reactions and response to social and environmental context has been compromised in ASD. Reading and understanding themselves, and others' emotions has also specific difficulties for these students. 

Anxiety is one of the specific factors that influence school failure and is very present in students with autism, due to the difficulty they have to integrate the context, relate socially or deal with sensory demands.

Self-regulation needs different toolkit box for different moments, and when a student with ASD is at the school it is important to share with the teachers some codes or permissions that help them to put on practice with success their calm down strategies.

• Calm bottles or calming glitter jars provide healthy and effective ways for little ones to help soothe themselves, calm down, take deep breaths, and work through their emotions. 
• Offer an escape plan or a calming corner: sometimes they need to leave the place in order to regain their control and reduce stimulation.
• Calming corner or sensory box: comfortable and calming space to go when they need some space, to calm down their bodies and to take a time-in to process their feelings when they notice their motions are starting to spiral out of control.
• Develop some simple exercises or routines that are calming: squeeze a stress ball, focus attention in deep breathes, imagine a safety place or think about a pleasant memory, count to 10.
• Take 5 minutes each day to practice: relaxation, meditation, stretching or listening to music.
• Reflection zone: provide a writing or drawing space for students to reflect on their emotion’s behaviour. Teachers can provide guided questions or have the student engage in their own free write.
• Volcano technique: individualized graduation for each student specifies things that make them feel anxious and specific strategies for each situation.

4. INFORMAL AND FORMAL SEXUAL EDUCATION

4.1. SEXUAL EDUCATION TOPICS IN AUTISM

Sexuality is something fundamental that allows us to be, to recognize ourselves from the other, with the other. We are sexed beings from the moment of birth.

Today, the habit of silencing and treating sexuality as a taboo subject in people with functional diversity has been left behind.

It is important to make visible the desires, the fantasies since sexuality is present in everyone.

People's sexuality has intimacy as a value and it is important that each person write their own "sexual biography" with their interests, needs, desires, fantasies ... choosing how to express that sexuality.

It is very important to explicitly explain the vocabulary used when referring to different sexual content. Being able to naturally introduce sexuality as a part of life will make them not see it as a taboo subject. Thus, it would be important to make graphic material with them where vocabulary, terms, slang are explained and they can answer questions and doubts.

• Sexual diversity:
• General Terms: ally, intersexual, LGBTQUIA, SOCIE
• Sexuality: sexuality, sexual orientation, asexual, bisexual, lesbian, gay, homosexual, pansexual, queer, straight/heterosexual
• Gender: gender, gender identity, gender presentation/expression, gender binary, afab an amab, agender, androgyne, gender blender, bigender, cisgender, cross-dresser, drag kings/queens, enby, gender dysphoria, genderfluid, gender non-conforming, genderqueer, gender variant, non-binary, transsexual/transgender, transition
• Sexual biological development: is typically treated as a form of individual development, but sexuality and sexual behaviour have strong links to interpersonal experiences. 
• Puberty: moment of life when a boy or a girl becomes sexually mature. It is a process that usually occurs between the age of 10 and 14 for girls, and between 12 and 16 for boys. It causes physical changes and affects in different way for boys and girls.
• Self erotism/unspoken rules: as we have seen in other modules, people with ASD find it difficult to ask for help and sometimes ask about the anxiety that having to interact socially can generate, for this reason it is necessary to explain their own sexuality issues, such as masturbation and the "rules unwritten "about self-stimulation
• Pregnancy/Childbearing: pregnancy, also known as gestation, is the time during which one or more offspring develops inside a woman. Childbirth, also known as labour or delivery, is the ending of pregnancy where one or more babies leaves the uterus by passing through the vagina or by Caesarean section.
• On many occasions it is necessary to break the myths that the media, series or movies transmit to the society, since they acquire wrong models, being able to normalize and internalize behaviours
• Relationships: explain the free choice of having a partner or not and the social conditioning that this has. In addition, indicate the different types of partners that may be. All this could be supported by possible questions that may arise or hypothetic situations and think how they would act and anticipate it.
• Public/Private behaviour- sexual abuse prevention: give clear guidelines to identify situations of abuse and differentiate privacy from private. Talk about consent and how to ask reference people when there are doubts. Explain clearly which phrases would be used in situations of abuse or blackmail.
• Pornography: legal aspects, use and difference from reality, not being a model or an example to follow.
• Birth control/condom use and sexually transmitted infections (STIs): explain in a practical way or accompanied with material, visually presenting the pros and cons of each contraceptive method, the purpose, uses and generating questions
• Prostitution: Practice of having sex with other people in exchange for money or other financial benefits. Explain the possible causes of prostitution and the legal aspects that this entails.
• Abortion: Natural or voluntary interruption and premature termination of pregnancy, made before the fetus can survive outside the uterus. Explain causes and consequences, reasons why there are both voluntary and involuntary interruptions of pregnancy. Methods of termination of pregnancy. Legal aspects for a voluntary interruption of pregnancy.

5. FOCUS ON STRENGTHS

5.1. REMARKABLE STRENGHTS COULD HAVE ASD STUDENTS

Strength-based assessment (SBA), which has been used in work with children with milder behavioural disorders, may also have value for individuals who have ASD. SBA provides a method for identifying personal, familial, and broader contextual strengths and it can be a useful addition to assessment protocols because it provides specific information on assets that can be incorporated into interventions. Further, SBA has the potential to affect the attitudes and beliefs of parents and educators involved in the assessment, creating greater hope about the ability of the child to function well and contributing to a stronger bond between the assessor, the child, and their family. 

It will increase motivation and success in learning. There is a growing body of research that agrees about the manifestation of specific talents in autism, but also these existing talents go unnoticed on many occasions, and there are almost no references or models focused on educating these students on educating them from their strengths and potentials instead from their weaknesses.

• Great attention to Detail
• Honest and Direct Communication: tendency to be honest and non-judgemental
• Thrive with Routines
• They use to follow rules in strict sense
• Love patterns, and predictability 
• Extensive knowledge about topics of interest: they usually have a very high level of motivation in topics and activities that are of interest. 
• Excellent Memory Skills: specially for facts and figures.
• Logical and Independent Thinking: Ability to bring an innovative approach to problem solving
• Visual learners: their ability to look at parts of a whole and focus on small details and patterns. They use to be able to use written reminders, photos, visual schedules and diagrams to enhance their learning.
• Exceptional skills in creative arts, such as Art and Music
• Tendency to have a strong sense of loyalty in all social relationships

6. SELF DETERMINATION (SD) AND SELF ADVOCATE (SA)

6.1. SELF-DETERMINATION

Self-determination (SD) is the ability of individuals to know themselves, control their lives, plan and reach their goals and self-advocate. Are the skills, knowledge, and beliefs needed to engage in goal-directed behaviours based on an understanding of one’s strengths, limitations, and self (Field, Martin, Miller, Ward, & Wehmeyer, 1998). SD focuses on reforming systems to provide greater opportunities for choice and self-direction and on providing people with disabilities, in this case students with ASD, skills and information so they can express self-determination in their own lives. It is focused on five principals: freedom, authority, support, responsibility and confirmation.

SD plays a vital role in several contexts. It has been shown to increase life satisfaction in later life (Ekelund, Dahlin-Ivanoff, & Ekelund, 2014), promote physical activity and weight loss (Silva et al., 2010; Teixeira et al., 2012), moderate occupational burnout (Fernet, Guay, & Senecal, 2004), and motivation (Gagné & Deci, 2005) among many others.

6.2. SELF-ADVOCACY SKILLS BENEFITS

When self-advocacy skills and self-determination capacities are developed, students have: 

• Self-confidence in their ability to succeed
• An understanding that education and learning are necessary for long-term career success
• A belief in using abilities to their fullest to achieve high-quality results and outcomes
• A positive attitude toward work and learning
• Perseverance to achieve long- and short-term goals
• Ability to manage transitions and ability to adapt to changing situations and responsibilities

6.3. STRATEGIES TO HELP STUDENTS TO DEVELOPED SD/SA:

• Learn more about the needs of students with disabilities
• Work with other educators to identify out-of-school experiences that reinforce students’ personalized learning plans
• Participate in classroom behaviour observations and help measure students’ progress visually
• Ensure that all students have access to information about career development and establish a comprehensive school counselling program to empowered students to act in a self-determined manner in taking advantage of these opportunities. Make sure the student knows his/her rights
• Involve the student in decisions about his/her learning: it gives them a chance to talk directly with the team about the goals, the transition plan, what helps or not.
• Practice how he/she can talk to teachers about his/her issues: those conversations can be hard for a teen to initiate. Practice ‘conversation starters’ to make it easier.
• Effective modelling of self-advocacy skills

• Stop, look, listen: some children with ASD are self-focused and personalized situation in order to the difficult of understand some social behaviour. It is useful for them to asking themselves some questions:
• Who is involved here? Are these friends, acquaintances, authority figures? What do I know about these people? What can I expect?
• Where are we? What is the context?
• What is happening/what are people doing? It’s important to verbally go through who is doing what.
• What do the others feel, and what might be their points of view?
• What’s my role here? Is this personal to me?
• What’s likely to happen?
• Problem-solving skills:
  
• Identify the problem: what are thing like when they are the way we want them to be?
• Analyse the problem: at what stage is this problem? This helps to identify the urgency of the problem
• Describe the problem: writing it in the form of a statement using 12 words approximately.
• Look for root causes: what caused this problem? Who is responsible for this problem? When did this problem first emerge? Why did this happen? How did this variance from the standard come to be? Where does it hurt us the most? How do we go about resolving this problem? Can we solve this problem for good so it will never occur again? 
• Develop alternate solutions: develop a list of alternate solutions and rank them based of efficiency, long-term value and the resources you need and have.
• Implement the solution: planning on what happens next if something goes wrong.
• Measure the results: did it work? Was a good solution?

7. REFERENCES