Asperger's, Autism, ASD

For a graduate school class in Special Education. Enjoy...it's a long one! Students on the Autism Spectrum exhibit a range of developmental delays and disabilities related to communication, daily living skills, executive functioning, employment, continuing education, social/leisure, and emergency services as they approach adulthood (Krumpelman & Hord, 2021). These students fall through the cracks after high school unless there is a structured approach for transitioning into adulthood (Ivey, 2007). Most schools provide an Individualized Education Plan (IEP) with transition planning for Autistic students as required by the Individuals with Disabilities Education Act (IDEA), however IEPs typically focus on academic needs versus independent living skills. There has been a remarkable shift in increasing the number of goals in a student’s IEP Transition Plan. More needs to be done to fully prepare students on the Autism Spectrum for post-secondary living. In the past, the focus on post-secondary transition was limited (Katz, 2013). Transition planning centered around getting a job or going to college or community college in the process of obtaining employment, and transition goals in a student’s IEP reflected job-specific planning and actions. After high school, many students with developmental disorders or intellectual delays struggle with the planning and actions required to live independently and manage the number of roles and responsibilities needed to successfully transition into adulthood (Krumpelman & Hord, 2021). The end of services typically leads to little support, other than that provided by parents, with little prior planning and coordination with community organizations. This leads to students living with parents or family members as caregivers, with little to no self-autonomy or role in making decisions about their own life (Test et al., 2020). Some students might be sent away to live at larger institutions if the family has enough funds to privately pay. Many students do not build skills leading to independent living or making decisions about their own life (Ivey, 2007). The use of real-world practice in generalizing skills in the community leads to students being more prepared prior to high school graduation (Noyes & Sax, 2004). This improvement in the student trying their skills in the community leads to an increase in success post high-school, when less scaffolding and support is available. Communication Skills A significant part of living independently is the ability to receive and communicate information. Part of this involves teaching the context of word use, sometimes referred to as work related communication vs casual communication (Katz, 2013). Students on the Autism Spectrum sometimes struggle with timing and word choice–all things that can be taught as it relates to transition skills. The use of professional language in writing and conversation as it relates to work/family/school vs friends/casual environment can be part of IEP goals to build a sense of nuance in the student’s communication. Discussing metaphors, idioms, and slang is critical for Autistic students, as they often lack the ability to decipher hidden meanings. Teacher-led discussions about hidden meanings in words/phrases can model thoughtfulness as well as students asking for help if they don’t understand the context of a statement–all critical skills to learn in preparation for post-secondary life (Buchanan et al., 2016). Non-verbal communication is another aspect of daily life that students on the Autism Spectrum struggle with. From facial expressions, gestures, and body language, many students with developmental delays struggle to navigate non-verbal communication as it exists in professional and casual settings. There is an abundance of books and strategies for teaching the autistic student to look for hints and clues as to what another person is communicating without speaking. Having transition goals that include role-playing with a teacher/speech and language therapist can help improve these communication skills. Another part of communication in preparation for transition is dating, boundaries, physical safety, and emotional safety (Krumpelman & Hord, 2021). Adolescents on the Autism Spectrum might feel or not feel the changes that occur during puberty, and for some students, lessons on the changing body and being aware of these changes will help in navigating this potentially awkward time in life. Schools in the middle-school years might use small group versions of lessons on puberty to guide autistic students in a less awkward setting on what to expect during teenage years regarding the changing male and female body, boundaries, and respecting one’s own and another’s boundaries by having effective communication. A closely related skill regarding puberty years is pause-and-think also known as having a filter. For many kids on the Autism Spectrum, if this is not taught explicitly, it will not be learned and used in post-secondary life. Daily Living Skills From waking up in the morning to going to sleep at night, there are numerous steps that occur each hour to navigate the day’s needs. Some students on the Autism Spectrum need direction on: A. Morning routine including self-care/hygiene, dress, and transition to work. B. Apartment and room organization. C. Cooking, dishes, food storage, and grocery shopping. D. Laundry, domestic cleanliness, home maintenance services, and fix-it support. These hard skills tend to be emphasized by the parents of students on the Autism Spectrum, but they can also be broken into lessons taught by the student’s high school. A more challenging habit that students need to master is calendar use. Whether a physical or electronic calendar, students need to be able to add appointments to a calendar and schedule the needs for each day, week, and month. Many students on the Autism Spectrum struggle with planning and organization. The use of an iPad, computer, and iWatch with a calendar app synced together is a great form of adding structure and reminders to a student’s schedule. The ability to link this to a parent’s schedule helps encourage family support and investment as the student develops autonomy on their own after high school. Executive Functioning Skills This list of skills relates to the brain’s ability to plan and prioritize, filter out distractions, and manage emotions. Executive Functioning Skills (EF) grow rapidly during the ages of 3-5 as well as during adolescence and young adult years. Students on the Autism Spectrum often test lower in EF Skills and require structured coaching, practice, and guided problem-solving in order to generalize these skills as a young adult. A model of 11 EF Skills created by Dawson and Guare (2018), can be grouped into three categories with similar skills. Emotional Regulation, Flexible Thinking, and Impulse Inhibition This foundational triplet of skills is often referred to as the most critical because of their use in interpersonal communication and problem-solving in relationships, employment, and one’s personal life (Dawson & Guare, 2018). Without the structure and routine of high school, students have to navigate the nebulous day-to-day activities of young adulthood. For students on the Autism Spectrum, who often over-analyze and become overwhelmed by sensory input, this can present a major set of hurdles to overcome each day. Building a student’s awareness of emotions is often the first step in the process of learning these three skills. The red, yellow, green, and blue Zones of Regulation is a great tool to identify individual emotions (Kuypers & Winner, 2021). The Zones of Regulation separates emotions with specific colors that represent a category of feelings. The red zone contains words of high energy and intensity such as anger, elation, and out of control. The yellow zone is for an elevated internal feeling such as excitement, silliness, frustration, and nervousness.  The green zone focuses on a calm, alert state of being with feelings such as happy, satisfied, and calm. The blue zone represents bored, tired, sad, and sick. This can be used from early elementary years through high school, and it is a foundational step in the process of understanding feelings, emotions, and energy levels. There is no preferred or right-or-wrong zone to be in; it is a non-judgemental tool for students to identify their feelings. One helpful strategy in teaching the 3 skills of emotional regulation, flexible thinking, and impulse inhibition is having the student discuss different ways of handling a situation and verbalizing the challenge in-the-moment. Rigidity is a common trait in many students on the spectrum, and easing a student into considering alternatives to a situation or dilemma is a way to initiate the process of flexible thinking. If a student is to generalize these skills (unassisted, in public, as a young adult), then they need guided practice and support in high school. Planning, Organization, and Task Initiation As elementary-age students, most children are guided by parents, teachers, and the community when it comes to their roles and responsibilities. In young adulthood, students must be able to organize their day, plan the week ahead, and approach their monthly schedule in a manageable way if they are to learn to prioritize the changing needs and demands of independent living (Dawson & Guare, 2018). The ability to make decisions about how to work through competing roles and responsibilities is critical to managing employment schedules, transportation, leisure and weekend activities, and maintaining a social life. Planning and Organization can be taught in a visual manner with high school students using physical or electronic graphic organizers. Task Initiation is the ability to begin a task, activity, or chore and independently generate responses or solutions to the situation. A reminder app on an iPhone or iWatch can help with task initiation and keeping a student on track. Goal-Directed Persistence, Sustained Attention, and Metacognition The use of SMART goals (Specific, Measurable, Achievable, Relevant, Time-bound) is a process for breaking a plan into chunks to work on and lead to goal-directed persistence (McGlynn & Kelly, 2017). SMART goals and strategies can be taught in class and online as there are plenty of video tutorials aimed at teenagers. By focusing on the student’s goals and desires, teachers and counselors can guide the process of an autistic student laying out a framework in which to work towards and achieve the goal. Sustained Attention is the capacity to focus on a task or situation in spite of distractions, fatigue, or boredom (Dawson & Guare, 2018). Building the grit to continue working until a goal is achieved, might be one of the biggest challenges for students on the Autism Spectrum, who through past failures, have a higher tendency to give up. Metacognition skills include the ability to self-monitor, self-evaluate, and consider one’s own progress in a situation, task, or setting. It involves the ability to think about how you think. Checking one’s work when finished to see if you accomplished the task, re-reading answers on an assignment, as well as recognizing when you are stuck are metacognitive tasks that lead to processes of student self-review. Metacognition helps a student be aware of their in-the-moment work and supports the skill of persistence. Students on the Autism Spectrum who learn to generalize these and other Executive Functioning Skills, lead more independent lives with a higher degree of autonomy and self-actualization (Dawson & Guare, 2018). Time Management and Working Memory Both Time Management and Working Memory benefit from organizing a daily plan to prioritize and remember short-term and long-term assignments and tasks (Dawson & Guare, 2018). Time management involves not only accomplishing a task by a pre-set deadline, it requires organization and breaking a project into smaller parts. The skill of organization is critical in using time effectively during and after high school, and the daily actions to emphasize time management must be taught, modeled, and guided by teachers and counselors. Working Memory is a measurable skill involving short-term memory. It involves the ability to self-monitor, self-evaluate, and consider one’s progress in a situation, task, or setting. Students on the spectrum with low working memory often float between classes and struggle with accomplishing school and home responsibilities unless directed by a teacher or parent. Teaching organizational skills using checklists for morning, school-day, and after-school activities, is a great way to introduce a student to solutions to help them plan and execute their role successfully each day. Involving the student in the planning and review of roles and tasks leads to more independence and preparation for post-high-school life. Employment A major jump in the transition from elementary to middle or high school is getting a first job. Working with co-workers, taking directions from a boss, and doing physical labor are real-world experiences that begin the process of generalizing skills into the community (Morgan, 2018). For students on the Autism Spectrum, who are often delayed in the process of getting a job, they don’t typically have the incremental growth in high school that sets them up for employment as a young adult. The employment process needs to be broken into individual steps for students on the spectrum. Completing a job application, whether online or physical, and submitting it appropriately are new steps for students who might need support (Noyes & Sax, 2004). Interview preparation, interview practice, and follow-through on a possible job are actions that need to be guided and supported. For many jobs that require employment training such as online videos and tutorials, as well as the actual first day of work, students on the spectrum benefit from more individual support in initiating these tasks. A first job can be intimidating! In a report on the Perceptions of Mental Health Concerns for Secondary Students with Disabilities during Transition to Adulthood, authors Poppen et al., 2016, shared a table expressing teacher/professional and community concerns regarding the services needed to enable a more successful transition. Continuing Education: Job Training, Community College, and University Options Part of the transition process is deciding what will be the next step in education after high school. Teacher-led discussions around student aspirations and ideas help begin the process of the planning for job training, community college, or 4-year university options (Krumpelman & Hord, 2021). For students transitioning into the workforce, are there training requirements or certifications that need to be earned? Some companies in the technology industry require certificates for coding and other online-based positions. Many have specific role-based training that needs to be accomplished prior to day 1 of employment. For most students on the Autism Spectrum, initiating and following through on all pre-work training needs support (Richler, 2015). If a student is applying to community college or university, the process needs to be broken down into steps of: 1. College search 2. Application with letters of recommendation 3. ACT/SAT preparation and test 4. College essay and Interview 5. Possible pre-college assignments or assessments 6. Examining college support and tutoring resources on campus 7. Transition to living on campus or independently Social and Leisure Life Building an independent life with hobbies, interests, and sports activities is sometimes challenging for autistic students after high school (Notbohm, 2019). The uncertainty of the outcome in social settings often leads to a lack of exploring and trying free-time hobbies. Students who plan, experiment with, and evaluate options in their community, under the guidance of high school staff, build the confidence to generate personal interests outside of work and are more likely to build healthy hobbies as a young adult (Bagwell et al., 1998). Physical Fitness Transitioning to young adulthood should include plans for physical activities and working out. Students should investigate options for doing this such as a local gym, swimming pool, indoor climbing wall, basketball/soccer league or outdoor adventure group which also can connect to positive peer groups in the community. Online/Social Media Safety Students should be aware of building healthy habits around social media and time spent online. Young adults on the spectrum often find online relationships easier to initiate versus in-person relationships. The skill of time-management regarding Social Media can build awareness of time spent on apps and websites and help students be aware of healthy versus unhealthy habits. A very real challenge for students who might be more naive in terms of the internet is how to identify when someone is trying to scam a user or leading someone down a path to being manipulated into losing money. Autistic students who find an online friend who, at first might have good intentions, could later lead the student to share information that is personally compromising in an effort to extort them. Teachers and support staff need to help students grow an awareness of signs and hints that an online person might be a scammer or have harmful intentions. Community Resources and Volunteering For students transitioning to independent life, there are resources in the community that can be part of being successful as a young adult (Kaffenberger, 2013). Public Libraries often serve as resources not only for books and magazines, but also online access in a safe environment. Students can reach out to staff at libraries ahead of high school graduation to form relationships and see resources available. Some libraries also connect people to community groups seeking help. For students on the spectrum, volunteering is often a first step to a job or to making connections to community groups. Local animal shelters, eldercare facilities, museums, nature preserves, community improvement groups, or religious organizations can guide young adults into volunteer positions, which provide structure and purpose. Emergencies, Life Complications, and Solutions Challenges and unexpected hurdles exist for all students transitioning to young adulthood. For students on the Autism Spectrum, role-play around emotions and problem-solving ahead of time allows for more appropriate responses during the situation (Smith et al., 2015). Personal Physical and Mental Health What constitutes a life-threatening injury? When does an injury, pain, or an accident go above my own ability to manage it? When should I reach out for medical help, either physically or mentally? These questions and the actions of obtaining help can be addressed prior to transition. Tours of instant care facilities and hospitals, as well as identifying mental health resources can be guided by teachers, family, or support staff. Many students on the Autism Spectrum benefit from using a personal therapist, trained in Applied Behavior Analysis and a blend of therapeutic methods to support the transition to young adulthood (Boutot & Hume, 2012). Police Roles and Interactions Students on the Autism Spectrum need to be introduced to the police to build a healthy understanding of how to interact with police with respect. Situations where one encounters police such as a speeding ticket, car accident, or car breakdowns on the side of the road can be role-played ahead of time. Some communities even have a simulated experience for special-needs students of what it is like to get pulled over by police and how to interact. These simulations can help young adults predict how to respond with respect and appropriateness in what can otherwise be a foreign, stressful experience. New Strategies and Partnering with Community Resources In the years leading up to high school graduation and living more independently, a student’s support system of the IEP, teachers, counselors, Speech and Language Therapist, Occupational Therapist, friends, and family members are critical to their success (Kaffenberger, 2013). These individuals can contribute to the preparation, skill-building, and exploration of all aspects of post-high school life. A combination of examining independent living, combined with supported experiences in the community looking at Vocational Rehabilitation, Assisted Living opportunities, and local rideshare options for transportation are a great place to begin (Noyes & Sax, 2004). Disability and Non-profit organizations such as the United Way, Special Olympics, National Ability Center, Easter Seals, and hospital organizations should all be considered in the process. All discussions during the IEP meeting relate to transition– the IEP is a long-range document that helps the student reach goals they have identified for adult life. Those goals might change, and yet a Transition Plan is required to be in each IEP by 16 years of age at the latest. Each year’s progress builds upon the previous year–reviewing the past plan, revising it, and updating each goal based on the student’s growth. It is the responsibility of the case manager/Special Education Teacher to collaborate with teachers, parents, and community to prepare for and guide each student towards a successful transition to adulthood. References Bagwell, C. L., Newcomb, A. F., & Bukowski, W. M. (1998). Preadolescent Friendship and Peer Rejection as Predictors of Adult Adjustment. Child Development, 69(1), 140–153. https://doi.org/10.2307/1132076 Boutot, E. A., & Hume, K. (2012). Beyond Time Out and Table Time: Today’s Applied Behavior Analysis for Students with Autism. Education and Training in Autism and Developmental Disabilities, 47(1), 23–38. http://www.jstor.org/stable/23880559 Buchanan, R., Nese, R. N. T., & Clark, M. (2016). Stakeholders’ Voices: Defining Needs of Students with Emotional and Behavioral Disorders Transitioning between School Settings. Behavioral Disorders, 41(3), 135–147. https://www.jstor.org/stable/26780305 Dawson, P. & Guare, R. (2018). Executive skills in children and adolescents: A practical guide to assessment and intervention (3rd ed.). Guilford Press. Ivey, J. K. (2007). Outcomes for Students with Autism Spectrum Disorders: What is Important and Likely According to Teachers? Education and Training in Developmental Disabilities, 42(1), 3–13. http://www.jstor.org/stable/23880134 Kaffenberger, C. J., & O’Rorke-Trigiani, J. (2013). Addressing Student Mental Health Needs by Providing Direct and Indirect Services and Building Alliances in the Community. Professional School Counseling, 16(5), 323–332. http://www.jstor.org/stable/profschocoun.16.5.323 Katz, J. (2013). The Three Block Model of Universal Design for Learning (UDL): Engaging students in inclusive education. Canadian Journal of Education / Revue Canadienne de l’éducation, 36(1), 153–194. http://www.jstor.org/stable/canajeducrevucan.36.1.153 Krumpelman, M. L., & Hord, C. (2021). Experiences of Young Adults with Autism without Co-occurring Intellectual Disability: A Review of the Literature. Education and Training in Autism and Developmental Disabilities, 56(1), 70–82. https://www.jstor.org/stable/27077948 Kuypers, L. M., & Winner, M. G. (2021). The zones of regulation: A curriculum designed to foster self-regulation and emotional control. Think Social Publishing, Inc.  Matthews, L. K., Wall, K. H., Hoffman, Y., Pantale, A., & De Martinis, J. (2019). The Unheard Voices of Transition: The Experiences of Four Female Young Adults with ASD as they Prepare to Graduate. The High School Journal, 102(4), 283–296. https://www.jstor.org/stable/26829644 McGlynn, K., & Kelly, J. (2020). The Forgotten Factor: Executive Functioning and Success in the Classroom. Science Scope, 43(7), 50–55. https://www.jstor.org/stable/27048050 McGlynn, K., & Kelly, J. (2017). Self-improvement through goal setting. Science Scope, 41(2), 22–24. http://www.jstor.org/stable/26387193 Morgan, C. A., & Wine, B. (2018). Evaluation of Behavior Skills Training for Teaching Work Skills to a Student with Autism Spectrum Disorder. Education and Treatment of Children, 41(2), 223–232. https://www.jstor.org/stable/26535265 Noyes, D. A., & Sax, C. L. (2004). Changing Systems for Transition: Students, Families, and Professionals Working Together. Education and Training in Developmental Disabilities, 39(1), 35–44. http://www.jstor.org/stable/23880019 Poppen, M., Sinclair, J., Hirano, K., Lindstrom, L., & Unruh, D. (2016). Perceptions of Mental Health Concerns for Secondary Students with Disabilities during Transition to Adulthood. Education and Treatment of Children, 39(2), 221–246. http://www.jstor.org/stable/44684104 Smith, S. W., Cumming, M. M., Merrill, K. L., Pitts, D. L., & Daunic, A. P. (2015). Teaching Self-Regulation Skills to Students With Behavior Problems: Essential Instructional Components. Beyond Behavior, 24(3), 4–13. http://www.jstor.org/stable/26342159 Test, D. W., Coyle, J., Rusher, D., Carter, E., Seaman-Tullis, R., & Odom, S. L. (2020). Secondary Transition of Students with Autism Spectrum Disorder: Recommendations for Researchers. Education and Training in Autism and Developmental Disabilities, 55(3), 247–263. https://www.jstor.org/stable/27077918

Part of the challenge for students with ADHD is managing the steps and focus needed in doing homework and long-term projects. For some students on the Autism Spectrum (and with an ADHD diagnosis as well), a strategy of decreasing stimulus as well as using managed stimulus can help with concentration and perseverance. For many students, environmental noises and sounds distract from the task at hand, thereby lowering a student's ability to initiate and complete school tasks (reading, assignments, essays, etc.). Brown Noise is a tool that might help some students with ASD and ADHD focus on school work as well as relax. It's worth checking out and seeing if you or your child might benefit from it. As always, pay attention to the volume recommended (not too loud!) as well as other recommendations. 1.Interesting comparisons of different noises in this article as well as discussion on benefits. https://www.washingtonpost.com/wellness/2022/11/14/brown-noise-adhd-focus/ 2. Discussion on brown noise from ADD website. https://www.additudemag.com/brown-noise-adhd-tiktok-trend-improve-focus/

A down-to-earth, approachable resource for mental health: the National Alliance on Mental Illness. This organization has information from disorders and diagnosis to treatment and strategies to create habits when managing mental illnesses. Their child, teen, and adult links for those with mental illness as well as caregivers gives a wealth of information from doctors and researchers to blog posts on those in the mental health recovery journey. We particularly liked the sections under "The Latest" where it shows Blogs, Personal Stories, News, From the CEO, and Videos. Check them out at: https://www.nami.org/home