Specific Application: Autism Spectrum Disorder

• Autism Spectrum Disorder including Asperger syndrome is a pervasive developmental-personality disorder characterized by significant problems empathizing, socializing and communicating with others and obsessional attitudes and behaviour with anxiety about change


• The incidence of Autism spectrum disorder is about 10 in 1000 children, 4-5:1 male to female ratio.


• Autistic children are stuck at all stages of STOP and THINK and DO with difficulties


• picking up social cues including feelings even when they look and listen


• communicating their own feelings and needs appropriately


• thinking of options from within a very narrow, rigid comfort zone


• connecting behaviour and consequences which limits their choices of action


• fine-tuning their behaviour to appear appropriate and skilled


• However, children on the autism spectrum do respond to the STOP THINK DO method of social skills training and behaviour management, with some modifications


• less emphasis is placed on brainstorming strategies at THINK which leads them off on unrelated or self defensive tangents, or outside of their comfort zone


• more emphasis is put on STOP to DO steps, clearly linking the specific problem and the choice of consequences which will directly effect them as rules


• they need definition, order and clarification about how they will be effected personally if they do not change their behaviour, rather than discussions about how their behaviour effects others since such empathy is lacking in these children



STOP to DO plans for social skills training




STOP Look at faces and bodies, and listen to voices = rules to understand people and feelings DO Appropriate verbal and non-verbal behaviours with people (eye contact, voice, distance, face, asking questions about others etc)




STOP to DO plans for behaviour management




STOP State problem clearly to child Keep words and emotions to a minimum DO Give choices of 2 options as rules with specific consequences for behaving appropriately and for not behaving appropriately Act on child's choice




STOP to DO plans for motivating learning




STOP Break down task or activity into smaller steps and list them DO Give choices of 2 options as rules with specific consequences if list is followed or not followed. May use obsessions as consequences. Act on child's choices.



• The school system needs to be flexible in terms of options (eg alternative activities like chess, library, music club may be arranged for them at play times) and in terms of consequences for misbehaviour (eg, removing a child with AS from a problem situation may be seen as reinforcement by the child who likes to do their own thing)


• Children with Autism spectrum disorder respond well to the STOP THINK DO approach to motivate their learning since
  
  • it is structured, clear and pre-planned so they know what is expected from them
  
  
  • learning plans may be drawn up as a checklist or set of rules to satisfy their need for order
  
  
  • consequences may be very explicit eg, work needs to be completed in the appropriate lesson or during computer time, if the child is particularly fixated on computer
  
  
  • expectations regarding yard behaviour may also be included in the checklist eg, stay away from a particular problem area or person in the yard and earn television time
  
  
  • pet topics may be used to encourage formal academic skills eg, a child fixated on motorbikes may develop maths and problem solving skills through calculations about motorbikes, and reading, writing and research skills around motorbike topics
  
  
• Many children with Autism spectrum disorder also have attention deficit disorder and/or learning difficulities which need to be remediated using appropriate programs incorporated into their individual plans for change