Following are a list of recommendations that were written in the course of serving many students with high-functioning autism. The recommendations cover several topics including, the use of schedules, adapting academic material for students with autism, developing social skills, and managing behavior. Not all of these recommendations will be necessary or appropriate for all high-functioning students. The major principles on which these recommendations are based, however, are the same for all students with autism. These principles include:
Keeping these principles in mind when you adapt these recommendations for your students, or when you develop your own techniques, will help to ensure their success.
Recommendations For Students with High Functioning Autism
1. When students with autism are mainstreamed into the regular classroom setting it would be best to do so for classes that are interesting to them and which are related to their strengths. For example, handicapped students are often mainstreamed into electives such as physical education classes. Such a strategy would probably not be successful for children with autism. The social nature of this type of class and the relative lack of structure would make it difficult for them to have success in this setting. They would be much more successful if they were placed in a class such as math, and electives, such as computers, which are academic strengths, strong interests, and take place in a structured setting.
2. Many high-functioning students with autism have been very successful in school when they are assisted by an individual aide. Again this should be a person who knows about autism. Such a person would benefit from receiving specific training regarding high-functioning autism. The role of this person should not be to serve as the student's shadow who steps in and helps whenever a problem arises. Instead, the aide is most helpful when she or he assists in developing and implementing the structure (schedules, modifying assignments, checklists, etc.) that will be useful in increasing the child's independence. This aide can also make sure that these structures are implemented throughout his day. Even when the student with autism is spending time in a special education class, it might be helpful for him to have the aide present. In this situation the aide might be responsible for implementing the structure and making sure that the student's assignments and instruction are commensurate with those being presented in regular classrooms. This might be necessary as his peers in a special education classroom may not have academic skills that are comparable to his.
3. Providing a student with autism structured opportunities to interact with peers can help him develop his social skills. Just putting him in situations where other children are present, however, is unlikely to be helpful. Instead, inviting students into his special education class to play structured games is a way to give him practice interacting while keeping the interaction focused through a concrete game. In some cases, providing his peers with simple information about autism is also likely to make his peer interactions more successful because they will know more about why he does the things that seem odd to them.
4. A student with autism might also benefit from having an assigned buddy who accompanies him in some less structured social situations. For example, an older mature student might volunteer to sit with him at lunch two days each week and help him to interact with other students in that setting. Such buddies might also help him develop leisure skills. Some older youngsters from boy scout troops, church groups, or college students are often willing to help children by accompanying them on a community outing each week to places such as the bowling alley, movies, or science museum. Often an older boy or young man can serve as a role model in a way that is more attractive to children with autism than when adults are telling them how to behave.
5. As students with autism move into middle school and high school, extracurricular activities become another structured opportunity for peer interaction. Joining groups that are related to the strengths and interests of a child with autism gives them the opportunity to interact around a shared interest.
6. Many students with autism benefit from using a notebook that helps them organize their work and materials. These notebooks are usually ring binders that have a folder for every class during the day. The folder should have two pockets: one for assignments and the other for completed work. In addition to the folders, there should be a place for his daily schedule, a notebook for communication between teachers and parents, and a plastic pouch to carry his supplies. If he has difficulty organizing his supplies for different classes he may need a separate pouch for each class which could be placed in front of the class folder. For example, he may need a pouch with a Spanish dictionary in front of his Spanish folder and a pouch with a calculator in front of his Math folder. If the student has long-term assignments he also may need a calendar in his notebook that displays when larger projects are due or when major tests are due.
7. Some students have difficulty remembering which books to take home. It is often helpful to give students with autism two sets of books; one for home and one for school. This reduces the number of ideas that the child needs to organize to be able to complete his homework in a timely way.
8. It is very important for individuals with autism to learn to rely on daily schedules. By doing so, they will be able to function in a more organized and independent manner as adults. We recommend that students with autism learn to independently follow the directions of a daily schedule that is contained on the inside cover of their school notebook. It could be housed within a laminated sleeve so that they can use a water soluble marker to cross off each event as it occurs. This is also a good avenue for introducing unexpected changes that may occurring during the day. Changes should be highlighted so that he can anticipate them without becoming upset.
An example of a daily schedule could be:
8:00-8:50 Homeroom (Folder 1 for homeroom directions
8:50-9:00 Go to restroom, then Science is Mrs. Mates
9:00-9:50 Mrs. Mates Science (Folder 2 for science directions)
9:50-10:00 Go to P.E.
10:00-10:50 P.E. (follow the direction Ms. Lowell gives)
11:00-11:50 Math with Ms. Handlan (Folder 3 for math)
11:50-12:00 Go to cafeteria for lunch
12:00-12:30 Lunch
12:30-1:00 Go to computer (folder 4 for directions)
1:00-1:50 Go to English with Mr. Jones (Folder 5 for directions)
2:00-2:50 Go to Social Studies with Ms. Hearsey (Folder 6 for directions)
3:00-3:30 Go to homeroom (Folder 7 for directions)
A similar schedule can be used at home on the weekends. This schedule will be more flexible but some structure is probably necessary for students with autism even during free time. For example, they may be able to avoid bothering their brother or sister if they have a list of choices of things to do during free time so that they have some direction to which might prevent them from getting into trouble. Since they are motivated to spend time with their brother or sister, time to play with them can be specified on the schedule so that they know that they will get to play with them at some time in the day. Again specifying a structured activity, such as a game, will help them to play more appropriately.
9. When you are preparing persons with autism to work or play independently, they will be most successful if you provide them with the following written information:
A. What am I expected to do? (work, play, chores, lines in a conversation, etc.)
B. How much am I expected to do?
C. How will I know when I am finished?
D. What will I do next?
By knowing ahead the answers to these questions, the child will be more successful and independent in completing activities. Having a clear understanding of what is happening and what they are supposed to do will also decrease any anxiety they feel when they are unsure and unable to ask for clarification.
Following is an example of the type of assignment that would meet these criteria:
FOLDER 2 (SCIENCE):
Complete the following steps. REMEMBER to cross off each step as you complete it.
1. Read all of the directions first. READ THE DIRECTIONS ONLY, THEN go back to number 2 and do what it says.
2. Read pages 34-38 in your book, "Airplanes of World War II."
3. Write 2 paragraphs about the information you read in the book. Each paragraph should have 5 sentences.
4. When you have finished writing, put your paper in the "finished assignments" bin on Mrs. Mates desk.
5. Check in your notebook for what is next on your daily schedule.
10. Providing a person with autism checklists is another way to help them remain organized. For example, when the student has homework assignments it would be helpful to provide two pieces of information. At the top of each homework assignment sheet would be a list of necessary materials. On the bottom would be his assignment written out in detail as described in recommendation 8. Giving the child checklists is particularly helpful when they has to complete short series of related activities or when they need to organize a group of materials. For a chore at home they might need a checklist for completing the steps necessary to clean their room. "Clean your room" would be an item on their schedule. Then a checklist could be posted in their room telling them all the things they need to do:
make your bed _____
put away your clean clothes _____
put your books on the shelf _____
put your school notebook in your backpack _____
put your toys in the toy bin _____
sweep the floor _____
They would check off each item as they completed it so that they would know whether they have finished all of their tasks.
11. A child with autism is likely to be more successful at completing school assignments and tests if the work is presented in a way that visually highlights and organizes important information. For example, the directions for a test might be highlighted so that he will be sure to see them. Important sections of a book can also be highlighted to help him study. If he will need specific information from a reading in order to complete an assignment, a teacher could highlight that information in the text, or give him a written reminder telling him the type of information to look for. For example, if he is reading a story about Thanksgiving and he is going to write an essay about the foods that pilgrims ate, his assignment could read, "Read pages 10-16 about Thanksgiving, and pay attention to what it says about FOOD."
Worksheets might need to be reorganized to help the student be more successful. He is more likely to finish all the problems and follow directions if there are fewer problems on each sheet of paper and if the place for his answers is large and prominent. For example, his class might have a homework assignment of 20 problems that are all written on the same page. The student might be more successful if his assignment contains the same 20 problems, but on 4 different pages. Each problem night be accompanied with a large numbered box that corresponds to the number of each problem so that he can clearly see where the answer belongs and also clearly see whether he has finished all of the problems on the page.
Very long tests may also need to be rewritten to help the student complete them successfully.
Homework assignments may need to be written in a way that gives more information that other students usually need. For example, the other students may remember to copy the assignment from the board, but a student with high functioning autism might need the teacher to write the assignment and put it in their folder. Along with the written assignment, the teacher may also need to write a checklist of the materials the student will need.
Finally, a child with high functioning autism may be more successful at mastering some academic skills if aspects of their curriculum are geared towards their interests. For example, instead of trying to stop them from thinking about airplanes, they could learn math using airplanes. For example, when teaching division, you can have them calculate the speed of a plan that takes 5 hours to go 1000 miles.
12. If classes rely on lecture as a teaching method if may be necessary to find someone who can help the student with high functioning autism to take notes. This help could take one or more of the following forms depending on the needs and types of help that work best for them. The student could be paired with a classmate who write clear notes and who could photocopy his or her notes to share with the student or the student with high functioning autism might tape record classes to help them remember the lectures or their teacher might provide them with an outline of the lecture.
13. Many people with high functioning autism have poor handwriting and their handwriting skills do not seem to improve with practice. It has been helpful to teach these clients keyboarding skills at as early an age as possible. Once these are mastered many children with autism have found it easier to complete homework assignments, take notes in class, and complete long-term projects. Often occupational therapists have provided valuable services in teaching students with autism to use keyboards.
Computer skills can also provide vocational and recreational skill. Many people with autism enjoy working on computers and find that some computer jobs suit them well. The use of the Internet has also been a way to meet others and form friendships that is more comfortable for people with autism than more conventional ways of meeting.
14. At times parents of students with high functioning autism have difficulty finding out what happened at school. Two methods can be used to improve communication between the school and home. First, the student should keep a notebook in his binder that teachers can use to send notes home. When the teachers write a note, the student should place it in their folder for that class so that they will remember to show it to them when they do their homework. Likewise, they can place information in the various folders that they want to communicate to the teachers.
Students might also be able to communicate more effectively if given some structure to help talk about their day. Answering a question like "how was your day?" is often too broad and abstract for students with autism.
Instead their parents might ask them to use a form such as the following. They might later be able to answer similar questions verbally.
On the way to school today on the bus, I _____________________________________.
One thing that happened in homeroom today was _______________________________.
In science and social studies today, I did two things,
They were_________________________ and _______________________________.
In math and English, I did two things
_______________________________ and _________________________________.
One more thing that I did today was _________________________________________.
A difficult thing that I did today was __________________________________________.
A really fun thing that happened today was _____________________________________.
15. Often because of difficulties with communication people with high functioning autism benefit from speech and language services. The focus of these services should be on developing pragmatic language skills. Speech therapists have served a number of roles in helping children with autism meet pragmatic language goals. The use of scripts can help the child learn what to say in a variety of situations. For example, if a student with high functioning autism has difficulty with other students during lunch, his speech therapist might help him develop a script for beginning a conversation and then a list of things to talk about. The student may also benefit from working with a speech therapist in groups where the group is learning to apply language skills in practical social situations, such as playing games together.
Students with high functioning autism also might benefit from visual techniques designed to help them understand the nature of reciprocal conversations. For example, visual symbols can be used to learn pragmatic skills such as taking turns and not interrupting. The student and a peer might be given a box of Legos and a list of topics. Each peer could take turns choosing a topic. This may help the child to understand that he can not always talk about his own interests. As each peer takes a turn to say something about the topic, he or she gets to place a Lego onto another and pass the structure to the next peer. Once the group get used to this game it can be elaborated. For example, the members of the group might only be able to put a block on if he says something directly related to what the person said before. Or the group members can draw cards that tell them what sort of comment to make on their turn. One card might instruct the child to ask a question of the child who just spoke. Another card might tell the child to say something he or she liked about what the person just said. Other cards might emphasize nonverbal pragmatic skills such as drawing a card that tells the child to show someone you are interested without saying anything or show someone you agree with out saying anything.
Strategies such as these give children repeated practice in conversational skills.
Sometimes if is difficult for people with high functioning autism to carry on reciprocal conversations because they are so driven to talk about their own interests. Many students with autism are able to put off talking about their interests to another time if they know when that time will be. For example, you might write on his schedule that he will be able to talk to Mrs. Mates about airplanes at 9:45. When he starts interrupting class or a private conversation by bringing up airplanes you can just remind him that you will talk about it at 9:45.
16. Often the outbursts and impulsive behaviors of students with high functioning autism can appear to be manipulative, purposeful rule breaking, or intentional rudeness. In most cases these problems will be related to the child's autism and should be addressed in ways that are different than the ways there behaviors might be addressed in other children. There are several alternative strategies that may be helpful in addressing behaviors that have been previously problematic.
First, many of the behavior problems seem in the past will be prevented if the strategies above are implemented. When a child with high functioning autism understands what is happening he or she is less likely to become upset. The use of written schedules, written instructions, and routines will help the child to understand what is happening better than in the past. Writing a schedule in a way that helps the child anticipate changes will help him to remain calm when those changes occur and writing activities into his schedule which are appealing to him will increase his interest in following the schedule.
Often people with high functioning autism are impulsive. They will need special preparation before entering new situations. This might require having someone who is familiar with the child "scout" the situation ahead of time to anticipate possible problems and then write out rules that the child with high functioning autism can review and keep with him when he enters that situation.
Consistent written rules will help the student with high functioning autism to know what is expected of them at all times. When one breaks a rule you should remind him to look at his rules, rather than telling him what to do. When a teacher tells a student what to do, the instructions take on a "personal" nature that can be difficult for a student with autism. By referring the child back to the rules the direction seems less personal, as though the rules sheet is saying what to do, not the person. Another way to make the rules seem more palatable are to put them on school letterhead, refer to them as school policy, or say that these are rules the doctor at the hospital (if they have been seen by a psychologist or psychiatrist) said they must follow.
Usually when persons with high functioning autism become upset or engage in inappropriate behaviors, they are unlikely to have the skills to appreciate why what they are doing is wrong because they can not form those cause and effect social connections. It is tempting to think that bright students, would know the effects of their behavior on others but this is often not the case and it is best to err on the side of autism when interpreting misbehavior. Visual comics and stories will help them to understand social situation better and will help them to know what to do (see recommendation 18).
17. If a child with high functioning autism feels a "rage" coming on, it would be helpful if a teacher or parent would give him a written note to go to a predetermined quiet area of the school to write about why he or she is angry. All verbal directions from staff or parents should stop as this tends to escalate the anger of a person with autism. If more directions are needed, it is helpful if the adults write them out. At first the student may crumple up the paper, but usually if you leave the paper by them and walk away, he will eventually read it.
If a student needs to communicate with others when they are upset they should also be encouraged to write to you (or write on the computer) as their ability to communicate verbally is reduced when they are anxious.
18. Social skills of people with autism will improve when they are provided with strategies that will improve their understanding of social situations and give them specific behaviors to use when they are interacting with others. Two such strategies, Social Stories and Comic Strip Conversations, have been developed by Carol Gray of Jenison Public Schools in Michigan. Instructions for implementing these strategies are available in books which are available though the Autism Society of North Carolina Bookstore(ASNC)() or through Future Education ().
19. Some high functioning adolescents and adults with autism benefit from individual counseling. This counseling does not take the form of insight oriented counseling. Instead it makes use of many of the strategies described above, such as the social stories, to help develop social skills. Other strategies include role-play, concrete problem solving, such as making a list of who to talk to when someone teases you, or helping them to develop the skills to write their own schedules. Occasionally there are more emotional issues that need to be addressed but every attempt should be made to relate these issues to concrete information that can be understood by the student and to keep these discussions from being too open-ended. Frequently some portions of these counseling sessions are more successful when they take place by writing back and forth to each other.
Kerry Hogan
Chapel Hill TEACCH Center