temple grandin autism and my sensory based world[1].pdf
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Autism and My SensoryBased World 3rd Edition
Temple Grandin
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A good teacher is gently insistent
Early intervention essential
Minimum 20 hours weekly of
one-to-one teaching
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A child has to be pushed to keeplearning new skills
Pushing too hard causes sensoryoverload and no progress
Never have sudden surprises. Thiscauses fright and tantrums
Adults and teenagers must also bepushed to try new things and keeplearning
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Sensory processing disorder occurs
with many other disorders (co-morbid)
Autism spectrum
Dyslexia
Learning problems
ADHD
Asperger
Head injury
Oppositional defiant
Many others
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Sounds are better tolerated whenthe child initiates them.
Little Rainman by Karen Simmons
Child blocks ears because
certain sounds hurt
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Auditory Threshold NormalHearing auditory detail is impaired
Stretch out and enunciateconsonants
Hearing may be like a bad mobilephone connection
Occurs with many disorders
Hearing may fade in and outlike a poor mobile phone
connection
Echolalia increases as receptive
language becomes worse.J acqueline Roberts, 1997
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Attention shifting slownessoccurs with many disorders
Takes longer to shift back
and forth betweentwo different things
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Ami Klin
Viewer with Autism (Red Line)
Normal Comparison Viewer(Yellow Line)
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Oliver Sacks
Visual images break up
and fragment
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Signs of Visual Processing Problems
Finger flicking near eyes
Tilts head when looking at things
Hates escalators
Hates fluorescent lights andsees flicker
Difficulty catching a ball
Eye exams may be normal
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Words vibrate and jiggle on page
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Interventions for Visual Processing Problems
Incandescent lamp by desk
Block fluorescent lights with a hat
Laptop or tablet computer
Gray, tan, or pastel paper
Irlen lenses or pale colored glasses
Balancing games - sit on ball
Prismglasses - Developmental Optometrist
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Severe Sensory ProblemsExtreme effort required to screen out
background noise and visual distractionsNeeds frequent breaks to prevent sensoryoverload
Mono-channel
Body boundary problems
Often an auditory thinker
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Best Books to Understand
Severe Sensory Problems
How Can I Talk if my Lips Dont Move
by Tito Rajarish Muhopadhyay*
Carlys Voice by Arthur Fleischmannwith Carly Fleischmann*
* Nonverbal and types independently
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What Have Scientists Learned?
Sensory problems are real
Immature lower brain areas
Abnormal circuits betweendifferent brain regions
Sensory problems are variable
Many word based tasks are processedin visual areas of the brain
Frontal cortex is used less because it
has missing circuits Eric Courchesne, Nancy Minshew, MargaretBauman
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Heller, W., and Nitsch, J .B. 1997, Cognition and Emotion, 11:637-661.
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Structural MRI Connection
s
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HighDefinitionFiberTracksofTempleGrandin
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Temple Grandin Normal Age MatchedSubject
Axon Projection Field Much Less Organized
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Visual
Representation
Speech
Production
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Auditory
Walt Schneider, Univ. of Pittsburgh
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Miller et al., 1998 Neurology, 51:978-981
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Develop the Childs Strengths
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My mind works like
Google for Images
Little Rainman by Karen Simmons
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Little Rainman by Karen Simmons
Sensory thinkers sort specific
pictures, sounds, touches, andsmells into categories
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I realized my thinking
was different when Iasked other people to
think about churchsteeples
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Most people see intheir imagination a
generalized genericsteeple
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I see only specific pictures of
steeples I have observed.
They flash into my memory like aseries of still Googled pictures
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My childhood church
First category under steeples
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Local churches in Fort Collins
Secondary category under steeples
Famo s Steeples
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Famous Steeples
Mormon Temple, Washington, D.C.Third category under steeples
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Famous Steeples
Old North Church - BostonThird category under steeples
F St l
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Famous Steeples
Notre DameThird category under steeples
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Famous Steeples
Westminster Abbey
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Brain Scans
T. GrandinControl
Humphreys, Minshew, Behrmann, and Cibu, 2006
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Brain Scans
T. Grandin Control
Humphreys, Minshew, Behrmann, and Cibu, 2006
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Abnormalities in Left
Hemisphere
University of Utah, 2010
D l T l t i th
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Develop Talents in the
Individuals Specialist Brain1. Photo Realistic Visual Thinking Poor at algebra
2. Pattern Thinker Music and Math Poor in reading
3. Verbal Facts Language Translation Poor at drawing
4. Auditory Thinker Visual perception fragmented
There can be mixtures of these thinking types
T C t i f
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Two Categories of
Mathematicians
Algebraistsa2 + b2 = c2
Geometers See this figure
Masha Gessen Perfect Rigor, 2009
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Robert Lang, 2006
H d A ti iti T ht
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Hands-on Activities Taught
Practical Problem Solving Skills
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All my thinking uses specificexamples to create concepts
It is bottom up thinking and nottop down thinking
I learned ALL concepts using
specific examples
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Play games with categorizing many objects to
learn concepts such as color, shape, bigger than,smaller than, clothing, food, etc.
Details are Attended to
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Details are Attended to
Instead of Whole Gestalts
Autism faster response time to small letters Attend to details of faces instead of the whole
Behrmann et al., Neuropsychologia 2005
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Is autistic learning just memorization? It ismemorization and scripting, but as more
information is memorized, it can be assembledinto more and more categories which will help
thinking to become more flexible.
Teach Number Concept
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Teach Number Concept
GeneralizationCount a variety of different kinds of objects
Addition and Subtraction - Teach with manyobjects
Fractions Teach by cutting up fruit and papercircles
Teach Word Concepts
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Teach Word Concepts
with Specific Examples
Walk down the stairs
A plane goes down and lands
Put a cup down
Lie down on the bed
Objects are More Interesting than Faces
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Objects are More Interesting than Faces
T. Grandin Control
Blue = objects Red = faces
Humphreys, Minshew, Behrmann, and Cibu, 2006
Social Interaction Through
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Social Interaction Through
Shared Interests
School Clubs
Organizations such as Scouting
Hobbies
Careers
Classes that really interestan individual
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Categorize Behavior ProblemsIs it biological?
Sensory over sensitivity
Hidden painful medical problem
Is it behavioral?
Frustration because cannot communicate
Get attention Escape from a task
Sensory and Neurological Problems
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Sensory and Neurological Problems
That May Need Accommodations
Screams when the fire alarm rings
Tantrums in a supermarket
Cannot tolerate scratchy clothes
Poor handwriting
Tantrums or hyperactive under fluorescent lights
Difficulty multitasking
Difficulty with long verbal directions provide writtendirections
My 1950s upbringing taught me many important
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My 1950 s upbringing taught me many important
social and job skil ls. Everything was learned bycategorizing specific examples into these
concepts:
Turn taking in conversation and activities such asboard games
Being on time
Doing family activities I disliked
Doing things that pleased other people
Saying please and thank you
Social mistakes were instantly corrected by telling mewhat to do
Bad Behavior Was Not
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Bad Behavior Was Not
Tolerated When I was a Child
Being rude
Bad table manners
Manipulating a teacher by having a tantrum constantrules at both home and school
Poor grooming and sloppy clothes
Laughing at an overweight woman
Swearing
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Teach Social Skills in the Community
Shaking hands
Eye contact when meeting people
Ordering food in restaurants
Table manners
Shopping Talking to store staff
Kids doing projects and playing
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Kids doing projects and playing
games where the rules andduties are negotiated teaches
valuable social skills
Eccentric is acceptable; being
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Eccentric is acceptable; being
dirty and rude is not.
Do not try to de-geek the geek!
NASA Space Scientist Cries
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NASA Space Scientist Cries
When the Shuttle Was Cancelled
Its ok for Geeks to cry!
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Rule System
1. Really bad things2. Courtesy rules
3. Illegal, but not bad
4. Sins of the system
Hidden Painful Medical Problems in
N V b l I di id l Th t C
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Non-Verbal Individuals That Can
Cause SEVERE Behavior Problems
Acid Reflux heartburn (most common). Not
always obvious.
Constipation
Urinary tract infection
Yeast infection
Ear infectionBad tooth
H pylori (stomach, ulcer bug)
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The squeezemachine helped
reduce anxiety
and panic
attacks
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Fear is the main emotion
in Autism. My amygdala(fear center) is three
times larger.
University of Utah, 2010
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Using pressure to calm the nervous
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system during therapy
Sometimes speech is easier
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when the child is swinging
Sitting on a ball and wearing a weighted vest
helps concentration Use for 20 minutes
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helps concentration. Use for 20 minutes
then take off for 20 minutes.
It is important to desensitize touch
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p
sensitive autistic children so thatthey will enjoy affection. Feeling the
good feelings of being held helps todevelop feelings of kindness.
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Preparing for Employment
1. J obs for teenagers2. Mentors3. Visit work place
4. Trade journals5. Wall Street J ournal
Make portfolio - people respect talent6. Sell your skill, not yourself
I was a poor student but I learned lots of
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valuable work skills in high school. I didbuilding projects that other people appreciated
Before After
Jobs for Middle School
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and High School KidsWalking dogs
Maintaining computers
Making PowerPoint presentations
Selling artwork or crafts
Working on church or neighborhoodwebsite
Working in a farmers market
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People Were Impressed
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With My Drawings
My Design in
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Google SketchUp
Search for sketchup spectrum
Educational Resources
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Community Colleges
Technical Schools On-line Learning
University Courses
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Science WebsitesU.S. National Science Digital Library Project
Khanacademy.org
Udacity.com
Free courses Stanford and MIT
Physics Education Technology PhET
Open Course Ware Consortium
Wolfram Mathematica
Show Kids Interesting Things
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The Guys Have Fun with
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Stuffy the Mechanical Cowon the HBO Movie Site
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Avoid InterviewsFind the Back Door
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I was wearing my portfolio.People respect ability.
Jobs for Visual Thinkers
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Industrial design Computer network specialist
Graphic arts Drafting Auto mechanic Computer repair Handcrafts Convention AV technician Photographer Animal trainer Architect Veterinary technician
Jobs for Music and
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Math ThinkersMath teacher
Scientific researcherElectronics technician
Music teacherChemist
Computer programmerEngineer
PhysicistMusician/composerStatistician
Jobs for Verbal Thinkers
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Stocks and bonds analystJ ournalistTranslatorLibrarianCopy editorAccountant
Specialty RetailBookkeeper & record keeperBudget analyst
Special education teacherBook indexerSpeech therapist
Inventory controlspecialistLegal researcherStage actor
Bad Jobs for People with Autism
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Require lots of short term working memory
and fast processing information
My working memory is terrible
Cannot remember more than three steps
Cashier in a busy restaurant would be verydifficult
Jobs for People with Poor
V b l Skill N V b l
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Verbal Skills or Non-VerbalShelve Library Books
Factory Assembly Work
Fast Food Restaurant Work
Data Entry
Lawn and Garden Work
Recycling Plant/Warehouse
Stocking Shelves
Inventory Control
Handcrafts
Evaluation of Treatments
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Risk versus Benefit
Cost versus Benefit
Evidence of Effectiveness
SSRIS AntidepressantsW k ll ll f i t d i tt k
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Work really well for anxiety and panic attacks
Prozac (fluoxetine)
Zoloft (sertraline)
Celexa (citalopram)
Lexapro (escitalopram)
Paxil (paroxetine)
Atypical Anti-Psychotics
May have severe side effects
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May have severe side effects
Risperdal (rhisperdone)
Geodon (ziprasidone)
Zyprexa (olanzapine)
Abilify (aripiprazole)
Seroquel (quetiapine)
Low Dose Principle
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Some individuals on the autism spectrumneed only to of the normal starting
dose of drugs in these 3 classes:
SSRI Antidepressants
Tricyclic AntidepressantsAtypical Antipsychotics
Too much causes insomnia, agitation and irritability. Otherdrugs usually require normal doses. If used in smallchildren, micro doses 1/10 of mg of Rispordal.
Principles of Using Medication
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Try one thing at a time
A medication should have an obvious beneficialeffect
Withdraw a medication slowly, if a person hasbeen on it a long time
Be careful switching brands
Dontexpect 100% control of a symptom
Blood Pressure Medications ReduceA i t d A U d Sl Aid
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Blood Pressure Medications ReduceAnxiety and Are Used as Sleep Aids
Much Safer than Atypicals
Beta blocker propranololClonidine
Anti-Convulsant Drugs for
Aggression and Mood
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Aggression and MoodStabilization
Depakote
Lamitel (lamotrigine)Topamax (topiramate)
ADHD Drugs and Autism
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Stimulants tend to make classicalautism worse
Stimulants sometimes helpindividuals with mild Aspergers
Look Up All Drug
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Look Up All DrugInteractions
Prescription drugs
Non-prescription drugs
Herbal supplements
Special diets work for some individuals
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Vitamins and supplements B6 andMagnesium
Vigorous exercise for calming
Weighted blanket or vest for calming
Omega 3 supplements help the brain
Poor diet more depression
Traits in Close Relatives
F G ti f B k
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Four Generations of Bankers
MIT-Trained Engineer/Co-Inventor Auto Pilot
Anxiety
Depression
Visual Thinking Skills Artist, Home Decorators
Food Allergies
Intellectual Giftedness Writing English Literature
Asperger Traits
Ei t i
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Einstein
had many
autistictraits
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Autism.org
800 3 AUTISM
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800-3-AUTISM
grandin.com
Future Horizonshttp://www.fhautism.com/
Autism Asperger Publishing
Books by Temple Grandin
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Thinking in Pictures
Developing TalentsAnimals in Translation
Unwritten Social Rules
Emergence Labeled AutisticThe Way I See It, 2nd Edition
Animals Make Us Human