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Thursday, 17 December 2009

People with autism 'have problem with self-awareness'

People with autism struggle in social situations
Scientists have produced evidence that self-awareness is a big problem for people with autism.

Sophisticated scans showed the brains of people with autism are less active when engaged in self-reflective thought.

The findings provide a neurological insight into why people with autism tend to struggle in social situations.

The study, by the University of Cambridge, appears in the journal Brain.

Autism has long been considered a condition of extreme egocentrism. But research has shown the problem is people with the condition have trouble thinking about, and making sense of, themselves.

The researchers used functional magnetic resonance scans to measure brain activity in 66 male volunteers, half of whom had been diagnosed with an autistic spectrum disorder.

The volunteers were asked to make judgements either about their own thoughts, opinions, preferences, or physical characteristics, or about someone else's, in this case the Queen.

By scanning the volunteers' brains as they responded to these questions, the researchers were able to visualise differences in brain activity between those with and without autism.

They were particularly interested in part of the brain called the ventromedial pre-frontal cortex (vMPFC) - known to be active when people think about themselves.

The researchers found this area of the brain was more active when typical volunteers were asked questions about themselves compared with when they were thinking about the Queen.

However, in autism this brain region responded equally, irrespective of whether they were thinking about themselves or the Queen.

Researcher Michael Lombardo said the study showed that the autistic brain struggled to to process information about the self.

He said: "Navigating social interactions with others requires keeping track of the relationship between oneself and others.

"In some social situations it is important to notice that 'I am similar to you', while in other situations it might be important to notice that 'I am different to you'.

"The atypical way the autistic brain treats self-relevant information as equivalent to information about others could derail a child's social development, particularly in understanding how they relate to the social world around them."

Dr. Gina Gómez de la Cuesta, of the National Autistic Society, described the study as "interesting".

"We know many people with autism do want to interact with others and make friends but have difficulty recognising or understanding other people's thoughts and feelings.

"This research has shown that people with autism may also have difficulty understanding their own thoughts and feelings and the brain mechanisms underlying this."

Saturday, 12 December 2009

Earlston High embark on a unique way to assist the transition from primary to secondary school

Original paper headline: This is your captain speaking, welcome aboard Flight 90210

When 190 new S1 pupils filed into their Borders high school for the first time, they weren’t expecting to be greeted by a captain and first officer at Earlston International Airport.

Captain Michelle Strong (headteacher) and co-pilot Jill McDonald (S1-2 year head) welcomed the voyagers who were shown into a departures lounge (assembly hall), where they were checked into registration classes by the guidance teachers and escorted to gates 1A-G by cabin crew (S6 pupils). They were then given an itinerary and in-flight menu.

“Captain Strong welcomed them aboard Flight 90210 and did her usual message - try your best, we’re here to help - but with a wee slant on it,” explains depute headteacher Beverley Clark. “We wanted to try something different, so high school is seen as fun and exciting rather than scary. We had a PowerPoint of a plane taking off, representing their journey into high school. It’s cheesy, but it worked - primary schools do a tremendous job of making learning enjoyable, and in secondaries sometimes we think we’re not allowed to make learning fun, but we are.”

Earlston High has always had a strong transition process, with guidance teachers going to each primary and gathering information about every child. Miss Clark works closely with the primaries, and they wanted something creative, that would give some continuity and make the start of secondary enjoyable, “because there’s a lot of pressure with the longer day and more structure”. Going from being the biggest in a small school to the smallest in a big school can be daunting for even the most confident of children.

And so their journey began. Earlston High’s transition project spanned six weeks - the last two of P7 and the first four of S1. Pupils from the eight feeder and nine other primaries (placing requests) made a two-day visit to the high school in June, then the real work started.

Miss Clark came up with the travel theme and journeys, and each department had to decide how it would address the theme for the first month of term - all while moving into their new school building in August. Meanwhile, the P7s did some preparatory work, making passports and preparing a leaflet about their home town or village.

“It made you feel better because you weren’t being thrown in at the deep end,” explains S1 pupil Rhona Callow.

The concept of a storyline was new for many of the secondary staff, though commonly used in primary schools. “We’d never done one before,” says Neil Westgarth, principal teacher of science. “There was a mixed reception initially, but once we got thinking of ideas, everyone got excited. We came up with a story that it was the year 2051 and our planet was dying and we needed to find another one to colonise.”

His department identified what skills they wanted to cover and introduced experimentation; investigated whether a potential surrogate planet would support life; explored how they would reach their destination and what they would take; and covered other lab work and theory. With information on six habitable planets, groups of pupils had to choose one and give a presentation on their reasons.

The science staff introduced the topic during their P7 visit. “They went away really excited,” says Mr Westgarth. “We got them to bring in plastic bottles to make ‘moon rovers’ for collecting samples from the surface of planets.”

The four weeks allocated quickly turned into eight. “If pupils wanted to investigate something further, we let them go with it. Before, it was difficult to go beyond the constraints of a topic. This pushed staff and brought out creativity.”

The extension has put a little pressure on the rest of the year, but Mr Westgarth feels the whole initiative has been hugely valuable for pupils and staff alike - and in first year, you can make up a lot of time in the way you deliver things. He also anticipates it will be easier next year, because it will be more familiar.

Pupils’ comments were “overwhelmingly positive”, he says. “If they’re interested, they’re going to be far more responsive. It was nice for staff who haven’t delivered a science topic like this before.”

The pupils also “gelled” more quickly because of all the group work and enthusiasm for tasks.

The maths department planned a family holiday to Paris. Pupils had to organise and budget for travel, accommodation, food and entertainment, as well as working on the 24-hour clock, time differences and exchange rates. Its story was created around Great Uncle Willy’s will. Uncle Willy had left £5,000 to the Masson family - mum, dad and three children - and the pupils did a code-breaking exercise, using logic and problem-solving. Nicer accommodation or food meant less to spend on entertainment, or taking the ferry meant less time there.

“A lot of children find maths a bit threatening,” says Christina Fleming, who teaches one able and one less-able class (maths is set in S1). “This was something they could relate to and have opinions on. It gave them time to settle in and it gave me and the other support staff time to get to know them.”

The English department decided on “Imaginary lands” to give the children creative freedom. Judith Weston’s two classes were each split into five groups of four, and every group had to create a land, considering everything from culture, geography and history to food and drink, language, people and lifestyles, currency, society, crime and punishment, dress, gender roles, constitution and work. One group even created a national anthem.

Pupils made cultural exchanges with other lands - another group in a different class - and did written work around the project, producing stories set in their land.

“It sparked their imagination, and pretty quickly they got into the creativity of it,” says Mrs Weston. “We got some very impressive pieces of writing, with convincing settings. As a department, we were able to assess their individual presentation skills.

“I think first-years spend a lot of time worrying about where they’re going and who their friends are. Some people feel they take a step back academically, but my view is they’re having to cope with 16 teachers in a big building and big pupils, which can be daunting. It was a very positive start to the year.”

The children’s parents are also positive about the new approach. Susan and John Sharp feel it helped their son Robin to settle in. “Robin has dyslexia. We were slightly concerned in case he lost confidence going from one teacher who knew him very well to 10 or 12 teachers, but the continuity helped - the core work was the same from primary to secondary - and made it smoother for him. Because the subject matter linked through in all the classes, he could concentrate on orientating himself around the building and making friends.”

Jane Niven’s son Mark is her first child in secondary school. “I thought it was going to be a bit scary,” she admits, “but it’s been absolutely excellent. Mark has been in a class with only one other pupil from his school. Everywhere they went, they were being helped to work together and everybody was having an input. It was a good way to make friends and he’s settled in brilliantly.”

Lesley Munro, the head at Earlston and Gordon primaries, says the transition into Earlston High has always been seen as an example of good practice, “but this gave it a context and much more meaning for the children”. She points to the collaboration between P7 and high school staff. “The teachers were doing it themselves rather than it being at management level, but Beverley has been the driver of the whole thing.”

Primary pupils are used to working in a themed way, she says. “Primaries can lose them a little for the last two weeks, but they had preparatory work to do and there was real continuity across the schools.

“Developmentally, expertise has been shared both ways. It’s been such a positive experience for the kids. It’s given them the fun element and alleviated any fears they they would have about the formality of high school.”

Natasha McLaren, the P5-7 teacher at Channelkirk Primary in Oxton, agrees. “I found it great that we could collaborate, and the children felt confident that they were going up with a bit of knowledge of what they would be doing. Coming from a small village school, they can get a bit apprehensive.”

S1 pupil Mary Hall endorses this. She was “apprehensive but excited - especially in English. We did group work, so it was easy to make friends.”

“It wasn’t like staring into a textbook,” adds Rhona Callow. “I think they did it really well. I’ve made lots of friends quite easily.”

For Captain Strong, the greatest thing has been the “buzz” among pupils and teachers. “Staff were allowed autonomy. The cross-sector working and the whole atmosphere has been incredibly positive. It helped students settle more quickly than they have done in the past.”

Finance, she says, is a “biggie” for any head. “This is evidence that you can be creative and transform things without investment. Right across Scotland there is this apprehension about Curriculum for Excellence. This project allowed teachers to take risks. It’s brought learning alive.”

And it’s been a smooth take-off for all, adds Miss Clark. “You’re not going to get wads of cash thrown at you, so let’s use the skills we have as individuals. We need people to try things and support them in trying them. Learning doesn’t have to be dry.”

Colleges are doing a largely good job in their work with students who have profound and complex needs, according to HMIE

The quality of programmes was generally of a high standard, there was a wide range of school-link arrangements, teaching staff were highly committed and skilled, and accommodation was appropriate.

But, after 30 teaching sessions in nine colleges, the inspectors concluded that practice was not always perfect. Although they paid tribute to staff, their report said it was often the enthusiasm and expertise of one or two individuals who made the difference, and this was often difficult to replace when these staff left.

Colleges also needed to do more to set out the entry criteria spelling out the skills required of learners, most of whose needs are variable and who suffer from sensory loss, physical disabilities, autism and disruptive behaviour.

While these students had specialised learning and support plans, few colleges developed them and targets for progress were often too long-term. The inspection noted, too, that “some colleges were not clear how their programmes should be structured to develop learners’ educational needs as opposed to their social needs”.

The HMIE report urges colleges to communicate more effectively with parents and carers. Managing the relationships with external agencies also proved to be a challenge, with concerns being expressed in colleges about transport, personal care and individual learning support needs. Supported employment opportunities were often lacking.

Graham Donaldson, the senior chief inspector of education, commented: “This challenging area of work is vital to the role of Scotland’s colleges in serving their communities

.Three authorities ‘named and shamed’ by charity as cutting assistance to families of children with additional support needs

A charity which helps parents of autistic children has accused Scottish councils of cutting support. It claims youngsters have been sent home because of schools’ diminishing resources.

The picture painted by the Princess Royal Trust for Carers to the Scottish Parliament’s education committee’s inquiry into autism is bleak. Budget cuts meant additional support needs (ASN) teachers were being forced back into mainstream to save money, leaving vulnerable children to flounder, said the trust.

The evidence against the authorities was anecdotal but compelling, said Lynn Williams, the charity’s policy officer. “I’m aware of two cases where children have been sent home because there were no pupil support assistants to support them. If you have a child with additional needs, you are already worried about what their life is going to be like and whether they will find a job. But if they have no education in the first place, where does that leave them?” she said.

Three authorities were “named and shamed” by the charity: Aberdeen, East Renfrewshire and Glasgow. Aberdeen City Council was cutting spending to the detriment of “vulnerable children”, said the trust.

“Further ‘efficiency’ cuts will, among other things, result in fewer teachers supporting pupils in Aberdeen City’s MICAS bases (specialist units for children with autism in mainstream schools). I also believe that schools were encouraged, by the council, to move support for learning teachers back to their subjects rather than having a full-time support role for children with additional needs in mainstream education,” said Ms Williams.

A spokesman for the council said that two years ago, the authority had reviewed its formulae for primary and secondary teaching staffing to include learning support, deprivation and behaviour support, linked to roll change. “The council values the role of all staff in supporting children and young people with additional support needs and continues to allocate resources appropriately and review on an ongoing basis to ensure best value,” he added.

In East Renfrewshire, parents have told the trust that there are not enough pupil support assistants for children in schools. They also fear that the next financial year will bring further cuts to pupil support staff. “These parents rightly question the benefit of their children being in mainstream education where not all will have access to additional classroom support,” said Ms Williams.

But a spokesman for East Renfrewshire Council said: “It is grossly unfair to present this as the norm in East Renfrewshire when at best it may represent one particular person’s viewpoint. There is a range of support mechanisms in place in schools and in our education service to support pupils with autism and each child is assessed individually.”

In Glasgow, parents have complained that school staff lack understanding of autism, there are not enough inclusive activities and their children are bullied in school.

Jonathan Findlay, executive member for education in Glasgow, countered: “Ms Williams’s comments are unjust and do not reflect the vast amount of work in the last year alone Glasgow has carried out to support children with autistic spectrum disorders.”

Councils face a reduction in funding of some 12 per cent over the next three years. The first draft budgets to be published by councils appear to confirm Ms Williams’s fears:

- North Lanarkshire Council, which is facing a £75m deficit, plans to cut three additional support needs teaching posts, a saving of £80,000 - one of a number of measures;

- Moray Council plans to cut its allocation of additional support assistants and teachers by 5 per cent to save £340,000; the council acknowledges in its budget consultation document that cuts would have a “severely detrimental impact” on children with ASN.

Children’s Minister Adam Ingram told the committee last week that, if councils were cutting down on classroom support, this was “short-sighted”. He announced the setting- up of a working group to “identify, share and disseminate” best practice in working with autistic children and adults.

Following the meeting, however, Labour MSP Ken Macintosh accused Mr Ingram of burying his head in the sand. Support for ASN children in his own constituency - East Renfrewshire - had worsened over the past year, he said.

Children with autism find their right place with peer passports

A support service in the Borders has led to better communication and integration

Alex is six years old and likes playing in the sand, with beads, eating and running around. He doesn’t like sitting for long periods, or big groups of people.

Without his peer passport, it’s unlikely Alex’s P2 classmates would have known these rudimentary facts about him, for Alex is severely autistic and, while he can speak, he rarely uses the right words at the right time and has no functional communication. He spends some of the week at his primary, St Peter’s in Galashiels, and the rest in a specialist unit at Wilton Primary in Hawick.

Children with communication problems often carry a passport which is used to introduce them to professionals - teaching or support staff, for instance. But in the Borders, it is used to introduce autistic children to other pupils in their class and contains short, age-appropriate explanations of what autism is.

The local Autism Spectrum Support team’s work in this area was recently flagged up as a good example by Learning and Teaching Scotland. Sarah Fitch, the manager of the spectrum support service and head of the authority’s complex needs team, says: “If, for the majority of the week, a child is not in the class, that can sometimes be puzzling for the others, and they may not know a lot about them because they can’t communicate adequately.”

Armed with a bit more information, however, children have proved to be understanding and inclusive, she says. “A lot of the time, inclusion can be tokenistic; the child with additional support needs just happens to be there. But you’ve got to make sure there is value in them being in mainstream. It’s about developing relationships, rather than ‘this child comes into the class, full stop’.”

All 17 children with significant autism, learning difficulties and challenging behaviour who attend spectrum support are on shared placements, spending at least a couple of afternoons a week at their primary and the rest of their time at a specialist unit. P1-3s, like Alex, attend the unit at Wilton, while children in upper primary go to St Ronan’s Primary in Innerleithen.

Now that they have been formally introduced to their mainstream classmates, thanks to the peer passports, the team is looking to take things even further.

In the Borders, autistic children communicate with staff using the Picture Exchange Communication System, by visually picking out symbols in books. Now they are being encouraged to use it with their peers in “communication groups” which consist of the autistic child and mainstream pupils.

“Children naturally communicate with others,” says Ms Fitch. “They don’t tend to spend all their time interacting with adults. In the communication groups, they come round a table and each child is given a motivational toy. The autistic child is then asked which toy they would like a turn with, which requires them to use PECS, and it goes from there.”

The authority has now launched inclusion groups for autistic children in upper primary, as well as communication groups. According to Ms Fitch, school becomes increasingly irrelevant for the youngsters as they get older and the language becomes more abstract. So they have organised regular activities such as games, dancing and sport, involving the autistic child and two or three classmates. “It helps maintain inclusion.”

A mix of specialist provision and mainstream is ideal for children with severe autism, Ms Fitch believes. Experts with a deep understanding of the disorder are vital, but so is the community where the children grow up and will, in all likelihood, continue to live. “It’s important we educate people in the community, as much as the children on the spectrum,” she concludes.

Steep learning curve

Borders Council’s Autism Spectrum Support started in 1995 with six boys at Denholm Primary in Hawick. But just 14 years ago, autism was something of a mystery to Scottish education, explains Sarah Fitch, the teacher brought in to run the service.

“It’s hard to believe now, but autism was just not something that was talked about then,” she says.

It was “a steep learning curve”, admits Ms Fitch, who is now the council’s team leader for complex needs. But a service that caters well for autistic children’s needs was established and in 2006 received a very positive report from HMIE. More recently its work was flagged up as an example of good practice by Learning and Teaching Scotland.

“Kicking, biting, screaming, shouting - you name it, we’ve probably had it. But you have to look at why that happens and try to make sure the environment is appropriate so these things don’t happen,” she says.

“A lot of children have sleep difficulties and a lot have extreme sensory difficulties - they are very sensitive to light, sound, taste and touch. One child we work with can hear an aeroplane coming long before we do and that causes challenging behaviour in him.”

The journey has not been without its challenges - one of the most recent being a fire at Denholm Primary, just months after inspectors left, which rendered them homeless.

“We lost everything - not through the fire, but through asbestos contamination,” explains Ms Fitch.

Since then, the early primary unit has been through a few stressful moves, but now is at Wilton Primary in Hawick, with upper primary at St Ronan’s Primary in Innerleithen.

Today, teachers are far better informed about autism, with a wealth of training on offer, says Ms Fitch. They also have access to the Scottish Government’s autism toolkit, which she describes as a “fantastic resource”, although she questions how many are aware of it.

Article as Mentioned in ADHD/ASD Courses

Reprimand for YouTube stripper who got shirty

Supply teacher also boasted to class that he would throw pupil from window

A suffolk teacher has been reprimanded after stripping half-naked in front of his class - an act that was videoed and posted on the internet - and threatening to throw a pupil out of a window.

Pupils used their mobile phones to film Martin Rouse when he took off his shirt during a lesson. Last week he was found guilty of unacceptable professional conduct by the General Teaching Council (GTC) and issued with a warning.

He has been banned from Sudbury Upper School and Arts College by headteacher David Forrest, as well all other Suffolk secondaries.

The online video was viewed almost 800 times, but has now been removed.

Mr Rouse, 59, told a local newspaper he was in a "state of shock" and "totally stunned" at being ordered out of the school.

He revealed he had a heart condition and diabetes, and has suffered from depression. Childen had nicknamed him "Gimli", after a dwarf character in Lord of the Rings.

Mr Rouse has been a teacher since 1976 and chose supply work because he was unable to work full-time because of his ill-health.

He had been teaching at Sudbury Upper School and Arts College for a week before the incident in April 2008. While teaching a class of Year 9s, including some disruptive pupils, he joked that he was strong enough to throw one pupil out of the window because he had been using chest expanders.

"I thought 'should I do this?', but I wanted to be cool because that is my rapport with the pupils," Mr Rouse told the local Suffolk Free Press. "I tried to roll up my sleeve, but couldn't so I took off my shirt quickly and then put it back on. It was a spur of the moment thing.

"It wasn't a chaotic lesson. It wasn't a wise thing to have done. I was just responding to the situation and getting students to co-operate and enjoy the lesson."

The GTC panel said it accepted that Mr Rouse had been trying to use humour to "engage" pupils when he threatened to throw one out of the window. "Nevertheless, the words used were capable of and may have been viewed as a threat by some of the pupils," the panel said.

"Mr Rouse's actions could have led to the class becoming dangerously out of control. In addition, some pupils may have felt intimidated by the words used.

"Mr Rouse removed his shirt in the classroom which was a clear breach of the standards of propriety expected of the profession.

"The video of the incident became publicly available and Mr Rouse's actions were seriously detrimental to the standing of the profession.

"As far we are aware these were isolated incidents which resulted from an ill-considered attempt to control the class. Mr Rouse has demonstrated some insight into his failings.

"As far as we can ascertain, Mr Rouse has a previous good history and this is supported by a reference from a supply agency for whom he worked successfully for two years."

Could do better

Teachers behaving badly

- When head of Willoughton Primary in Lincolnshire, Malcolm Beresford referred to female staff members as a "harem" and nicknamed a governor "posh pants". He also referred to a member of the governing body as "vindaloo". He is yet to be sentenced.

- Patricia Ann Baynes, head of Bordesley Green East Nursery School in Birmingham, "force-fed" children in her care and left them in soiled underwear. In September, the GTC banned her for three years.

- When head of Beaconsfield Primary in Southall, west London, Kanta Riley shook pupils, ordered them to go without shoes and threatened to wash their mouths out with soap. She was found guilty of unacceptable professional conduct.

Saturday, 5 December 2009

Social Stories Training

If anybody is interested in Social Story training please can you contact us. You will need a minimum of four delegates.

Toddlers with autism may benefit from early treatment

Intensive early treatment and education can improve the abilities of toddlers with autism to communicate and raise their IQ, new research suggests. The study is the first of its kind to look properly at treatment for children this young.

What do we know already?
Autism affects the way a child develops, communicates, and learns about the world. It tends to be picked up when a child is around 18 months of age, if the child doesn't meet the usual developmental milestones of smiling, following when people point, and speaking a few words. But some people say they knew there was something different about their baby right from birth.

Some research has suggested that early teaching and treatment, from both parents and therapists, started before a child begins school, can be helpful. But little research has been done into ways of helping very young children.

This new study looked at what happened to a group of 48 children aged 18 months to two and a half years, who'd been diagnosed with autism or pervasive developmental disorder (a condition similar to autism, but where the child doesn't meet all the autism criteria). Half were given intensive treatment using a programme called the Early Start Denver Model (ESDM), while half were referred for the usual care available locally. The children were tested after one and two years of treatment.

What does the new study say?
Children who'd had the intensive treatment programme had improved IQ scores, were able to communicate better, and got on better in everyday life.

The children's IQ scores went up fastest in the first year of treatment, then stabilised. Their scores on questionnaires measuring 'adaptive behaviour' (how they communicate and manage in everyday life) stayed stable for their age-group during the study. This means they were keeping up with the changes in behaviour expected as children get older.

The adaptive behaviour scores of children who'd not had intensive treatment got worse. They had a small improvement in IQ, but much less than the children with intensive treatment.

Seven of the 24 children who'd had intensive treatment improved to the point that they were no longer categorised as having autism by the end of the study (although they still had pervasive developmental disorder). Only one of the children not given intensive treatment was recategorised in this way.

How reliable are the findings?
This was a well-designed study (a randomised controlled trial) which is the best type of study for finding out whether a treatment works. The children were tested by independent assessors, using questionnaires and tests that have been shown before to be reliable.

The only potential problem is that the tests of 'adaptive behaviour' involved questioning the parents about how the children were doing. The parents who had been involved in the intensive treatments might have answered more positively, because they'd put so much effort into the treatment themselves, that they were very alert for any signs of improvement. This might make the treatment seem better than it is.

Where does the study come from?
The study was carried out by doctors and researchers from several universities in the US. It was published in the medical journal Pediatrics. It was funded by a grant from the US government's National Institute of Mental Health.

What does this mean for me?
If your child has been diagnosed with autism, you'll be interested in any treatment that can make a difference to how they grow up and develop. This particular treatment (ESDM) may not be available where you live. But it used techniques from a system called 'applied behavioural analysis' (also called Lovaas therapy, after the doctor who developed it) which is sometimes used in the UK.

These types of treatment ask a great deal of the family. For two years, the children had two hours of treatment, twice a day, five days a week, by a therapist coming to the home. And parents spent on average 16 hours a week using these techniques with their children themselves. That's a lot of time to devote to treatment. It's also unlikely that this intensity of treatment will be available freely on the NHS. And it would be very expensive to pay for it privately.

BMJ Group, Wednesday 2 December 2009 00.00 GMT Article history