educational assistant seeking advice for student with autism

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I work with a non verbal student in the 6th grade. He is a wonderful child but is in a school district that has full inclusion. The problem is that he has become so prompt dependent that he has to be prompted to do everything even eat. We are trying to find ways to help but have not found anything as of yet that is working. I (we) would appreciate any advice? Of course we have had "autism experts" help but I wanted to see if the real experts could help.

ever try social stories? those def help me.

Thank you for writing back. Yes we read social stories but he doesn't seem to understand what we are reading. He is very verbal as far as making a lot of sounds. He is a very happy guy but we feel that what he is doing has no meaning to him. He doesn't seem to understand a lot of what is going on around him. We may just think that he doesn't, I suspect a lot is going on in his mind but he is not able to communicate what that is. Yes letting me know what worked for you helps, thank you.

How does he communicate? Does he pick up what you say when you talk? (I don't mean look at you or respond, just understand.) If he's "prompt dependent" I'm assuming verbal prompts...

Any number of reasons for prompt-dependence... do these make sense or am I on the wrong track?
--executive dysfunction, problems planning things on his own, so he depends on other people to plan for him
--he's been taught to rely on prompts over the years, and doesn't know things can be done other ways
--he's afraid of messing up, either because of fear of punishment or perfectionism, and so lets people guide him
--doesn't know the reason behind some of the things he's being prompted to do
--bad at generalizing tasks to slightly different situations (ex. writing his name on a science test versus writing his name on a blank sheet of paper)
--gets tired out easily if he has to plan on his own, and is conserving energy

Have you tried a list of pictures, that he can use to prompt himself? Like one of those picture schedules, where you stick Velcro on the backs of the pictures and put them in order; only for the steps in a task. The idea is to learn to refer to the task list independently, and eventually make your own task lists.

Here's an interesting idea I saw which is apparently designed for TBI patients... it's a little PDA type device that shows pictures in order, and speaks a list of instructions. The user just picks the appropriate task and gets instructions that way. Don't know if that kind of thing is an option. It can be done non-electronically with a notebook--laminated pages and a tough spiral binding recommended.

Those are really just different kinds of prompts, though, unfortunately. I think it's probably going to take a while to teach him that it's OK to do things on his own. If he understands more than he says, maybe it'd be a good idea to explain things to him, the whys of them especially. Maybe leave a little time in between the sentences for him to catch up figuring things out, in case of auditory processing difficulty... Also give him lots of opportunities to do things for himself--like maybe there's something he really likes, a favorite object or a person he likes or whatever, and let him initiate stuff, just so he gets the point that it's OK to do that. Maybe somewhere along the line, there was an overbearing therapist or teacher who taught him "do what you're told and nothing else"...

Does he have enough down time, to do whatever he does to relax? I'm saying this because often times recess or lunch are just not relaxing for autistic people. They were the hardest part of the day for me--I wanted a quiet room, a book, maybe a bean bag chair to lie on... Of course, I never got that, and came home from school exhausted... But I wonder if maybe it would help to let him have some unstructured free time, where he doesn't always have to be listening for what he is supposed to do. If he's associating school with "do what I'm told", maybe that would help him break that habit as well as giving him some much-needed relaxation.

Hello, thank you for writing back. A lot of what you mentioned is in place, except the down time. It is really hard to tell if anything that we are trying to teach him has any meaning or is becoming rote. We all feel a great deal of responsibility for him. He is a wonderful child and being in middle school means that our time is short before he is in high school.

I think it may be really important to figure out whether this is something that's been taught him, or else whether he has a lot of problems initiating actions and uses the prompts as a framework. In the first case they're a hindrance, in the second, they're necessary, and they'd be two different approaches to take. I used to need to be told every step of things when I was little; but eventually I learned to make my own procedures. Some of them are still written down, and some are memorized. I do things the same way every time; it really helps. In a way, I'm prompting myself... For me, the effect of not having those procedures is a lot like severe ADHD, getting stuck having no idea what to do next, forgetting what I needed to do, being extremely inefficient... for him, maybe it's prompt-dependence. Or, like I said, he might simply have worked with somebody that forced him to do only what he was told and no more, and got used to it out of fear or a desire to please people or just habit. (You can become awfully afraid of having your favorite things taken away. As a child I would have done anything to keep my computer, and felt terrible about being forced besides.)

How is he on communication? If he communicates what he wants to do, you could walk him through it. That would increase the amount of stuff he decides for himself. Choices between two alternatives might be easier to figure out than just open questions, because all those alternatives can be kind of overwhelming.

He really doesn't communicate with those around him. He will say something if you tell him but not really on his own. We have to make sure that he drinks water because he won't unless he is told, his parents say he won't eat unless told to take a bite. Needless to say meal time is long. He wants to please others so he is very compliant never acts out. He is very loud when he starts making noises and the teachers are starting to complain. We try to find ways to refocus him but so far to no avail except taking him for walks but he is still vocal. He actually sounds so happy when he is noisy which is so cute but in school not so easy to deal with in a class.

Rosaleah said:

Callista said:



Is there an appropriate scheduling device? I've not used, but considering using a device with a scheduling program that can simply be described as an alarm clock that tells you when it's time to do everything and what it's time to do then. It seems like a PDA or a new phone might have programs that do that kind of thing (but I never used those that way before).

Pick one child or student thats close too his age that he may like or relate too, have that person eat / drink / etc in front of him as a Que for the interactions, have the adults leave the area so he may feel more open to respond to his peers.

Thank you so much for the ideas. His peers respond very well to him, he is such a likable guy. Pulling the adults is something that we can try more. I appreciate all the suggestions. Please if you have more send them my way.

Timex makes a watch that you can hook up to a computer and program with up to 200 alarms. Then when the alarm goes off, a message appears on the watch telling you what it is time for. I have one, and I know others have used it for ADHD. It doesn't speak though, so you'd have to be able to understand the message- I think you might be able to set different sounding alarms though, so you could have a different sound for different tasks.

He doesn't self-initiate anything? Do you know what he does when he's alone?

If things are always done in the same order, maybe you can get him to learn the schedule, and then one activity can serve as the prompt for the next activity.

....And other prompts so if something doesn't happen, he'll know what to do.( such as someone being late, ETC.)

I don't want to sound negative here but based upon my own life experiences I think trying to regiment somebody who is somewhere on the spectrum is kind of a torture that you don't realize. Forcing somebody to adhere to your ideas of what needs to be done at certain times isn't necessarily a very good thing to do. Think about it for a minute. I don't mean to be disrespectful of your situation. Just putting in my 2-cents.

Thank you for all of the advice, it helps getting different ideas. GaryWW I didn't think that you were being negative. If you are telling it like it is from your perspective than your advice is useful because of your experiences.

+1

If he is able to substitute a bell or alarm for a verbal prompt simply by being told to understand the bell that way, then you can probably explain to him about many other types of environmental cues. ie: a crumpled bit of paper on the floor is like a bell that says, pick up the paper and put it in the wastebasket. More food on your plate is like a bell that says, take another bite. And so on. You probably want to move on as soon as you possibly can to the idea that some of these 'bells' require more than one condition (like more food on plate + not feeling full = take another bite) or you risk creating OCD-like behaviors, though.

Understanding that environmental conditions other than the schedule comprise the prompts should make him better able to adapt when schedules change.