School 3 rd September 2015 Andrew Royle Dramatherapist Exploring Autism medically socially and as a way of being Eugen Blueler 1857 1939 Swiss Psychiatrist Autistic State 1911 ID: 650132
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Slide1
Tuning Into Autism,Earlsmead School 3rd September 2015
Andrew
Royle
,
Dramatherapist
.Slide2
Exploring Autism: medically, socially and as a way of being.
Eugen
Blueler
(1857 – 1939), Swiss Psychiatrist
‘Autistic State’, 1911
Autos : ‘Self’
Detached and self-orientated state of patientsSlide3
‘Triad of Impairments’ Lorna Wing (1979)
English Psychiatrist (1928 – 2014) & mother of autistic child.
1. Impairments
of social
interaction
2. Impairments
of thinking &
Behaving
3. Impairments
of Communication
‘Autism epidemic’ 1990s:
From: 1 in 2,000 people
To: 1 in 68 Slide4
DSM V: Autistic Spectrum Disorder (2013)
‘Deficits’ in……
Social/emotional reciprocity:
- N.A.S – ‘
mindblindness
’
Non-verbal communication:
- facial expressions, eye- contact, social cues
Relationships:
-Friendships/Social context
Stereotypical/repetitive movements:
- ‘Stimming’/echolalia
Insistence on
samness
:
- people, toys, routines, rigidity/ritualistic
Lack of imaginative play:
- ‘one
trackedness
’
Literality of language.
Slide5
M.C. Escher: Ascending and descending (1960) (a ‘huis clos’)Slide6
The autistic ‘spectrum’
‘Low Functioning’ ……………….. ‘High Functioning’
Non-verbal Asperger’s
‘
If you’ve met one child with autism, then you’ve met one child with autism’
Dr
Joe
Cubells
, Psychiatrist Emory Autism
Centre
Slide7
A more progressive view?
‘Impairments’, ‘Difficulties’, ‘Deficits
’……..
Autism as a medical ‘disorder tends locates the ‘ problem’ of autism in the child, the brain, the genes
A ‘One
P
erson Psychology’
Social factors can also determine behaviour (example) Slide8
Steve Silberman (2015)
Neurotribes
: The Legacy of Autism and How to Think Smarter About People Who Think Differently
(2015)
‘Neuro-typical’ & Neuro-atypical (labelling works both ways)
Cures & Causes rather than ‘
what can we do for people already there’
The term ‘special needs’ – implies in a state of ‘needing’ more?
Is the very notion of a Spectrum helpful?
Slide9
What to do?
.
‘The
challenge in working with autistic children is
crippling
anxiety and
fear……..
…..therefore
the first imperative is to
lower anxiety
levels’.
Jude Reagan,
The Queen’s
Mill Special
School, London Slide10
‘L’enfer c’est les autres’
‘
Tuning in exercise:
A - The speaker
B – The Listener (tunes in)
C – The observer (of A & B) Slide11
The still face experiment, Dr E. Tronick (1975)
.Slide12
Anne
alvarez
,
Child Psychotherapist
Autism as a ‘profound collapse’ – opposite of a ‘secure attachment’.
Repetitions then understood as providing as sense of power, control and omnipotence
A ‘Reassuring
S
tuckness
’
‘Live
Company: Psychoanalytic Psychotherapy with Autistic, Borderline, Deprived and Abused Children
(1992) Slide13
Attunement, Daniel Stern (1985) Attunement: A performance of behaviours that express a shared emotional state.
‘Performance’ – an improvisation of facial expressions/vocalisations/tone/rhythm
Connects with ‘emotional state’ – that is behind the behaviour. Not a mirroring (A Vitality Effect)
Two problems:
1. How can performance of behaviours occur, if the autistic child has difficulty reading social cues
2. How can the state be ‘shared’ with a child that is
primarly
relating to him/herself? Slide14
‘A different kind of performance! Slide15
Communing to misattunment Types of misattunement
:
Introduce
a sheet of paper that says ‘Now’ and ‘Then
’/sand-timer – transitions
Turning
an object into a flying saucer as you hand it back to the
child.
From a Secure Base (
Comuning
) to ‘make
an appeal to the freedom [of the child]’
RD Laing,
The Divided Self
(
1961)
Slide16
Tuning in as ‘being-seen’ – the primary connectionSlide17
Learning is ‘connecting experiences’ (Stern, 1985)The connection between Self & Other is the basis/the vital first step on which learning occurs Connection between the hands
of the clock and the time of the day
Connections between
t
he
words on the page and the words spoken
.Slide18
Tune into your table - exerciseTune into your table/group Write down what you feel is neededLet each person share their thought
Decide which one(s) to do – you can do all
Slide19
Autism – a call to change?Slide20
Qualitative learningExamples: - Variations in language/movements:
words,tone
, rhythm, intensity
- Developments in non-verbal communication
: eye-contact, facial
expressions
, physical contact
- Imaginative Play: The marble as a space-rocket
- Reduction/variation in stereotypical movements/sounds/
repetitons
- Changes in initiating/responding to physical contact Slide21
Recording progressN – Notice (Being-With the child, Communing Attunement, Secure Base)
T – Tune
in
(Listen, Respond, Tune/
Misattune
, Teach and Learn)
R – Record (Star Analysis, Pupil Profile, Levels)
Slide22
STAR ANALYSIS (Autism Education Trust)Recording both Progress and Challenges:Settings: 1:1 in the Sensory RoomTriggers The child heard the ice-cream van outside
Actions: The child said the new words: ‘Ice Cream Van’
Result: I whistled the ice-cream van tune – the child gave extended eye-contact and initiated physical contactSlide23
Measuring progressPupil Profiles – a termly review, contain information and aims for each child for the term ahead. Concerning planning and assessment.STAR - Gathering
d
ata – as it happens and go towards meetings with staff, Sarah and parents at the end of term.
The STAR data helps to establish where on the P scales the child is. (Qualitative to Quantitative Progress) – good for OFSTED, Parents, ourselves and the child
P-Levels: Progress Levels: P1 – P8
Next Meetings will be in December 2015Slide24
Strategies for autismN.A.S. recommends the uses of ‘Signs and Symbols’ for children with autismVisual Timetables (Sarah)
Use the Autism ‘Teacher Toolkit’
Now & Then sheets
Photos of staff
Working for charts
3 tick-box limit for asking questions (if you cannot bear the repetitions any longer)
Slide25
Other strategies and ideas Physical contact - literal connections with another person (Veronica
Sherbourne
)
Use the Sensory Room (1:1 work)
Use of sand-timers
The 50 minute cycle
‘Un-Velcro’ the SNA member of staff
Adopt on attitude of exploration, support for each other and non-judgmental approach. Slide26
Plenary