Video Modeling for Conversation Skills

ASD Early Signs/Characteristics

• ASD prevalence is 1 in 36 children (CDC, 2023).
• ASD is approximately 4.2 times more common in males.
• Diagnosis rates vary due to cultural awareness, stigma, and access to healthcare services.
• More diagnoses among non-Hispanic white children than non-Hispanic black children and Hispanic children.
• Females are often diagnosed later due to subtler symptoms and "camouflage" behaviors.

DSM-V Criteria

• Two core domains: Social communication and interaction deficits, and restricted, repetitive behaviors and interests.
• Diagnosis must specify with/without language impairment or with/without intellectual disability.

Severity Levels

• Level 1: Requires support; may have language but needs help with social interactions.
• Level 2: Requires substantial support; more social interactions.
• Level 3: Requires very substantial support; nonverbal.

Autism as a Culture

• Acknowledge strengths and unique characteristics of autistic individuals.
• Moving away from red flags to early signs.

Early Signs of Autism

• Limited eye contact; delayed speech/language development; limited use of gestures; and preference for routines.
• Detailed focus; strong memory skills; analytical thinking; and deep interest in specific topics.

Difference Between Screening and Diagnosing

• Screening: Quick, preliminary identification using tools like M-CHAT.
• Diagnosis: Comprehensive evaluation by a multidisciplinary team using standardized tools (e.g., ADOS-2).

Screening Guidelines

• Routine screenings from the CDC at 9, 18, and 24-30 months are recommended.

Gold Standard ASD Assessment

• ADOS-2 (Autism Diagnostic Observation Schedule): Direct assessment of communication, social interaction, play, and restricted/repetitive behaviors (40-60 minutes).
• Age range: 12 months-adult.

M-CHAT Process: Screener

• Screening tool for children aged 16-30 months.
• Involves a parent-completed questionnaire and a follow-up interview.
• Risk levels: Low (0-2), Medium (3-7, requires follow-up), and High (8-20, immediate referral).

Social Communication Questionnaire (SCQ)

• Used for children 4 years and older to assess social communication behaviors.
• Lifetime- 40 questions focusing on entire development.

Current-40 Questions

• Focuses on the last 3 months.
• Reviews medical history, direct observations, developmental and behavioral evaluations, parental interviews.

Interdisciplinary Diagnostic Team

• Includes pediatricians, psychologists, speech-language pathologists, and occupational therapists.

Medical Diagnosis vs. Educational Diagnosis

• Medical Diagnosis: Conducted by healthcare professionals for medical services access.
• Educational Diagnosis: Conducted within the school system for support needs determination.

Talking with Families About ASD

• Use supportive language; highlight strengths; discuss findings; and provide resources.

PCP Role in Diagnosing/Barriers

• Early screening and referrals; barriers include time, training, and access to specialists.

Genetic Component of ASD

• ASD has a complex genetic basis with high heritability and various genetic variations.

Language and Theory of Mind

• Individuals' struggle with theory of mind (understanding others' thoughts and feelings).
• Impacts social communication.

Typical Language Development

• Involves progression from babbling to single words, phrases, and complex sentences.
  • 6 months- generate own responses, demonstrations of joint engagement, nonverbal gestures to indicate an object of interest.
  • 1st Birthday- awareness of others, shared world, differences exist.
  • 12-15 months- value others, social exchange, respond to simple questions.

Pragmatic Language

• Challenges in understanding social cues, expressive/respective language, and nonverbal communication.
• Often delayed.

Sensory Processing Issues

• Hypersensitivity: Oversensitivity to stimuli.
• Hyposensitivity: Undersensitivity to stimuli (sensory seeking).
• Joint Attention
• Play
• Theory of Mind
• Language: simple sentences, errors in tense markers, understanding context, phonological processing, figurative language, and turn-taking
• Echolalia (immediate or delayed repeating of words/phrases)
• Perseverative Speech
• Exessive Questioning

Comprehensive Assessment of Language

• Formal tools like PPVT, CELF, and OWLS.
• Informal observations in natural settings.

Stages of Natural Language Acquisition (NLA)

• Development described by Marge Blanc.
• GLPs (gestalt language processors) move from echolalia to spontaneous, flexible language.

Idiosyncratic Language

• Unique words/phrases not found in standard language

Interventions to Support Communication

• Who: Children in early language stages (MLU<=3.0).
• Theoretical Bases: behavioral theory, social interactionist theory, and developmental approaches.
• 6 stages of EMT:
  • Environmental Arrangement
  • Responsive Interaction

Levels of DIR

• Shared Attention and Regulation
• Engagement and Relating
• Two-Way Intentional Communication
• Complex Problem Solving
• Creative Representations
• Representational Differentiation and Emotional Thinking

Elements of Individual Processing Profile

• Sensory Modulation
• Sensory Processing
• Motor Planning and Sequencing
• Sensory-Affective Processing

Functional Outcomes of DIR

• Improved social-emotional engagement, communication, and flexible thinking.
• Interdisciplinary understanding of child's development.

Practical Requirements of DIR

• Multidisciplinary collaboration and parent involvement.
• Parent commitment to 6-8, 20-minute sessions throughout the day.
• Certification in DIR is ideal.

DIR Assessment Process

• Observation-based assessment focusing on functional emotional developmental levels.

DIR Type and Prognosis for Treatment

• Categorizing engagement types to guide individualized interventions.

DIR Data Collection

• Use of Functional Emotional Assessment Scale (FEAS) for tracking progress.

JASPER Model

• Acronym: Joint Attention, Symbolic Play, Engagement, Regulation
• Goal: Enhance social communication and play skills
• Target Population: Children up to age 9, particularly those who are minimally verbal.
• Functional Outcomes: Improved joint attention, play diversity, and engagement.

Target Areas

• Joint attention, symbolic play, and emotional regulation.

Practical Requirements

• 30-60 minute sessions, 2-4 times per week.

JASPER Strategies

• Includes imitation, modeling, and expanding play routines.

Early Social Interaction (ESI)

• Parent-implemented intervention aimed at improving developmental outcomes for toddlers at risk for or diagnosed with ASD.

Key Components of ESI

• Parent Implemented
• Natural Environments
• Family-Centered Framework

###Naturalistic Developmental Behavioral Interventions (NDBIs)

• Integrates principles from ABA and developmentally appropriate strategies.
  • Natural Reinforcement
  • Modeling and Prompting
  • Fading Procedures
• Goals of ESI
  • enhance social-communication skills
  • embed learning opportunities to promote skill generalization
  • parent empowerment supporting parents in developing skills.

Executive Function and Social Communication Supports for Autistic Adults

• Typical areas of support for autistic adults:
  • Sustained Attention
  • Working Memory
  • Time Management
  • Mental Flexibility
  • Emotional Regulation
  • Context Awareness/Social Communication

This quiz explores the use of video modeling as an effective teaching strategy for conversation skills, particularly for autistic clients. It covers color coding methods, benefits of video modeling, and identifies skills that can be taught using this approach.