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autism and deafness
I am an educator for children with autism. I have a child in my classroom who is autistic and profoundly deaf. He has a cochlear implant. He does not show any signs of hearing and does not show any comprehension of sign language. He uses picture exchange for communication. We use photographs and gestures in order to give him directions but he only follows the direction if a preferred activity is involved. My question is: Does anyone know of an organization, or expert in the field of autism AND deafness?
I think you are going to have to observe your son to get a good picture of what is going on. But it does sound more like 'he is screening out all noise' when he is focused on something else, otherwise he wouldn't be able to hear the car key if it was loss of hearing.
There is alot of discussion going on at the moment about sensory issues. I would recommend you google the name 'Olga Bogdashina' and read her article published in Autism Today. She is a reputable academic who has two autistic children and has founded an insitute in the Ukraine. She has written a number of books ie. Sensory and Perceptual Differences in Autism and Aspergers. She has been invited by the autism department in my area to speak to Professionals and Parents about sensory issues. If you have the time, it is worth reading her book. But it is important to note that sensory differences are variable day to day and throughout the day so in the morning your son may seem 'deaf' to quite loud noises and in the afternoon can hear the slightest sound. Many autistic people talk about this sensory processing difficulties. Sometimes it is explained as being hypersensitive (over sensitive) or hyposensitive (under sensitive). But there is also monoprocessing whereby certain sensory functions are shut down to enable the autistic to screen out extra sensory stimulation to allow them to focus and perform in certain 'busy' environments.
My son also responds differently to auditory sensory stimulation. He may complain of noises (I can't hear anything) or be unable to concentrate or talk if there is the TV/radio on in the same room. If I turn the vaccum cleaner on he runs out of the room. He cannot tolerate talking toys because it is unpredictable noise. Yet at his school fayre he wanted to pop the ballooms.
If you are able to read Olga's article/book I think it will give you a much better understanding of what may be going on. At the back of her book there is also a sensory profile checklist you can complete to give you an idea of your child's sensory profile. A number of professionals are using that in the UK.
There is alot of discussion going on at the moment about sensory issues. I would recommend you google the name 'Olga Bogdashina' and read her article published in Autism Today. She is a reputable academic who has two autistic children and has founded an insitute in the Ukraine. She has written a number of books ie. Sensory and Perceptual Differences in Autism and Aspergers. She has been invited by the autism department in my area to speak to Professionals and Parents about sensory issues. If you have the time, it is worth reading her book. But it is important to note that sensory differences are variable day to day and throughout the day so in the morning your son may seem 'deaf' to quite loud noises and in the afternoon can hear the slightest sound. Many autistic people talk about this sensory processing difficulties. Sometimes it is explained as being hypersensitive (over sensitive) or hyposensitive (under sensitive). But there is also monoprocessing whereby certain sensory functions are shut down to enable the autistic to screen out extra sensory stimulation to allow them to focus and perform in certain 'busy' environments.
My son also responds differently to auditory sensory stimulation. He may complain of noises (I can't hear anything) or be unable to concentrate or talk if there is the TV/radio on in the same room. If I turn the vaccum cleaner on he runs out of the room. He cannot tolerate talking toys because it is unpredictable noise. Yet at his school fayre he wanted to pop the ballooms.
If you are able to read Olga's article/book I think it will give you a much better understanding of what may be going on. At the back of her book there is also a sensory profile checklist you can complete to give you an idea of your child's sensory profile. A number of professionals are using that in the UK.
He is not bothered by such noises. If I open a window when driving he would turn to that direction. Like you said he doesn't respond all the time when his name is called depending upon if he is playing or watching TV. But at the same time if I take out the car key with very little noise(just a little tingling noise)... he would come to get the key, even when he is in middle of an interesting play.
SKVVV
SKVVV
You could look into AIT training. It is something I have 'on the back burner' so to speak. And from a child's point of view it is non-invasive. Depending on where you are you need first to find an authentic practitioner of AIT. I would speak to the person that does it to find out exactly what kind of hearing difficulties it can help. For example my son is also echolalic, and I think that is something that cannot be helped with AIT.
Out of interest, does he appear not to notice noise when he is 'doing something' eg. making a model, playing with legos, doing a puzzle, watching TV etc. The reason I ask is that he could be monoprocessing ie. effectively his ears are 'turned off' when he is focused on looking at something or doing something.
Out of interest, does he appear not to notice noise when he is 'doing something' eg. making a model, playing with legos, doing a puzzle, watching TV etc. The reason I ask is that he could be monoprocessing ie. effectively his ears are 'turned off' when he is focused on looking at something or doing something.
My Son who is going to be 4 is very under sensitive to sounds. His hearing test with tomponogram looks good. But if a fire alam goes off, he is tottaly fine. There has been many times I have noticed that he doesn't react to noice that we all will close our ears but he doesn't. He is non-verbal.
Any Idea about AIT training? will that help the situation?
SKVVV
Any Idea about AIT training? will that help the situation?
SKVVV
Thanks for the input on eye contact. Very important ... "Sometimes I do inadvertantly do eye-contact, but once I become aware of it, then I must look away or I start to feel uncomfortable and then (lose focus on the speech)". So for a more severe person looking may mean 'becoming deaf', as they cannot do both at once.
I agree with MJ about eye contact. That may be very difficult for him to do for a number of reasons which are variable between autistic people I have spoken with. I will give you an example of the difficulties my son has.
My son has sensory integration problems and mainly works through one sense at a time (at other times he can be using more than one sense). It depends on the environmental stressors and on whether it is the beginning of the day or towards the end etc. What this means is that if I ask him to 'look' at me or at something he will 'only look'. Whilst he is looking he loses his hearing ability and his sense of touch. Therefore if I want him to 'listen to instructions' I will say 'look at .... (the object). Then I will say 'now you must listen ...' and I will give him the simply instruction. I never ask for eye contact unless he is giving it without prompting. I don't even insist that he is facing me. I will tell him I have something important for him to listen to and then I will say it.
Nearly every autistic person I have come across (and these have been high functioning and verbal) has difficulties in multi-tasking from a sensory point of view. As this child appears quite severe it is even more likely he has these type of problems.
As the person with autism is working through mainly one sense at a time you must also consider that your actions may make them 'change sense' involuntarily. This can cause tantrums (because they have switched sense, because they have lost their place in what they were doing etc). It may mean (if they were part way through a sequential piece of work) that they have to go back to the beginning of the task and start again.
Advice I have been given by autistic people and autistic teachers is to always 'address the object' and never 'address the person'. So if the child is making something don't go up to him and say 'hello john' and then expect eye contact. By talking to him you have made him switch senses and by expecting eye contact you have made him switch again and now he may be either (trying to process what you said or is mentally repeating what you said in his head, or is now looking at you and is focused on something you are wearing etc). Instead you would go up and sit alongside him (not opposite) and might say something like 'good train' (if he is making a train or drawing a train etc). The difference seems to be the 'focus' of the interaction. If your comment 'focuses' on the thing he is already focusing on them it doesn't cause a switch. If you focus on the 'person' when they are focused on the 'object' your interaction with them will cause a switch. Does this make sense?
In your case you could sit down and produce a card for good work. But don't touch him unless you want him to switch from 'doing' to 'feeling'.
Again, if he is deaf with an ear implant, it might make it even harder for him to understand verbal instructions because of any auditory processing/auditory sensory problems he may have on top of the deafness. Is it possible to turn this device off just to see if he actually copes better without the auditory noise?
I don't know if any of the above is helpful, but is worth considering as so many people (and my son) confirm it to me.
To get a better overall picture of these problems you can google the name Olga Bogdashina and read her article about sensory differences that was published in Autism Today. She has also published a number of books. She is reputable and has been brought over to the UK by our autism education department to give seminars to both professionals and parents.
My son has sensory integration problems and mainly works through one sense at a time (at other times he can be using more than one sense). It depends on the environmental stressors and on whether it is the beginning of the day or towards the end etc. What this means is that if I ask him to 'look' at me or at something he will 'only look'. Whilst he is looking he loses his hearing ability and his sense of touch. Therefore if I want him to 'listen to instructions' I will say 'look at .... (the object). Then I will say 'now you must listen ...' and I will give him the simply instruction. I never ask for eye contact unless he is giving it without prompting. I don't even insist that he is facing me. I will tell him I have something important for him to listen to and then I will say it.
Nearly every autistic person I have come across (and these have been high functioning and verbal) has difficulties in multi-tasking from a sensory point of view. As this child appears quite severe it is even more likely he has these type of problems.
As the person with autism is working through mainly one sense at a time you must also consider that your actions may make them 'change sense' involuntarily. This can cause tantrums (because they have switched sense, because they have lost their place in what they were doing etc). It may mean (if they were part way through a sequential piece of work) that they have to go back to the beginning of the task and start again.
Advice I have been given by autistic people and autistic teachers is to always 'address the object' and never 'address the person'. So if the child is making something don't go up to him and say 'hello john' and then expect eye contact. By talking to him you have made him switch senses and by expecting eye contact you have made him switch again and now he may be either (trying to process what you said or is mentally repeating what you said in his head, or is now looking at you and is focused on something you are wearing etc). Instead you would go up and sit alongside him (not opposite) and might say something like 'good train' (if he is making a train or drawing a train etc). The difference seems to be the 'focus' of the interaction. If your comment 'focuses' on the thing he is already focusing on them it doesn't cause a switch. If you focus on the 'person' when they are focused on the 'object' your interaction with them will cause a switch. Does this make sense?
In your case you could sit down and produce a card for good work. But don't touch him unless you want him to switch from 'doing' to 'feeling'.
Again, if he is deaf with an ear implant, it might make it even harder for him to understand verbal instructions because of any auditory processing/auditory sensory problems he may have on top of the deafness. Is it possible to turn this device off just to see if he actually copes better without the auditory noise?
I don't know if any of the above is helpful, but is worth considering as so many people (and my son) confirm it to me.
To get a better overall picture of these problems you can google the name Olga Bogdashina and read her article about sensory differences that was published in Autism Today. She has also published a number of books. She is reputable and has been brought over to the UK by our autism education department to give seminars to both professionals and parents.
Good luck with the eye-contact. Maybe training him to look at your face or the shoulder area would be better. At least then he looks like he is doing eye-contact and it would help him pay attention.
For me to do direct eye-contact, feels like looking into the sun minus the spots and temperary blindness. I've learned looking in the general area of the face seems to help. I can pay attention but not be so fixed on someone's eyes that I lose attention. Sometimes I do inadvertantly do eye-contact, but once I become aware of it, then I must look away or I start to feel uncomfortable and then lose focus on the speech.
If I am extremely pissed off, then it seems I have a much easier time doing eye-contact...It becomes a deliberate fixed stare. It doesn't mean I feel better about the eye-contact. No I still feel that uncomfortable feeling but this time it is an effort to transfer the uncomfortable feeling I feel to the person I am staring at that pissed me off...
For example, a guy who almost hit me at an intersection by doing a right turn and disregarding that the walk light was on... I whipped around and glared into his face...
For me to do direct eye-contact, feels like looking into the sun minus the spots and temperary blindness. I've learned looking in the general area of the face seems to help. I can pay attention but not be so fixed on someone's eyes that I lose attention. Sometimes I do inadvertantly do eye-contact, but once I become aware of it, then I must look away or I start to feel uncomfortable and then lose focus on the speech.
If I am extremely pissed off, then it seems I have a much easier time doing eye-contact...It becomes a deliberate fixed stare. It doesn't mean I feel better about the eye-contact. No I still feel that uncomfortable feeling but this time it is an effort to transfer the uncomfortable feeling I feel to the person I am staring at that pissed me off...
For example, a guy who almost hit me at an intersection by doing a right turn and disregarding that the walk light was on... I whipped around and glared into his face...
A follow-up to your questions: All of my student's days are personalized to their individual goals and objectives. He will communicate spontaneous using PECS for his wants and needs and we are currently using the PECS Protocol Level 2 to increase his distance between him and the communication partner. We attract his attention by offering preferred things to him and when he initiates communication, we prompt him to give us eye contact before gaining access to the preferred item. We are hoping that by getting the eye contact, we will be able to get him to cue into our world more. Eventually, with eye contact, we want to be able to get him to follow our directions to do preferred, play with favorite items, eat, drink, etc. and non-preferred activities, such as going to the rest room and transitioning from one place to the other without flopping to the floor. For the other students following routines, I give verbal directions and they use a picture or icon-based schedule to transition from one activity to another. The problem with this student following his picture schedule is that he will only follow directions to get his lunch bag and pack up at the end of the day, preferred activities. His previous placement was a school for the deaf where they were not able to get him to do these things either. I have been on a bunch of websites and have heard back from a teacher of students with hearing impairments from another state. I will continue to research this topic and am just looking for more avenues to take and to get more training for myself regarding this issue.
I'm semi worried about the implant. If the child really was deaf, then it may help, but if the child wasn't, then the implant may not have been needed...but now that it is in, it will likely be a permanent thing... That may also play into a problem...
I can't say what hearing would be like with the implant, but I've read it may be sort of mechanical... I just know with my hearing if there's a lot of background noise going on, or even just one other noise if it is loud enough, that it takes my attention away.
In noisy situations conversation can come off like a bad cell phone connection... I hear parts of the conversation, but the rest fades into the background and just becomes noise.
If you're telling me: Please look at the chalk board, pull out your #2 pencil and list these things... and there's a garbage truck banging right out the window while emptying the bin I hear:
Please look *bang-clang, clunk* list these things... No wonder I'm confused...
Sometimes I may hear you, but my mind is busy repeating the first sentence you said. For instance if you are talking about the US: There are 50 states in the US and 5 great lakes... These Great lakes are connected by several river systems
I may hear: There are 50 states, *in my head: 50 states, 50 states.* these great lakes are connected by several river systems...
-----------------
And here's another one: The “mind wander factor” Okay, let's go back to the 50 states and the great lakes...
Once you start talking about the lakes, a mental image of me swimming in Lake Michigan in the beach a couple times plays in great detail. I can "feel" in my head the waves slapping against my body and remember the cold temperature... I may even remember accidentally getting some water in my mouth...ick... Then my mind wanders over to hearing a news feature about the deep tunnel and raw sewage being dumped into the lake... Then I think about pollution...global warming...the hole in the ozone layer...and I can go on...
Unfortunately when I am engaged in any deep thought process, it seems my mind just shuts off to the outside world. I am lost in thought... With age, I become better able to break between the two modes, because I have to...but if I don't make a conscious effort it could cause problems.
I personally find the mind wander factor and the background/foreground auditory distraction to be a couple main problems for me.
I can't say what hearing would be like with the implant, but I've read it may be sort of mechanical... I just know with my hearing if there's a lot of background noise going on, or even just one other noise if it is loud enough, that it takes my attention away.
In noisy situations conversation can come off like a bad cell phone connection... I hear parts of the conversation, but the rest fades into the background and just becomes noise.
If you're telling me: Please look at the chalk board, pull out your #2 pencil and list these things... and there's a garbage truck banging right out the window while emptying the bin I hear:
Please look *bang-clang, clunk* list these things... No wonder I'm confused...
Sometimes I may hear you, but my mind is busy repeating the first sentence you said. For instance if you are talking about the US: There are 50 states in the US and 5 great lakes... These Great lakes are connected by several river systems
I may hear: There are 50 states, *in my head: 50 states, 50 states.* these great lakes are connected by several river systems...
-----------------
And here's another one: The “mind wander factor” Okay, let's go back to the 50 states and the great lakes...
Once you start talking about the lakes, a mental image of me swimming in Lake Michigan in the beach a couple times plays in great detail. I can "feel" in my head the waves slapping against my body and remember the cold temperature... I may even remember accidentally getting some water in my mouth...ick... Then my mind wanders over to hearing a news feature about the deep tunnel and raw sewage being dumped into the lake... Then I think about pollution...global warming...the hole in the ozone layer...and I can go on...
Unfortunately when I am engaged in any deep thought process, it seems my mind just shuts off to the outside world. I am lost in thought... With age, I become better able to break between the two modes, because I have to...but if I don't make a conscious effort it could cause problems.
I personally find the mind wander factor and the background/foreground auditory distraction to be a couple main problems for me.
Have you tried posting on the expert forum? If you get no success there have you tried approaching a deaf school for their input. I know that many deaf/blind children have alot of 'autisms' in their behaviour. You might be able to get a system from them and adapt it to an autistic approach as well.
Sounds like you know far me than me anyway. So, are you saying that at the moment their time in school is pretty personalised around this child and his wants etc and you want to integrate him a bit more into whole classroom instructions/routines etc? You say he can communicate through PECS. Does he initiate communication or only when prompted? How do you attract his attention at present? How are whole class instructions/routines communicated to the rest of the class.
Sounds like you know far me than me anyway. So, are you saying that at the moment their time in school is pretty personalised around this child and his wants etc and you want to integrate him a bit more into whole classroom instructions/routines etc? You say he can communicate through PECS. Does he initiate communication or only when prompted? How do you attract his attention at present? How are whole class instructions/routines communicated to the rest of the class.
Thanks for the information. My classroom is Applied Behavior Analysis and Verbal Behavior. We do "Pairing" which is basically following the student's motivation and gaining interaction based on what the child wants to do at that time and gradually increase the demands from there. Sensory activities are a staple in my classroom. I feel they are essential to student success. This student is able to request his wants and needs through picture exchange. Because he has a good repertoire of things he can request and his performance with the picture exchange, I know he can discriminate pictures and objects. My goal is for him to be able to follow directions and classroom routines. I am really looking for some person out there who knows of someone with experience with such a complex child as this. Wish me luck :)
I don't know about autism/deafness, someone else may post regarding that.
But 'only following direction if a preferred activity is involved' is quite typical in autism. I went to a seminar recently given by Wendy Lawson (autistic, from Australia I think??). She was talking mainly about the difference of attention/focus for those with autism/aspergers.
Neurotypical people can divide their attention (almost like dividing a pie). They can be focused on a number of things at any one time, and also monitoring other things going on in the environment. Autistic people tend to only be able to put 'all' (the whole pie) of their attention and focus into something and are unable to pay attention or monitor anything/anyone else at the same time. It is like super focused concentration.
On top of this ability/diability (depends on how you view it), the autism can mean they are 'attracted' to certain things (from a sensory point of view)(or have narrow interests), and therefore do not have control over their attention in the way that we do. Therefore things like 'motivation' are very difficult because, if they are not interested, they cannot make themselves pay attention, whereas we can.
She suggested (and so have other autistics), that the best way to teach is to use their interests because then you will gain their full attention and they can concentrate on a topic they like for hours. It has also been suggested to do it in a 'non-confrontational' way ie. addressing the object/interest rather than the person. So instead of 'what are you doing' you would say 'what a beautiful train' etc.
You could start with a more personalised learning programme around their interests as this might give you a better idea of ability because they will be trying within the area of their interest. From there you might be able to introduce other things into their timetable by rewarding them with an amount of time doing something they enjoy (also visually built into their timetable. If there is alot of sensory stuff distrating/absorbing them then you might need input from OT. Don't know if that helps?
But 'only following direction if a preferred activity is involved' is quite typical in autism. I went to a seminar recently given by Wendy Lawson (autistic, from Australia I think??). She was talking mainly about the difference of attention/focus for those with autism/aspergers.
Neurotypical people can divide their attention (almost like dividing a pie). They can be focused on a number of things at any one time, and also monitoring other things going on in the environment. Autistic people tend to only be able to put 'all' (the whole pie) of their attention and focus into something and are unable to pay attention or monitor anything/anyone else at the same time. It is like super focused concentration.
On top of this ability/diability (depends on how you view it), the autism can mean they are 'attracted' to certain things (from a sensory point of view)(or have narrow interests), and therefore do not have control over their attention in the way that we do. Therefore things like 'motivation' are very difficult because, if they are not interested, they cannot make themselves pay attention, whereas we can.
She suggested (and so have other autistics), that the best way to teach is to use their interests because then you will gain their full attention and they can concentrate on a topic they like for hours. It has also been suggested to do it in a 'non-confrontational' way ie. addressing the object/interest rather than the person. So instead of 'what are you doing' you would say 'what a beautiful train' etc.
You could start with a more personalised learning programme around their interests as this might give you a better idea of ability because they will be trying within the area of their interest. From there you might be able to introduce other things into their timetable by rewarding them with an amount of time doing something they enjoy (also visually built into their timetable. If there is alot of sensory stuff distrating/absorbing them then you might need input from OT. Don't know if that helps?
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