A Conversation with Will Martin, VP of Clinical Quality at AIM Clinics
Jillian Mendoza: Who are you?
Will Martin: I am a board certified behavior analyst, focusing on early intervention with a specialization in autism spectrum disorders. I have worked with people on the autism spectrum for over ten years now, first as an instructional assistant, then working directly in homes designing 1:1 programs to help kids with social skills and decreasing challenging behaviors. I have partnered with the Tennessee Department of Education and the Treatment & Research Institute of Autism Spectrum Disorders, researching autism specific interventions and their outcomes. I am currently the Vice President of Clinical Quality Outcomes for AIM Clinics, where we provide services to people in rural and underserved communities.
Jillian Mendoza: First of all, thank you for all of your service to kids with autism. In your years of experience in autism education, what kinds of supports do you find to be beneficial for teachers to use with their students?
Will Martin: Thank you! I do want to point out that supports can look different for teachers depending on the setting. Some teachers have kids with autism in their general classrooms, whereas others have them in autism-specific programs. So keep that in mind as I share my two cents...
What we know about visual supports is many kids with autism, generally speaking, learn better from visual supports rather than verbal cues. Many kids with autism prefer and thrive with structure and clear expectations. When we provide visual supports for students, they can help signal the steps or plan for an activity. When we give kids an order, they know what is expected of them and it helps set them up for success.
Kids with autism can also struggle with transitions, and visual supports can help them prepare for transitions throughout an activity or the school day. It is also common to provide planned breaks for kids with autism, where they know they are working towards a break with an iPad, recess, or a fun activity. Providing visual supports shows kids when the break is happening as well as what the expectations are for getting there. In comparison, if we give these cues verbally it can be challenging for the student to reference them afterwards which leads to frustration on both the student and the teacher.
My recommendation for teachers is to set a clear agenda that is visible to students, perhaps on the whiteboard or printed for an individual student. Within an individual activity, give clear written expectations for the activity, keeping in mind what motivates that particular student. Some kids with autism aren’t as motivated by social praise, so think about what they enjoy doing. Many times that could mean providing downtime where the student can watch a video or play on an iPad. Be sure to include these motivators in your visual agenda to help students know when a reward is coming, and it will help reduce stress around the classroom tasks you’d like them to accomplish.
Mendoza: That’s great, I remember this being very successful in my own classroom. How do visual supports connect to student’s ability to uptake instructions?
Martin: Kids with autism benefit from clear steps being provided. When these directions are shown it can be a lot easier for kids to process them than it is when a teacher is talking and showing directions at the same time. If you think about a general education classroom, most of the time teachers are talking a lot. Even when kids with autism have an instructional aide, they aide may provide a lot of verbal supports, which can be tough if the student has challenges with reciprocal interactions.
When teachers can write down instructions it can do two things: first, it can increase student independence because they do not have to be prompted all the time for what they should be working on. Second, it can be a permanent product for students to see directions for each task. They can avoid frustration if they can go back and reference information without being dependent on another adult or student.
One way teachers can implement this in their classroom is to provide a post-it on the student’s desk with directions for an activity. I’ve also seen teachers display directions on the whiteboard. If the directions are on a handout, say with 30 math problems on it, teachers can highlight and chunk the work for students. A really great visual cue that teachers can use is a classroom countdown timer, where students can see how long each task will take and how much time is currently remaining.
Mendoza: I used a timer as a teacher and I am definitely guilty of letting the timer run out while I am on one side of the classroom helping a group of kids. How important is it to adhere strictly to the use of timers or set agendas?
Martin: For some kids with autism it is okay to have a slip up like this where you don’t stick exactly to the allocated time, but for others it is very important. One of the goals for kids with autism is accepting variability in life, but we often have to teach them this in a really implicit way. If we are using visual supports and we know they struggle with variability, it is really important to stick with it closely while your team helps that student to accept some of those changes.
For some students who are ready, you can practice this kind of variability and how to respond to spontaneous situations. I like to make an ‘oops card’ which is where we switch up the order of activities on their agenda. This is a really controlled way to practice for variability, and I only recommend doing it if you feel a student is ready for that level of practice.
Mendoza: I really like that, giving students a simulation of what to expect when things don’t go to a specific plan. I’m curious to hear how you would use technology mediated intervention with kids with autism?
Martin: We know that there is data to support kids with autism using technological supports in educational settings. Kids with autism often really enjoy using technology in a variety of ways, and embedding it in a class setting is often preferred by the student or students. Social reciprocity can be hard for kids with autism so it can make a lot of sense to provide assignments or instructions using technology such as an iPad or laptop. Many kids with autism like to interact with videos and apps on devices like an iPad. If they struggle to transition away from these devices, we can instead think about how to embed them in our lessons.
For many adults we don’t think about how our environment has an impact on kids with autism. Sometimes something environmental, like a fluorescent light in a classroom, can be distracting or uncomfortable for a student. It might even be something like the color of ink on their paper, or the tag on their clothes, and the sensation is so overwhelming it causes a distraction from learning. Sometimes students will prefer headphones or something that helps remove some of these distractions. Technology may be a motivating and helpful way to present new learning concepts to some students on the autism spectrum.
Have questions? Continue the conversation with Will Martin on LinkedIn.
Aim Clinics resources for people with Autism can be found here.