Nurse Media Journal of Nursing, 6 .
, 2016, 1 - 8 Available Online at http://ejournal.
id/index.
php/medianers Strategies for Successful Transition into Mainstream Schools for Young Children with Autism Spectrum Disorders: A Case Study Mardiyanti1 1Faculty of Medicine and Health Sciences.
Islamic State University of Syarif Hidayatullah.
Indonesia Corresponding author: mardiyanti@uinjkt.
ABSTRACT
Background: Meeting changes can be very problematic for children with Autism Spectrum Disorders (ASD.
whereas other children may take it for granted.
As a result, they may cry, get upset, scream, do hand flapping or even self-harming that shows their inability to cope with the changes and their preference of sameness and routine To understand the issue of changes in children with autism, people should know the complexity of the disorders.
Purpose: This article will explain further about the strategies for successful transition into mainstream schools for young children with autism as illustrated in JackAos case study in the appendices.
Methods: A case study was conducted to one respondent.
Firstly, the article will explain ASDs and its atypical characteristics of 6-years old Jack.
Then it will discuss strategies to help JackAos transition process, as well as strategies to support his learning process during schooling which finally comes up with conclusion to support Jack and his familyAos transition into mainstream primary education.
Results: Strategies for successful transition into mainstream schools for young children with autism include using visual information and activity schedules, managing sensory overload, and building literacy skills.
Conclusion: Attractive playing can be effective strategies to build skills for successful transition of young children with autism.
Keywords: Autism Spectrum Disorders (ASD), transition strategies, children Copyright A 2016.
NMJN, p-ISSN 2087-7811, e-ISSN 2406-8799 Nurse Media Journal of Nursing, 6 .
, 2016, 2
BACKGROUND
Meeting changes can be very problematic for children with Autism Spectrum Disorders (ASD.
whereas other children may take it for granted (Lawson, 2001.
Smith.
Donlan, & Smith, 2.
Even small changes in day-to-day life can be very overwhelming for For instance, changing the room decoration, clothes, route, unannounced visitors and changing activities from weekday activities to weekend activities and vice versa can create confusion and anxiety.
As a result of changes they may cry, get upset, scream, do hand flapping or even self-harming that shows their inability to cope with changes and their preference of sameness and routine activities (Lawson, 2.
To understand the issue of changes in children with autism, people need to know the complexity of the disorders (Dodd, 2.
People with autism have core deficits in social communication .
ncluding speech, comprehension, tone of voice, use of body language, facial expression and gestur.
, social interaction .
nability to understand other thought and feeling, does not understand what happen and why it is happening, inability to mix and engage with socially-accepted behavior.
and limited interest or showing stereotype behaviors (Dodd, 2.
These deficits or difficulties may put the children and their families into more difficult situation if they have to meet with significant changes in their life, for example starting new schools.
Nevertheless typical development children may find it hard too to start a new school but they are less likely to show challenging behaviors as children with autism.
Every child with ASDs is unique and therefore the planning of the interventions need to be adjusted based on the needs of every individual and family (Lindgren, 2.
If one child is successfully treated with one particular intervention, the others may not necessarily be addressed by the similar intervention (Huang, 2.
Families, teachers and the environment should focus on how children learn, rather than seeing that children experience learning difficulties.
This reason underlies the overriding importance of the embodiment of coping strategies for children with autism who have been studied in the previous researches.
However, real description of how the strategy is implemented in actual cases is rarely discussed.
OBJECTIVE
This case study aims to explain the strategies for successful transition into mainstream schools for young children with autism.
METHODS
This article use a case study of a-6 years old Jack who has Autism Spectrum Disorders (ASD.
to analyze the possible best strategies for successful transition into mainstream The case is illustrated in appendices.
DISCUSSION
Understanding autism Autism Spectrum Disorders refers to lifelong neurodevelopment disorders with unknown etiology (Robert & Prior, 2.
characterized by persistent impairment in reciprocal social interaction and communication, and restricted and repetitive pattern of behaviors, interest and activities (Diagnostic and Statistical Manual of Mental Copyright A 2016.
NMJN,p-ISSN 2087-7811, e-ISSN 2406-87 Nurse Media Journal of Nursing, 6 .
, 2016, 3 Disorders.
Fifth Edition [DSM-V].
American Psychiatric Association [APA], 2.
DSM-V now only uses the term ASD to cover all the categories .
utistic disorder .
Asperger syndrome and Pervasive Development Disorder not otherwise specifie.
which has been used previously under DSM-IV.
There are three level of severity: level one is requiring support.
level two is requiring substantial support, and level three is requiring very substantial support.
In addition, the diagnosis may be followed by specifiers such as intellectual disability and co-morbid conditions such as ADHD or anxiety disorder to understand fully the person condition (Autism Spectrum Australia [ASPECT], 2.
People may refers autism as an invisible disability because apparently there is nothing different with other children until the way that someone communicates, socializes and learns to reveal the symptoms of ASDs (Verdick & Reeve, 2.
Jack in this case study, is having problems with social interaction and communication as he only masters two to three words which is atypical child development for six-year old (Hamaguchi, 2.
He is also reported for repeating the last words or AoecholaliaAo while communicates with others or when anxiety occurs.
Jack may also find it difficult to interact with other people as he does not like being put in a group.
He also likes sameness and refuses changing activities in particular to activityAos moving from indoor to outdoor activities, gets obsess with his transport toys AuThomas the tank and friendsAy and shows a lack of imaginative playing as typical development child usually does.
also shows stereotype or restricted behavior such as lining up his toys.
Another characteristic of autism to Jack case study is that he usually covers his ears due to his difficulties in managing sensory integration.
Issue with transition Inclusive education Even though children with autism prefer sameness and refuse changes, they should be introduced to significant changes which are inevitable in everyday life.
Changes may bring the opportunity to a new and exciting experience, bring the benefit of stimulation and education to the children to increase their self-esteem and self-awareness as well as promote new relationships and independent performance (Smith.
Donlan, & Smith.
Jack in the case study, has already undertaken preschool setting and next term he will begin the school in a mainstream classroom which currently becomes popular choice for children with disabilities worldwide (Keane.
Aldridge.
Costley, & Clark, 2.
Mainstream classroom embraces the philosophy of inclusion which means that children with disabilities including autism will be educated in the general classes with general curriculum similar to other children without disabilities (Keane et al, 2.
Studies have shown that this strategy will bring advantages and disadvantages for the children.
The strategy promotes equal rights, and increases the interaction within their peers in a learning environment and thus promotes gaining appropriate social skills (Crisman.
Reiter & Vitani, 2007.
Tsaputra, n.
On the other hand, the students will also be put in high risks of more distress and fearful situation due to the exposure of sensory overload such as noisy classroom, teasing and bullying, and inability to cope with school demands, peer expectation and new routine (Humphrey & Lewis, 2.
Copyright A 2016.
NMJN,p-ISSN 2087-7811, e-ISSN 2406-87 Nurse Media Journal of Nursing, 6 .
, 2016, 4 Transition techniques Children with ASD need to be provided with the necessary skills and training to succeed in a mainstream classroom (Humphrey & Lewis 2008.
Jordan 2.
It is likely that training on social and communication skills, educating social norms, rules and expectation before transition reduce anxiety and improve their ability to function effectively into a mainstream classroom (Humphrey & Lewis, 2.
Humphrey .
also recommends the introduction of predictable routine and classroom order, developing peer understanding and modifying language for communication to assist their transition.
However, to meet the most useful strategies for transition planning is likely depends on the child as each child with autism is different and one strategy which works to a child may not work to another.
Dunlop et al.
argued that the things need to provide for transition are: Aoproviding information about where they have to be, who might be there, what they will or should be doing, what behavior is expected, how much they have to do, how will they know that they are finished and what they will do nextAo .
However.
Dunlop .
only explained AowhatAo things need to do but does not explain further about AohowAo to do it.
Use visual information to introduce new routines Helping children with autism using visual support are highly recommended as the child is best learns through visualization (Dunlop et al, 2010.
Marks et al, 2.
Visual supports such as pictures, cue cards, prompts, story boards, diagram and graphic schedules have been effectively useful for learning (Marks et al, 2.
Hume .
and Smith et al .
also recommended visual support such as picture and photograph which can be collected from Google image engine to introduce a new activity.
Smith et .
also recommends to introduce new routines step by step, breaking the information of new routines into small pieces and using signs, sketches or scripts to help the young child transition.
Smith et al .
strategies may help in describing the AohowAo to do with transition.
In term of AowhatAo and AohowAo to support transition, those suggestions may be helpful for JackAos transition into mainstream education.
Firstly, use the schoolAos picture or photograph then information about why he should be there, when he should be there, who might be there and what he will do there.
While doing these, it can be possible to use someoneAos judgment to identify how much information should be given and breaking it down into several times.
In addition, involving the preschool teacher to introduce the new school would be very helpful.
Later on, tell the child about visiting the new school.
This may need to build up very slowly by first just passing through the then the next day visiting the school in a quiet day and stop at the schoolAos gate.
Later on try to come in into the school and finally meet new people there.
Try to involve preschool teachers and parents while visiting, or have a plan to meet Jack sister and brother in the school.
It is also recommended to introduce him with a buddy who will have the same class when he starts his new school.
Copyright A 2016.
NMJN,p-ISSN 2087-7811, e-ISSN 2406-87 Nurse Media Journal of Nursing, 6 .
, 2016, 5 Using activity schedules to introduce changes between activities Banda.
Grimmet & Hart .
recommended the use of activity schedules using visual supports to anticipate transition between or within activities.
The technique is almost similar with visual schedules from Hume .
and visual information from Smith et al .
The different is that activity schedules are provided in a sequential format to represent activities throughout the day, thus provide predictability of the new activities but may lead to adultAos dependency (Banda et al, 2.
One example of activity schedule is picture communication symbols that consist of many pictures of activities which are arranged in order to illustrate between-activity schedule in a day.
Activity schedule may be used for Jack to introduce a new routine while schooling, such as the list of activities that start from the beginning of class until finishing the class.
Managing sensory deficits during transition Sensory overload is likely the most problem affected the child in everyday life including in the transition process (Myles, 2.
Knowing what senses he might affected by the new situation is the key to manage sensory overload.
Some strategies to manage sensory difficulties are: using earplug, cards, sunglasses, hat or distraction techniques to reduce fear and anxiety (Myles, 2000.
Smith et al, 2.
It is also recommended for controlling the stimulus by modifying the environment such as segmenting space for specific activity, and minimizing auditory as well as visual distractions by using visual boundaries such as using tablecloths or rugs to cover instruments in the classroom (Hume, 2.
Grandin .
in his personal account found the sound of the toilet flushing in his school was very painful for him.
In his case, modifying the school toilet for him may be helpful.
Learning strategies Building literacy skills become a major issue as Jack is ready for reading program.
Literacy skills may also become a key for Jack to be able to communicate any message and socialize with everyone (Grether & Pelatti, 2.
When the child develops literacy skills, the development of speaking, reading and writing occurs concurrently (Grether & Pelatti, 2.
However, in term of communication, children with ASD often have difficulties in the development of spoken language or gestures, lack of ability to initiate or maintain conversation, have repetitive and idiosyncratic use of language and lack of pretend play.
Gabriel .
suggests to build communicative gestures by encouraging eye contacts, reaching, grasping and giving the objects, touching or tapping objects, pushing object away, pointing, or any other controlled, purposeful and coordinated Gabriel .
also suggests to build social communication and social interaction from the child interest either based on behavioral learning theory or developmental theory, or even combination of them.
Pivotal Response Training (PRT) strategies from the behavioral principle can be employed to increase the motivation of using communicative gestures such as pointing to request the desired toys.
Meanwhile, the Picture Exchange Communication System (PECS) also teaches the child with autism how to communicative using objects or sharing pictures.
Researchers recommended PECS for nonverbal children with autism (Kelley, 2.
Engaging the child in back and forth turn-taking activities can increase a the childAos desire to use spoken language and thus build social interaction and social communication (Gabriel, 2.
Copyright A 2016.
NMJN,p-ISSN 2087-7811, e-ISSN 2406-87 Nurse Media Journal of Nursing, 6 .
, 2016, 6 Building attractive play can also be a suitable strategy particularly for young children like Jack (Chandler.
Christie.
Newson.
Prevezer, & Venus, 2.
Children love play and playing gives the child opportunities for learning about the world in a fun way thus will develop cognitive concepts, socio-emotional skills as well as language skills (Gabriel, 2.
Chandler et al .
describe that attractive play involves imitation and commenting such as imitate the vocal sound from the child and commenting of what the child does while trying to attract his/her attention.
Attractive plays are aimed to develop the child interaction actively so that the child gets used to shared interest, looking, listening and taking turn.
In addition, playing games can build social interaction where people can use pauses within the interaction sequence to obtain a childAos gestures (Gabriel, 2.
Another strategy for reading skills comes from Grandin .
He suggested a visualized reading method from Miller and Miller as beneficial for some children with The method introduces the word as it respective meaning.
For example Aothe word AofallAo has the letters falling over and the word AorunAo has the letters that looks like runnersAo (Grandin 1995, p.
Those learning strategies can be maximized by involving family members as well as peer participation into the planning.
CONCLUSION
Meeting changes can create difficulties for children with autism and their family.
Building strategies for successful transition is a key to support the children and their Transition strategies should describe the AuwhatAy and AuhowAy in order to give clear picture about things that people should do before the changes, during the changes and after the changes.
Using visual information and activity schedules are recommended as the child with autism is a visual learner and likes sameness or routine.
Managing sensory overload is also important as children with autism mostly have problem with sensory processing.
It is also suggested to build literacy skills as well as social communication and social interaction after JackAos transition into mainstream education.
Building those skills may be effective by addressing attractive playing as young children like Jack loves playing.
Furthermore, it is also suggested that teachers, families and the environment surrounding need to apply a strategic approach to children with ASD individually, especially when they enter a new school environment.
REFERENCES