First Then Visual Schedule – Down Syndrome with a Slice of Autism

Autism, Behavior/ ABA, Down syndrome, Dual Diagnosis Down syndrome and autism, Education and Special Needs, Resources for Special Needs

Blog#257~DS-ASD=Taking on Transitions

Posted on February 5, 2024 by Teresa Unnerstall

Blog #257~DS-ASD=Taking on Transitions

The challenges faced by individuals with co-occurring Down syndrome and autism (DS-ASD) are complex. These can include communication deficits, cognitive delays, sensory processing issues and rigidity. Transitions can be tough, moving from one activitiy to another, changing venues, staff and caregivers can all be stressful. Predictability and consistency are key components which help individuals with DS-ASD cope in a world that moves fast. My son Nick is 29 years old, and has co-occurring DS-ASD. Many of the families that I’ve worked with over the years find transitions to be hard to navigate. There are many evidenced based practices which can help support your child.

Here are 5 Tips for Taking on Transitions:

1. Figure out “the why”. Do a little detective work to determine what might be triggering the resisistance to moving forward. Possible antecedents might be sensory overload (loud noises, crowds, etc), changing from a preferred activity to a non-preferred activitiy, not understanding what comes next and not feeling in control. These are just a few examples of why they might be struggling. Once you determine the function of the behavior, then you can put some supports in place.

2. Use a visual schedule to help provide an effective cue to move to another activity or venue. There are many apps available as well including First-Then, Kids ToDo List, and Visuals2Go.

3. Allow for processing time. Give advance notice when an activity is coming to an end, and when it will be time to move to the next. Visual timers are great tools to help with transitions. Here are two of my favorite timer apps which include the Countdown Timer and Timed Timer:

4. Create a social story to help provide a clear and predictable framework for what will happen next, what to expect and how navigate a new experience. Use the social story like a pre-game rehearsal. This allows the individual to understand what to expect, how to behave and give them a “buy in” to the transition.

5. Give verbal and non-verbal praises and provide a reward such as a transition object to help motivate the child. “Good job walking and staying close”, thumbs up/smiley face icons, high fives can all reinforce successful transitions made throughout the day. Transition objects guide the child over the bridge that encourages moving from point A to point B. The object should be highly preferred, motivating and limited access so that it keeps their interest.

Providing support for individuals with DS-ASD to assist with transitions can ease stress by helping them understand what will be happening throughout the day. It also allows the child to feel more in control over their life. For more information and tips on navigating co-occurring Down syndrome and autism, scroll the archives of this blog and check out my book A New Course: A Mother’s Journey Navigating Down Syndrome and Autism click to order here: https://amzn.to/2W3Un6X

That’s what is in my noggin this week 🙂

~Teresa

Follow us on social media: #Down Syndrome with a Slice of Autism

Dual Diagnosis Down syndrome and autism, Education and Special Needs, IEP (Indivdualized Education Plan), Parenting Special Needs

Blog #247~DS-ASD Back to School Tips

Posted on September 5, 2022 by Teresa Unnerstall

Blog #247~DS-ASD Back to School Tips

This week I have 10 back to school tips and strategies specifically geared to individuals with a dual diagnosis of Down syndrome and autism (DS-ASD) and their families. My name is Teresa Unnerstall, I am a DS-ASD parent, consultant and author of A New Course: A Mother’s Journey Navigating Down Syndrome and Autism. My son Nick is 28 years old and my passion is to help families, educators, therapists, medical professionals and anyone interested in supporting individuals with co-occurring DS-ASD.

**Order your copy on Amazon at** **https://amzn.to/2W3Un6X**

10 Back to School Tips for DS-ASD Families:

1. Prepare the student with a visual countdown calendar, and re-instate morning/evening routines.

2. Tour the school with your child. Then, create a social story or video social story of the school settings and staff that the student will be interacting with. Review this story regularly for the first few weeks of school.

3. At the tour, ask the teacher to show you the safety & hygiene precautions, accommodations and equipment that is listed in the IEP to make sure everything is in place.

**Teaching feelings visual accommodation**

4. Prepare a student “About Me” profile sheet. There are many templates available online that you can Google or try Canva for free. You can include different sections such as, Things I love, My Strengths, What Works Best for Me, How to best support me, What I struggle with and Interests. Make several copies to share with the staff.

5. Determine the modes of communication back and forth with the teacher and school staff. Examples include texting, email, communication logs/notebooks and daily report sheets. This is very important as many students with DS-ASD who have language deficits or may be non-verbal and unable to share how their day went.

6. Review the child’s IEP to insure that all goals and accommodations are still relevant and meaningful. Note any additional needs or concerns you have coming off of the summer break and share these with the staff.

7. If the student has a behavior support plan (BSP), check to see if this has been shared with all staff and is ready to put in place on day one. Make a list of any new target behaviors that need to be addressed and added into the BSP.

8. If the student uses AAC (Augmentative and Alternative Communication) make sure the teacher and aides are familiar with how to use the program, whether it’s high tech or low tech like a picture exchange system (PECS). You can request a training for staff and parents on how to program devices, navigate tabs and get trained on how to utilize PECS with the school speech and language therapist or school district AAC specialists.

9. Students may have lost skills or experienced regression over the summer break. Evidenced-based practices help students regain lost skills and develop new ones. Some examples are using visuals, schedules, task strips, task analysis, first-then prompts, visual timers, choice boards and sensory breaks.

Sensory Break PECS Icon, Is there a sensory break area at your child’s school?

10. Show your commitment by staying on top of your child’s progress. Ask for data at each quarter. Data drives decision making for future conferences and IEP meetings. If possible, volunteer at school, (room parent, field trip chaperone, art awareness presenter, book fairs, picture day and assisting with making learning materials like laminating and making copies).

Being prepared and invested in your child’s needs will help them reach their full potential for the new school year. That’s what is in my noggin this week.

~Teresa

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Augmentative and Alternative Communication (AAC), Autism, Behavior/ ABA, Down syndrome, Dual Diagnosis Down syndrome and autism, IEP (Indivdualized Education Plan)

Blog #210~DS-ASD Preparing for Transitions

Posted on July 23, 2018 by Teresa Unnerstall

Blog #210~DS-ASD Preparing for Transitions

Many of the topics I write about are inspired from parents in dual diagnosis of Down syndrome and autism (DS-ASD), support groups on Facebook. It’s natural to feel anxious when change come into our lives. School transitions in particular can result in behavior problems. These can include regression of previously learned skills, avoiding tasks and meltdowns. Behavior problems may come from a child not knowing what is coming next and feeling afraid. Putting supports in place before school starts this fall, will better prepare your child for successful school year.

There are three things that help ease transitions, these include predictability, structure and visuals. One of the themes that thread in my blogs is providing a blueprint for your child. Depending on their level of functioning, this can be written or in a visual form. If they can see it, they will understand it.

My son, Nick is 24 years old and has a dual diagnosis of DS-ASD. His verbal speech is limited, but his receptive language is strong. He uses visuals to navigate his routine and to communicate. This is in the form of PECS (Picture Exchange Communication System) and also an AAC (Augmentative and Alternative Communication) device. Another theme woven into my writing about DS-ASD is that behavior and communication go hand in hand. Many behaviors, both good and bad are an attempt to communicate something. If you can give your child the visual tools to express their wants and needs, they will be less frustrated.

Parents and educators should give a child with DS-ASD concrete visuals by creating a social story of the transition to a new classroom or school setting. Start with a building tour with your child and teacher, before school begins. Together with the support teacher/case manager, take pictures or a video of the classroom, gym, lockers, lunchroom and any other area that your child will utilize. In addition to the physical areas, include pictures of teachers and therapists that will be working with your child for the upcoming school year.

Here’s part of Nick’s Back to School Social Story, used to transition to high school….

Social stories and videos can enhance a positive transition. These should be reviewed daily for several weeks prior to school starting. They can be used both at home, school and for community outings. If there are any changes to a routine, this tool will be beneficial for a child with Down syndrome and autism. For example, one was used in high school when Nick’s quarterly P.E. activity changed from using the treadmill to swimming. Social stories are great when introducing a new activity to your child. In the past, I’ve made them for doctor/dentist visits, swimming lessons, bike camp, tennis class, vacations, and other special events. You can access many PECS visual from your support teacher/case manager and speech therapist. Google Images also has a ton of visuals available. Keep the wording concise and straight forward, when creating social stories.

As I mentioned earlier, providing the blueprint with social stories is one component. Another tool is to have a daily visual schedule that your child can use at school. This schedule will help your child know what is coming up and also what is expected of him or her. Work with your child’s support teacher/case worker to create a schedule that will be easy for your child to follow. Social stories and visual schedules will support your child with a dual diagnosis of Down syndrome and autism, and should be written in their IEP (Individualized Education Plan).

Visual schedules are helpful at home and encourage the development of independent living skills……..

There are many apps available to create visual schedules…….

Preparing your child for transitions by using visual tools such as social stories, videos and schedules will help them better understand what their day will look like. It will also enable your child to know what is expected of them. The goal should be to give them that blueprint, which will lessen anxiety. When you take fear out of the equation, the child’s behavior will improve, along with their productivity.

That’s what is in my noggin this week!

~Teresa 🙂

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