Autism Spectrum Disorders

1. Autism Spectrum Disorders What is Autism?

2. The DSM-IV defines autism as a pervasive developmental disorder characterized by: • -impairments in communication and social interaction • - restricted, repetitive and stereotypic behavior, interests and activities It is a complex neurological disorder that affects the functioning of the brain

3. Diagnosis of Autism: A diagnosis of autism is made by a team of professionals consisting of: Pediatrician or psychiatrist Speech/Language pathologist Psychologist

4. Pervasive Developmental Disorders Childhood Disintegrative Disorder Autism Asperger ‘s Syndrome Rett’s Syndrome PDD-NOS

5. Prevalence of Autism • Affects more boys • Numbers of cases are increasing In 2003 – 1 in 165 2005- 1 in 150 2009- 1 in 100 May have co-morbid conditions such as ADHD, seizure disorder or anxiety disorder

6. Causes of Autism: • Chromosomal abnormalities • Metabolic Disorders • Infectious Diseases • 75% of cases have no known cause and a high percentage have abnormalities in: - Immune system -Gastrointestinal system - Nervous system

7. Characteristics associated with Autism 4 categories of characteristics: 1. Communication 2. Social Interaction 3. Unusual behaviour characteristics 4. Learning characteristics Others include:unusual patterns of attention, unusual responses to sensory stimuli, and anxiety

8. Limbic System • (Emotion and learning) • Appreciation of novelty • Maintaining attention • Integration of sensory experiences • Memory (rote and cognitive associative memory) • Frontal Lobe • (Executive functioning) • flexibility • maintaining attention • controlling impulses • applying skills • mental planning • problem solving • managing transitions The Brain • Cerebellum(Regulation) • Abilty to anticipate • Motor planning • Static balance • Modulation of emotion • Modulation of fine/gross motor skills • Use of mental imagery • Word retrieval • Attention shifting

10. Communication- Autism and its effect on Expressive language -Delayed or lack of expressive language skills -Difficulty with pragmatics of conversation -stereotyped and repetitive use of language or idiosyncratic language -Difficulty with non-verbal communications -Significant differences in oral language -Echolalic speech -Restricted vocabulary -Tendency to perseverate on a topic

11. Autism and its effect on:Receptive language -Difficulty in comprehending verbal information -Unable to follow long verbal instructions and remembering the sequence -Comprehension may be context specific -Experienced regardless of cognitive ability

12. Impairment in Social interactions: -Differences in social interaction and difficulty in establishing age appropriate social relationships with peers -Impairment in language processing and the use of multiple non-verbal behaviours -Lack of “Theory of Mind”, the ability to understand that others have a perspective that differs from our own -Difficulty in understanding mental states are connected to actions

13. Three subtypes of Social Interaction • Aloof - interact to meet needs • Passive - don’t initiate but will accept initiation from others • Socially - active but awkward Typically children with ASD do not acquire social skills incidentally, by observation or participation. As a result social skills should be a target for specific instruction

14. Mosimbia We are visiting the country of Mosimbia, their social communication conventions have rules vastly different than ours: -You must stand very close -No eye contact - Gesture with left hand, keep right hand at side -Bow to anyone older -Never show your teeth

15. Unusual Behaviour Associated with Autism • Restricted range of interest with specific with interest in one specific topic or object • Inflexible about a non-functional routine • Stereotypic motor mannerisms • Overly concerned with object components • Fascination with moving objects • Insist on sameness and resistance to change • Unusual responses to sensory stimuli

16. Learning characteristics of students with ASD • Difficulty in paying attention to relevant cues and information and attending to multiple cues • Receptive and expressive language with particular difficulty with abstract reasoning • Difficulty in concept formation • Social cognition inability to share attention and emotion with others • Inability to plan , organize and solve problems (Executive Functioning)

17. Implications for Instruction • Use of visuals to support learning of abstract concepts • Focus attention • Emphasis on relevant points

18. Unusual Response to Sensory Stimuli • May be under reactive (hyposensitive) or over reactive (hypersensitive) to sensory stimuli • May apply to any sensory stimulus in the environment

19. Tactile system • Includes the skin and the brain • Information is gathered through the skin through touch, temperature and pressure • This is interpreted by the brain as pain, pleasure or neural information

20. Auditory System • Hyper or Hypo sensitive to sounds • May be extremely reactive to bells, sirens, alarms etc. and some people experience extreme intensity

21. Visual and olfactory • May react extremely to odors such as perfumes • Others may seek out smell to gain information about their environment • May avoid or seek shiny things or bright light

22. Vestibular and Proprioceptive systems • The vestibular system consists of tiny hairs in the inner ear which transmit information to the brain to let us know where our body is in space • People with ASD have abnormalities in this orienting system such that some individuals are fearful of movement and have trouble orienting themselves on stairs and ramps and others seek intense movement such as whirling, spinning and swinging. • The proprioceptive system interprets feedback from muscles and joints such that we are able to move fluidly, whereas people with ASD may appear clumsly, sloppy or have odd posture

23. Implications for Instruction • Important to recognize sensory over or under stimulation because behaviour may be a result

24. Anxiety: may be related to: • Inability to communicate • Difficulty processing sensory information • Fearing some sources of sensory stimuli • Need for predicability and resistance to change • Difficulty understanding social expections • Fearing situations because they are not understood

25. Copy the following: • After synthesis or endocytosis, transmembrane proteins are shuttled to various intracellular compartments where different processing events occur. Disrupting protein trafficking can alter processing and impair function. For example, amyloid precursor protein (APP) is cleaved differently in endosomes than at the cell surface; because endosomal processing leads to production of β-amyloid, increasing endosomal delivery of APP increases the amyloidogenic processing associated with Alzheimer's disease (AD). Interaction with the sorting receptor sorLA slows APP exit from the Golgi network, thus preventing amyloidogenic processing. Mutations in sorLA are linked to AD. Similarly, levels of retromer, a protein complex involved in transporting sorting receptors from endosomes to the trans-Golgi network, are reduced in AD, and retromer deficiency increases β-amyloid production. Fjorback et al. provide evidence that retromer affects APP trafficking indirectly, via interactions with sorLA. Disrupting this interaction caused sorLA to leave the Golgi and accumulate in the tubular endosome network, taking APP with it.

26. You Tube Video • http://www.youtube.com/watch?NR=1&v=AbeyIG7Fz8s&feature=endscreen • http://www.youtube.com/watch?v=i1XMSPfNyiA