Autism

1. Autism Prepared by: CiciliaEviGradDiplSc., M. Psi

2. Autism Spectrum Disorder • ASD  umbrella term  includes 3 conditions: Autism, Asperger Syndrome, Pervasive Developmental Disorder not otherwise specified (PDD-NOS) • Limitations in 3 areas of development  communication, social interaction and repetitive behaviors or interests • 1 of 150 children in US have an ASD

3. ASD  spectrum, which implies similar characteristics but great variance in the actual behavioral patterns exhibited • Two excluded conditions (prior to DSM-IV-TR) • Rett syndrome • Childhood disintegrative disorder (CDD)

4. Rett Syndrome • Genetic condition – only in girls • Appear early in life, what appears to be normal development then stops and begins to reverse (Percy, 2001) • Behavior  progressive expression of repeated stereotypic hand wringing; lack of muscle control; along with communication and social deficits  misdiagnosed with Autism (no hand wringing and loss of motor skills) • Better social skills than children with Autism • Most have intellectual disabilities  more severe

5. CDD • A far rarer disorder than autism • These children develop as their peers w/o disabilities  until 5 or 6 years old when developmental regression begins • Lose acquired language and social skills  worse long-term outcomes because the regression continues to deepen • CDD is the least understood

6. Challenges • Temple Grandin “I think in pictures. Words are like a second language to me. I translate both spoken and written words into full-color movies, complete with sound, which run like a VCR tape in my head. When somebody speaks to me, his words are instantly translated into pictures” • People with ASD struggle to understand their worlds as they relate to others

7. Autism • Difficulty in communication  50% do not talk (Wetherby & Prizant, 2005)  express their needs through gestures (pointing) or alternative communication system (PECS) • Speech patterns are characterized by echolalia repetition of words they have previously heard; limited vocab, poor intonation, pronoun reversals, trouble with pragmatics of speech (starting/ending conversation, making eye contact, taking turns speaking)

8. Social impairments  no spontaneous social interactions, seems to live in their own world, fewer friendships, tend to spend their time alone, difficulties to understand the meaning of social situations • Stereotypic behaviors, unusual/very focused interests, rigid/set patterns of behaviors  if disrupted, tantrums or hand waving

9. 75%  have intellectual disabilities; 25%  have average or above-average intelligence • Autism may not be one single thing but, rather, a tight clustering of highly related disorders that manifest themselves in multiple but often similar ways • Autistic savant  less than 1% of individuals with autism

10. Asperger Syndrome • A collection of behavioral characteristics that are associated with problems developing adequate social skills and with restricted or unusual interests • Develop speech and language as par with children w/o disabilities  but using language very literally, difficulties in forming flexible conceptual categories, understanding jokes or interpret behaviors of others  social use of language

11. Unlike individuals with autism  they have normal intelligence and should not be confused with high-functioning autism • Unique characteristics of Asperger (p. 412)

12. PDD-NOS • One of the ASD in which not all three ASD characteristics are present, or they are mild • The diagnosis for PDD signifies characteristics are very similar to those of autism and Asperger syndrome, but not clearly expressed

13. Characteristics • A lifelong disability, no specific characteristics are associated with this condition • Affects 3 important aspects  communication, social interactions, restricted range of interests or behavioral repertoires • See table 12.4, p. 413 • Unusually sensitive to sensory input  loud noises or soft touch, serious problems with their behavior, self-injury tendencies, aggression

14. A Strength-Based Perspective • People with ASD are unique and have a variety of strengths and abilities • Children with Asperger syndrome tend to become experts on their special interest area • Using a specific interest area  teachers can encourage conversations, reduce anxiety, and increase academic motivation (Winter-Messiers et al., 2007)

15. Prevalence • 1 in 150 children in the US • 10 times higher than in 80’s or 90’s • Contributing factors  broadening diagnostic criteria and increased public awareness account for the relatively rapid increase in reported cases

16. Causes • NOT caused by bad parenting • ASD is a neurobiological disorder that has a genetic basis  not yet understood which genes place an individual at risk • Identical/fraternal twin and sibling with ASD  more likely to have ASD themselves • To complicate matters  significant numbers of children experience loss of skills before the signs of ASD fully develop (Rogers, 2004) • Speculation is DANGEROUS!

17. Prevention • Is not yet a realistic goal  because there is so much to learn about the causes of ASD • Until then, educational interventions are our primary basis for improving symptoms associated with ASD

18. Assessments • Important  because if the diagnosis is delayed, then intervention is delayed • Early screenings  Figure 12.3, p. 417 • ASD is complex and lifelong  therefore assessment is not a straightforward procedure  involves careful evaluation of the individual’s history and unique behavioral characteristics

19. General considerations: • Maintain a developmental perspectives • Carefully evaluate with developmental milestones • Include information from multiple sources and contexts • To consider child’s skills across multiple settings • Conduct multidisciplinary assessments • To provide a more complete picture of a child’s skills • Joint attention  important in the development of social and language skills

22. Early Intervention • Programs for toddlers  parent-mediated approach, Walden program, Inclusive program • Homeopathic remedies  little scientific evidence • Psychotropic medications  response is inconsistent and medications are unlikely to help children learn new skills , side effects • Educational program for 3-5 years old  most developed, best studied – but still much to learn • No universal recommendations

23. Key elements  p. 419 • Including some common targets for instruction  clear, specific and concrete • Two popular programs: • Treatment and Education of Autistic and Communication-Handicapped Children (TEACCH) • Young Autism Program (YAP)

24. Teaching Students with ASD • The important questions  p. 421 • Access to general classroom  should provide materials that are aligned with what students w/o disabilities learn • As a basis for common learning and social experiences • Instructional Accommodations  p. 422 • Tips for classroom management