Understanding Autism

1. Understanding Autism Module 1 Lesson 2

2. Objectives Students will understand… The social interaction deficits of students with autism. The communication deficits of students with autism. The repetitive and restricted stereotyped patterns of behavior, activities, and interests of students with autism. Additional academic, behavioral, emotional, physical, and medical characteristics of students with autism.

3. What are Autism Spectrum Disorders? • Autism spectrum disorders are a group of disorders under the category of pervasive developmental disorders. • Pervasive Developmental Disorders consist of: • Autistic Disorder (autism) • Asperger Syndrome • Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) • Rett Syndrome • Childhood Disintegrative Disorder

4. Defining Autism Autism is a neurologically-based developmental disability with onset before the age of three that is defined by marked impairments in communication and social interaction and the presence of stereotyped behavior, interests, and activities (Autism Society of America, 2004; APA, 2000).

5. Impairments in Social Interaction • According to the Diagnostic Statistical Manual-IV-TR (APA, 2000), an individual with autism will have at least two of the following characteristics: • Impairment in the use of nonverbal behaviors such as eye contact, facial expressions, body posture, and social gestures • Difficulty establishing developmentally appropriate peer relationships • Failure to spontaneously seek opportunities to interact with other people • Poor social or emotional reciprocity

6. Impairments in Communication • According to the Diagnostic Statistical Manual-IV-TR (APA, 2000), an individual with autism will have at least one of the following characteristics: • Delay in, or lack of, spoken language development • Stereotyped and repetitive language use • Lack of varied, developmentally appropriate spontaneous make-believe play or social imitative play

7. Repetitive and Restricted Stereotyped Patterns of Behavior, Activities, and Interests • According to the Diagnostic Statistical Manual-IV-TR (APA, 2000), an individual with autism will have at least one of the following characteristics: • Marked preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in focus or intensity • Inflexible adherence to nonfunctional routines or rituals • Stereotyped and repetitive motor movements • Persistent preoccupation with objects or parts of objects

8. Other Characteristics of Students with Autism

9. Deficits in Imitation • Imitation is impaired in individuals with autism from the time of diagnosis through adulthood. • This is apparent in both higher functioning and lower functioning individuals • Imitations deficits include difficulties imitating actions on objects, imitating body movements, and imitating oral-facial imitations (Volkmar, 2005)

10. Anxiety • Children with autism present higher levels of anxiety than typically developing children (Gillot, Furniss, and Walter, 2001) • The presence of elevated physiological arousal combined with social skills deficits results in higher levels of social anxiety (Bellini, 2006) • You may see in the literature that children with autism “prefer to be alone.” However, students may resort to being alone to avoid the anxiety they feel during social situations in which they are not equipped with the skills they need to be successful. • Thus, it is important to address the anxiety by providing the supports needed to ensure social success as much as possible.

11. Tantrums • Some students may have severe tantrums • While it may seem that they happen for no reason at all, most often there is a function for this behavior. • The function of the tantrums should be determined by conducting a functional behavior assessment to develop a behavior intervention plan that addresses the reason why the tantrums are occurring. • In the module entitled “Positive Behavioral Supports,” you will learn more about this topic.

12. Medical Issues • Some students may have sleep disorders that require behavioral interventions as well as medical interventions when necessary. • Some students may have gastro-intestinal problems that require medical intervention • They may have a variety of allergies that may require medication and/or special diets • Approximately one third of students with autism have seizures (Deykin & MacMayhon, 1979)

13. Sensory Issues • Students with autism may have over-sensitivity or under-sensitivity to sensory information such as auditory, visual, and kinesthetic input. • For example, they may not be able to focus if the environment is too loud, they may be bothered by fluorescent lighting, and certain textures may feel very uncomfortable if they touch their skin.

14. Fine and Gross Motor Issues • Fine motor and gross motor issues • Some students may have extreme difficulty with writing due to fine motor deficits • Some students may have difficulty participating in team sports due to deficits in gross motor skills (and social interaction skills) • Some students may have poor eye-hand coordination, trouble combining multiple motor skills into one motor task, poor perceptual motor skills, and difficulties with balance in general (Menear, Smith,  & Lanier, 2006)

15. Cognitive Impairments • Years ago, the percentage of students with autism who had mental retardation was suggested to be 70-75%. • However, this statistic did not consider that the method of obtaining an IQ score requires communication and social interaction skills that are considered core deficits for students with autism. • There are very limited empirical studies to support that a high percentage of individuals with autism have mental retardation. • There are questions related to whether or not the examiners who conducted the IQ tests in the limited empirical studies had experience working with individuals with autism • Thus, while some students with autism do have mental retardation, the statistic is much lower than what was indicated in the past. (Edelson, 2006)

16. Attention • Students with autism often have problems attending for long periods of time • They may not know where to focus their attention • They often have difficulty shifting their attention (Siegel, 2003) • This refers to stopping what they are doing/attending to and attending to something else • They may intensely attend to things that typically developing children would not (ex. the light coming through a window, the sound of an A/C unit, the spinning of a ceiling fan)

17. Autism Speaks • Autism Speaks is a national organization that offers information and resources to families and professionals to raise autism awareness. • Visit their website at www.autismspeaks.org • Click on the autism video glossary link, click on log-in and register (it’s free), view the videos that are available.

18. Module 1 Lesson 2 Activity Using the language presented in the previous slides, write a multiple paragraph description of a child that discusses the social interaction impairments, communication impairments, behavioral characteristics, and other additional characteristics of a child with autism that you are currently working with or have worked with in the past to demonstrate your understanding of the content presented in this module. If you are not currently working with a child with autism and have not in the past, you can write about a child you viewed on the videos on the Autism Speaks Website.

19. References American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author. Autism Society of America. (2008). What is Autism? Retrieved May 2, 2008 from http://autism-society.org Bellini, S. (2006). The development of social anxiety in adolescents with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 21(3), 138-145.  Chakrabarti, S., & Fombonne, E. (2001). Pervasive developmental disorders in preschool children. Journal of the American Medical Association, 285, 3093-3099. Deykin, E. Y., & MacMahon, B. (1979). The incidence of seizures among children with autistic symptoms. American Journal of Psychiatry, 136, 1310-1312. Edelson, M. G. (2006). Are the majority of children with autism mentally retarded? A systematic evaluation of the data. Focus on Autism and Other Developmental Disabilities, 21(2), 66-83.  Gillot, A., Furniss, F., & Walter, A. (2001). Anxiety in high-functioning children with autism. Autism, 5, 277-286. Menear, K. S., Smith, S C, & Lanier, S. (2006). A multipurpose fitness playground for individuals with autism: ideas for design and use; Because traditional playgrounds often do not serve the needs of children with autism, something new was needed. The Journal of Physical Education, Recreation & Dance, 77(9), 20-26.  Siegel, B. (2003). Helping children with autism learn: Treatment approaches for parents and professionals. New York: Oxford. Volkmar, F. (2005). Handbook of autism and pervasive developmental disorders: Diagnosis, development, neurobiology, and behavior 3rd ed. Hoboken, New Jersey: John Wiley & Sons.